DILANTIN

Dilantin (phenytoin) stands as one of the pioneering anticonvulsant medications, originating in the early 1900s. Its primary application lies in the prevention of seizures, especially tonic-clonic seizures affecting the entire brain, and partial seizures affecting either half of the brain or a specific area.

Despite its prescription requirement, Dilantin does not induce significant euphoria, even though it can be used to manage pain. Notably, the United States Drug Enforcement Administration does not classify it as a controlled substance.

Dilantin has the potential to interact with various substances, including stomach acid reducers, sedatives, antidepressants, estrogen hormone replacement, phenothiazines, disulfiram, methylphenidate, sulfa drugs, carbamazepine, sucralfate, molindone, phenobarbital, valproic acid, divalproex sodium, steroids, antibiotics, digoxin, furosemide, or theophylline.

Throughout the years, Dilantin has been linked to cerebellar atrophy or degeneration, a form of brain damage stemming from the breakdown of neurons in the cerebellum, the brain region governing balance and muscle coordination.

For Dilantin capsules, the highest serum levels are typically observed 4 to 12 hours post-administration. Optimal control without clinical signs of toxicity often correlates with serum levels ranging from 10 to 20 mcg/mL, although milder cases of tonic-clonic (grand mal) epilepsy may respond to lower phenytoin serum levels.

Fentanyl, a synthetic opioid akin to morphine but dramatically more potent (up to 100 times), ranks among the most frequently abused pain relievers in the United States, and it is the leading cause of overdose-related deaths, according to the Centers for Disease Control and Prevention.

Common effects of Dilantin may include seizures, tremors (involuntary, repetitive shaking of limbs), drowsiness, and slowed or slurred speech.

Both drugs are effective for their licensed indications. Your doctor will discuss which medication is the most suitable considering your health circumstances and condition which is being treated.

Dilantin (phenytoin) and Keppra (levetiracetam) are both antiepileptic drugs, used for seizure control. They share similar side effects, including dizziness, drowsiness, and nervousness.

Adult Dosage: The recommended initial dose for adult patients who have not received prior treatment is one 100-mg DILANTIN (extended phenytoin sodium capsule, USP) taken orally three times daily. Adjust the dosage as needed, with a maximum of two capsules three times a day.

Medications such as phenobarbital, phenytoin (Dilantin), and carbamazepine (Tegretol) can increase the risk of acetaminophen side effects. These drugs may heighten the likelihood of liver damage resulting from acetaminophen use.

Phenytoin (Dilantin) stands as one of the leading culprits behind Drug-Induced Liver Injury (DILI) and liver failure. However, it’s important to note that liver damage associated with this medication remains relatively rare, occurring in fewer than 1 in 1,000 individuals taking phenytoin. Typically, liver injury manifests 2 to 8 weeks after initiating phenytoin treatment.

Phenytoin (marketed as Dilantin and Phenytek) is a drug that stabilizes abnormal electrical activity in the brain during seizures. Occasionally, it is prescribed to manage irregular heart rhythms. However, it can potentially lead to panic attacks, restlessness, and anxiety.

Dilantin may interact with various substances, including stomach acid reducers, sedatives, antidepressants, estrogen hormone therapy, phenothiazines, disulfiram, methylphenidate, sulfa drugs, carbamazepine, sucralfate, molindone, phenobarbital, valproic acid, divalproex sodium, steroids, antibiotics, digoxin, furosemide, or theophylline.

Possible side effects of Dilantin use encompass headaches, nausea, vomiting, constipation, dizziness, vertigo, drowsiness, difficulty sleeping, or nervousness. If any of these effects persist or worsen, promptly inform your doctor or pharmacist.

Recent clinical studies involving bipolar disorder patients have suggested that, similar to other anticonvulsant drugs frequently utilized in bipolar treatment like valproate and carbamazepine, phenytoin may exhibit mood-stabilizing properties in addition to its well-established anticonvulsant effects.

Nevertheless, scientific literature has documented various forms of side effects associated with phenytoin. We present a case of a patient who exhibited signs of toxicity, including mood disturbances, altered behavior, cognitive symptoms, academic difficulties, and personality changes, following prolonged phenytoin treatment.

Pfizer’s antiepileptic medication Dilantin has been associated with cerebellar atrophy, a permanent condition that can result in significant motor skill impairment, memory loss, and other severe adverse effects.

If you are scheduled for surgery, including dental procedures, it is essential to inform your doctor or dentist about your phenytoin usage. This medication may induce dizziness, drowsiness, and coordination issues. Avoid operating a vehicle or machinery until you understand how this medication affects you.

Individuals with epilepsy and comorbid anxiety should steer clear of antiepileptic drugs that may possess negative psychotropic properties, such as levetiracetam, topiramate, zonisamide, and felbamate.

Dilantin is a commonly prescribed medication for specific forms of epilepsy. Gingival overgrowth is a recognized common side effect, leading to painful and swollen oral tissues. It may even alter the alignment of your teeth when biting down on objects.

Abruptly discontinuing phenytoin can trigger continuous seizures, a life-threatening condition known as status epilepticus. Additionally, it can affect the levels of other medications in the body, potentially leading to increased side effects or reduced effectiveness.

Potential side effects of anti-seizure medications (ASMs) encompass mood fluctuations, irritability, agitation, or depression. It’s worth noting that in some individuals, ASMs can have a positive impact on their mood. The likelihood of experiencing side effects may be lower than anticipated.

Maintain your DILANTIN regimen as long as your healthcare provider recommends. While DILANTIN assists in managing your condition, it does not provide a cure. Therefore, it is crucial to take your medication daily, even when you’re feeling well. Do not alter or discontinue your DILANTIN dosage without consulting your doctor.

Refrain from ceasing your DILANTIN medication without first consulting your healthcare provider. Abruptly discontinuing DILANTIN can result in significant issues, including an increased frequency of seizures or the development of seizures that do not cease (status epilepticus).

Discontinuing Dilantin suddenly heightens the risk of seizures, including tonic-clonic grand mal seizures and temporal lobe epilepsy.

Initial dosage: 100mg taken three times daily. Adjust weekly as necessary, with a maximum dosage of 200mg taken three times daily. Once-daily dosing is exclusively applicable when using extended-release capsules and only for patients effectively controlled on a 300mg daily dose.

While many individuals can safely use phenytoin for months or even years, prolonged treatment with phenytoin may lead to certain side effects over time. Long-term phenytoin therapy has the potential to reduce vitamin D levels in the blood, potentially contributing to osteoporosis and osteopenia, increasing the risk of bone fractures.

Possible side effects of phenytoin usage include headaches (rest and hydration can help alleviate these), drowsiness, dizziness (these side effects tend to diminish as your body adapts to phenytoin), nervousness, unsteadiness, shakiness, nausea or vomiting, and constipation. Additionally, it may lead to sore or swollen gums.

Anticonvulsant medications like Dilantin are not typically used for recreational purposes. However, consuming alcohol or engaging in substance abuse while on Dilantin can reduce its effectiveness or result in serious side effects, including an increased risk of frontal lobe seizures.

Rapid, uncontrollable eye movements or double vision, dizziness, drowsiness, or confusion, impaired coordination of limbs or body, and slurred speech may manifest as symptoms of Dilantin toxicity.

DILANTIN can lead to severe side effects, including a life-threatening condition known as Stevens-Johnson syndrome and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), which may result in fatality.

Overdose symptoms may encompass profound mental/mood alterations, extreme drowsiness, loss of consciousness, and slowed breathing. While using this medication, it is advisable to undergo laboratory and/or medical tests, such as monitoring phenytoin blood levels, assessing liver function, and conducting a complete blood count.

Intoxication primarily presents with symptoms like nausea and central nervous system dysfunction, particularly confusion, nystagmus, and ataxia. More severe cases may involve a depressed level of consciousness, coma, and seizures.

Dilantin has been linked to cerebellar atrophy or degeneration for many years, a form of brain damage resulting from the deterioration of nerve cells in the cerebellum, the region of the brain responsible for balance and muscle coordination.

Dilantin has the potential to interact with a range of substances, including stomach acid reducers, sedatives, antidepressants, estrogen hormone replacement, phenothiazines, disulfiram, methylphenidate, sulfa drugs, carbamazepine, sucralfate, molindone, phenobarbital, valproic acid, divalproex sodium, steroids, antibiotics, digoxin, furosemide, or theophylline.

Allergic reactions to phenytoin typically manifest as a rash, and if you notice any skin issues, it is crucial to contact a doctor promptly. In rare instances, allergic reactions to phenytoin can lead to liver or bone marrow damage.

Phenytoin toxicity is rarely fatal, but it can result in neurological symptoms ranging from nystagmus to ataxia to coma. Intravenous administration of phenytoin may occasionally lead to the rare complication known as Purple Glove Syndrome.

In legal matters, Pfizer was instructed to pay $10 million to a Dilantin patient suffering from Stevens-Johnson Syndrome (SJS) and cerebellar shrinkage in January 2010. Furthermore, they settled another Dilantin and SJS lawsuit for $4 million just 11 months later.

Phenytoin (Dilantin) ranks among the most frequent causes of Drug-Induced Liver Injury (DILI) and liver failure. However, occurrences of liver damage due to this medication are relatively rare, affecting less than 1 in 1,000 individuals taking phenytoin. Liver injury typically arises 2 to 8 weeks after initiating phenytoin treatment.

Antiepileptic drugs like carbamazepine (Tegretol) and phenytoin (Dilantin) have been associated with decreased bone density, believed to result from low vitamin D levels and reduced calcium absorption in the intestines.