Dilantin Capsule

Phenytoin Na

Control of generalised tonic-clonic (grand mal) epilepsy & psychomotor seizures.

Adult Initially 300 mg daily in 3 equally divided doses. Maintenance: 300-400 mg daily in 3-4 equally divided doses. Childn >6 yr & adolescent Min: 300 mg daily. Childn Initially 5 mg/kg daily in 2-3 equally divided doses. Maintenance: 4-8 mg/kg daily. Max: 300 mg daily.

Should be taken with food: When administering to patients on nasogastric or other enteral feeds, do not administer feeds 2 hr before or after a dose. Be consistent throughout therapy in relation to feed times. Swallow cap whole, do not open/chew/crush. Do not switch dosage forms/brands w/o prior consideration.

Hypersensitivity to phenytoin or other hydantoins. Co-administration w/ delavirdine or other NNRTIs.

Hypersensitivity syndrome (HSS)/DRESS. Discontinue use if rash appears. Not effective for absence (petit mal) seizures, seizures due to hypoglycemic or other metabolic causes. Increased risk of suicidal ideation/thoughts or behaviour. Severe cutaneous ARs eg, acute generalized exanthematous pustulosis, exfoliative dermatitis, SJS, TEN. Risk of osteomalacia, bone fractures, osteoporosis, hypocalcemia & hypophosphatemia in chronically-treated patients. Hyperbilirubinemia, hypoalbuminemia; bradycardia & asystole/cardiac arrest; angioedema; porphyria, hyperglycemia, diabetes. Immunosuppressed patients. Slow metabolism. Monitor for hematopoietic effects. May produce confusional states. Maintain good dental hygiene. Black patients. Acute alcohol intake. Avoid abrupt w/drawal. May affect ability to drive & use machines. Renal impairment. Hepatic impairment or hepatotoxicity. Women of childbearing potential should use effective contraception. Pregnancy. Not recommended during lactation. Elderly, gravely ill patients.

Anaphylactoid reaction, anaphylaxis; nystagmus, ataxia, slurred speech, decreased coordination, mental confusion; dizziness, vertigo, insomnia, transient nervousness, motor twitchings, headache, paresthesia, somnolence; chorea, dystonia, tremor, asterixis; sensory peripheral polyneuropathy (long-term therapy); facial features coarsening, lip enlargement, gingival hyperplasia, hypertrichosis, Peyronie's disease; acute hepatic failure, toxic hepatitis, liver damage, vomiting, nausea, constipation; hematopoietic complications; HSS/DRESS, SLE, periarteritis nodosa, Ig abnormalities, angioedema; dermatological manifestations; taste perversion; osteoporosis & other bone metabolism disorders.

Increased serum levels w/ acute alcohol intake, analgesic/anti-inflammatory agents, anesth, antifungals, benzodiapines, Ca-channel blockers/CV agents, H₂-antagonists, HMG-CoA reductase inhibitors, hormones, immunosuppressants, oral hypoglycemics, PPIs, SSRIs. Decreased serum levels w/ chronic alcohol intake, antiulcer, CV & hyperglycemic agents, antiretrovirals, bronchodilators, folic acid, St. John's wort. Increased or decreased serum levels w/ antibacterials, anticonvulsants, antineoplastics, psychotropic agents. Altered serum levels &/or effects of antibacterials, anticonvulsants, antifungals, antihelminthics, antineoplastics, antiretrovirals, bronchodilators, Ca-channel blockers/CV agents, corticosteroids, coumarin anticoagulants, cyclosporine, diuretics, HMG-CoA reductase inhibitors, hormones, hyperglycemic & neuromuscular-blocking agents, immunosuppressants, opioid analgesics, oral hypoglycemics, psychotropic agents/antidepressants, vit D, folic acid. Decreased serum levels of protein-bound iodine. Increased serum levels of glucose, alkaline phosphatase & γ-glutamyl transpeptidase.

Anticonvulsants

N03AB02 - phenytoin ; Belongs to the class of hydantoin derivatives antiepileptics.

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