ganaxolone (Ztalmy)

Indications

• treatment of seizures associated with cyclin-dependent kinase-like 5 (CDKL5) deficiency

Dosage

• if < 28 kg
  • start: 6 mg/kg PO TID (18 mg/kg/day)
  • maximum: 21 mg/kg TID (63 mg/kg/day)
• if > 28 kg
  • start: 150 mg TID (450 mg daily)
  • maximum: 600 mg TID (1800 mg daily)

Oral suspension 50 mg/mL

Pharmacokinetics

• 99% protein-bound in serum
• terminal half-life for ganaxolone is 34 hours
• metabolized by CYP3A4/5, CYP2B6, CYP2C19, & CYP2D6
• metabolites eliminated in feces 55%, urine 18%

Adverse effects

• somnolence, sedation
• pyrexia,
• salivary hypersecretion
• seasonal allergy

• drug adverse effects of anticonvulsants

Mechanism of action

• GABA-A receptor positive modulator

More general terms

• anticonvulsant

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=6918305