Phenytoin

Brand names of phenytoin

  • Dilantin
  • Dilantin Infatabs
  • Di-Phen
  • Diphenylan
  • Ekko JR
  • Ekko SR
  • Ekko Three
  • Mebroin [CD]
  • Novo-Phenytoin
  • Phelantin

Phenytoin is an anti-convulsion medicament that was synthesized for the first time way back in 1908. This medication is available in two forms - oral as well as injectable. While the scientists and doctors are yet to ascertain the precise means by which this medicament works, it is possible that phenytoin acts to lessen the brain nerves' susceptibility to extreme stimulation and also to lower the communication between the nerves through impulses. Initially, the Food and Drug Administration (FDA) approved the sale and use of phenytoin in the United States in 1939 - three decades after it was synthesized.

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Things you need to tell your physician before taking phenytoin

Before you begin taking phenytoin, you should inform your physician and pharmacist whether you have any allergic reaction to this drug or any of its elements. Also tell them about all the prescription as well as over-the-counter medications, herbal remedies, dietary supplements, and vitamins you might be taking from before or propose to take shortly. You should especially notify your physician if you are using any antacid that encloses calcium (for instance, brand name medications like Mylanta, Maalox, Tums or any other). If you are taking any of these antacids, it is likely that your physician will ask you take phenytoin and the antacid after a considerable gap in time.

You need to let your physician know if you consume or have earlier consumed heavy amounts of alcoholic beverages and also if you are suffering from or had previously had porphyria (a health condition wherein particular natural substances build up within your body and may possibly result in stomach pains, change in thoughts and actions and/ or added symptoms); diabetes; and any ailment related to the liver or the kidneys. People consuming alcoholic beverages should consult their physician regarding the safe use of alcohol while taking phenytoin.

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Women intending to take phenytoin for their condition should inform their physician if they are pregnant, or planning to get pregnant. They should also tell whether or not they are breast feeding. In case a woman becomes pregnant during the course of treatment with phenytoin, they should contact their physician immediately for advice and guidance.

People, who may require undergoing any type of surgery, including a dental process, should tell their dentist or physician in advance that they are taking this medication.

If you are being treated with phenytoin, you ought to know that this drug may possibly result in a dizzy feeling and also cause difficulties with coordination. Therefore, it is not advisable to undertake any task that requires alertness, for instance, operating a machine or driving, till you are sure about the impact of the medication on your body.

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Patients who are undergoing therapy with phenytoin should be aware of the fact that they may experience unexpected changes in their mental health and may also have suicidal thoughts (for instance, thoughts regarding injuring or killing themselves or even planning or attempting to commit suicide) while using this drug. During clinical trials, it was found that a few adults and children who were five years or older (approximately one in every 500 persons) who used anti-seizure medicaments like phenytoin to cure various health conditions turned out to be suicidal during the course of their therapy. Some such patients had suicidal thoughts as well as behaviour very early (in about a week's time) after commencing treatment with anti-convulsing drugs such as phenytoin.

While it is true that taking anticonvulsant like phenytoin is accompanied by some risks of experiencing changes in mental health, the fact remains that such people would experience similar or different changes in their mental health if they do not treat their condition, and that too timely. Hence, it is up to the patient and his/ her physician to decide whether the hazards of taking phenytoin is greater than the risk related to not using this medicament.

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In case you are experiencing any symptom like restiveness or agitation; panic attacks; depression or anxiety; any new or deteriorating tetchiness; problems in falling asleep or keeping awake; acting on hazardous impulses; becoming angry, aggressive or having a violent behaviour; talking or having thoughts about a desire to harm yourself or commit suicide; mania (for instance, having an unusually excited mood or becoming frenzied); obsession with mortality or dying; becoming secluded from family members and friends; and/ or any additional abnormal alterations in mood or behaviour, you, your caregiver or your family should immediately call your physician for help. Also ensure that your caregiver as well as your family members are aware of the precise symptoms that may possibly turn out to be critical so that they are able to call the physician when you are not able to ask for treatment yourself.

While being treated with phenytoin, you should also consult your physician regarding the best method to keep your mouth, teeth and gums healthy. Phenytoin has the potential to cause damage to your gums and, hence, it is extremely important for you to take additional and appropriate care of your mouth.

Usage

The anti-seizure medication phenytoin is employed to put off the occurrence of or regulate convulsions while treating specific forms of epilepsy as well as additional health conditions.

How to use phenytoin

Before you use phenytoin for the very first time as well as every time you obtain a refill, make sure that you carefully go through the medication guide, which your pharmacist will provide you. In case you are unable to comprehend any instruction or have any question you may seek the help of your physician or pharmacist. If you are taking the liquid form of phenytoin you must shake the bottle containing the drug well prior to taking every dose. Generally, this medication is taken orally twice to thrice daily. Alternately, you may also use phenytoin according to your physician's prescription. In fact, phenytoin should never be used only once daily. In case you have stomach disorder after taking phenytoin, you may take it along with food. Before taking the medication, measure the prescribed dosage carefully using a particular spoon/syringe or other measuring device. Never measure your dose using a common household spoon, as it may not provide the exact dosage.

It is important to use phenytoin on a regular basis, for it not only helps to maintain a steady level of the medicament in your body, but also helps you to get the best results. Take the doses at the precise time(s) every day.

The dosage of phenytoin is completely dependent on the medical condition of the patient and his/ her response to the treatment. You ought to know that a number of products containing calcium (for instance, calcium supplements and antacids) and dietary tube-feeding (enteric) items may possibly reduce the body's ability to take in phenytoin. Hence, it is advisable that you avoid all such products while you are being treated with this medicament. If you are taking nutritional products in liquid form, take them no less than an hour before or after taking phenytoin. However, you may also follow your physician's instructions in this regard.

You should not discontinue phenytoin abruptly or without talking to your physician in advance. If you stop taking this medication all of a sudden, it is likely that the seizures will deteriorate further. Before you stop using phenytoin, you need to decrease the dosage of the medication gradually over a period of time. Contact your physician if you find that there is no improvement in your condition or if it deteriorates further even after starting therapy with phenytoin.

How phenytoin works

Phenytoin is an anti-convulsing medicament that is believed to inhibit the actions of specific areas in the brain and, at the same time, restrain the abnormal as well as unrestrained release of neurons, which are responsible for seizures.

Side effects

Serious:
Common:
  • dizziness
  • excessive growth of body and facial hair
  • lethargy
  • nervousness
  • sedation
  • thickened gums
Less common:

Possible interactions

Herbal medicines or minerals:
While undergoing treatment with phenytoin you should never use ma huang or kola, because this combination may cause undesirable stimulation to the central nervous system. Similarly, kava kava and valerian may interact with this medicament to enhance stupor. On the other hand, you should exercise added caution while using St. John's wort, as it may result in augmented photosensitivity. You also need to be cautious regarding enhanced intake of vitamin D and calcium. However, people using phenytoin may be required to take dietary supplements containing vitamin D, vitamin K, calcium and folic acid.
Alcohol:
Consumption of alcoholic beverages should be restricted or avoided completely while taking phenytoin, as when they are consumed in large amounts and continuously they may possibly diminish this medication's efficiency to thwart the occurrence of seizures.
Exposure to sun:
People using phenytoin should exercise additional caution while exposing themselves to sun light, as this medication may possibly lead to sensitivity to sun light.
Occurrence of unrelated illness:
People using phenytoin should be aware that even occurrence of ailments that are not related to their condition in any way may slow down the process of removing this medication from their body, thereby augmenting the possibilities of toxicity owing to its elevated levels in the bloodstream. Therefore, it is advisable that you immediately contact your physician for help if you develop any new ailment while taking phenytoin.

Discontinuation

You should never stop taking phenytoin all of a sudden, because abrupt discontinuation of this medication may possibly result in serious as well as recurring seizures. If you want to stop taking phenytoin, you need to decrease the dose of the medication gradually during a period of three months. You may try to stop taking this medication for good only after three to four years after you experienced the last seizure. Nonetheless, it has been found that seizures may possibly recur in as many as 40 per cent of adults and about 20 per cent to 30 per cent of children.

Storage instructions

Ensure that you always store phenytoin at normal room temperature in the range of 20°C and 25°C and in a place that is free from light and dampness. Never keep this medication in a refrigerator or in your bathroom medicine cabinet. It is important that you keep all medications in a place that is not reachable by children or pets. When any medication is not required or becomes outdated, discard it in a safe and proper way. Unless you have been directed to do so, never dispose of such products by pouring them into any drain or flushing them down your toilet. If necessary, you should talk to your pharmacist or any waste disposal firm in your neighbourhood for further information regarding the safe and proper disposal of your outdated and unwanted medications.

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