To control partial & generalized tonic-clonic seizures. Adjunct to emergency treatment of status epilepticus. Prophylactic control of seizures associated w/ neurosurgery or severe traumatic head injury. Treatment of trigeminal neuralgia & cardiac arrhythmia.
Dosage/Direction for Use
Epilepsy (control of seizures) Initially, 3-4 mg/kg daily as single dose or in divided doses or 150-300 mg daily, increased to 600 mg daily. Min increment interval: 7-10 days. Usual maintenance dose: 200-500 daily. Childn Initially, 5 mg/kg daily in 2 or 3 divided doses. Max: 300 mg daily. Maintenance dose: 4-8 mg/kg daily in divided doses. Treatment of tonic-clonic status epilepticus Initially, a benzodiazepine eg, diazepam is usually given followed by phenytoin Na IV 10-15 mg/kg by slow IV or by intermittent infusion at a uniform rate. Max: 50 mg/min. Patient not previously treated w/ phenytoin Na 100-200 mg IM.
Special Precautions
Liver impairment; diabetics; uremia. Do not administer IV to patients w/ sinus bradycardia, heart block or Stokes-Adams syndrome. Hypotension, heart failure & MI. Monitor BP & perform ECG during IV therapy. May interfere w/ some thyroid function tests. Pregnancy. Neonates. Elderly.
Adverse Reactions
Lack of appetite, headache, dizziness, transient nervousness, insomnia & GI disturbances eg, nausea, vomiting & constipation. Tenderness & hyperplasia of the gums; acne hirsutism & coarsening of the facial features. Nystagmus, diplopia, slurred speech & ataxia. Mental confusion (sometimes severe); dyskinesia & exacerbations of seizure frequency. Mild hypersensitivity reactions w/ skin rashes, morbilliform or fever. Hypoprothrombinemia of the newborn; congenital malformations.
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