Dilantin
(Phenytoin)
In 1980, Russian scientists reported that the drugs Dilantin
(phenytoin) and Phenformin had extended animal lifespan
by 25% and 23% respectively in a strain of mice prone to autoimmune
disease. Dilantin is an FDA-approved drug commonly prescribed to
normalize electrical activity in epilepsy patients. Studies around
the world have shown that Dilantin is useful for a wide variety
of conditions including depression, headache, and neurologic disorders.
Phenformin is a prescription antidiabetic drug, which lowers blood
sugar in patients suffering from this disease, which suggests that
it might have antiglycosylation effects. Both drugs have serious
side effects, which makes them relatively poor candidates for long-term
use.
Why is this drug prescribed?
Dilantin is an antiepileptic drug, prescribed to control grand
mal seizures (a type of seizure in which the individual experiences
a sudden loss of consciousness immediately followed by generalized
convulsions) and temporal lobe seizures (a type of seizure caused
by disease in the cortex of the temporal [side] lobe of the brain
affecting smell, taste, sight, hearing, memory, and movement).
Dilantin may also be used to prevent and treat seizures occurring
during and after neurosurgery (surgery of the brain and spinal cord).
Most important fact about this drug
If you have been taking Dilantin regularly, do not stop abruptly.
This may precipitate prolonged or repeated epileptic seizures without
any recovery of consciousness between attacks--a condition called
status epilepticus that can be fatal if not treated promptly.
How should you take this medication?
It is important that you strictly follow the prescribed dosage
regimen and tell your doctor about any condition that makes it impossible
for you to take Dilantin as prescribed.
If you are given Dilantin Oral Suspension, shake it well before
using. Use the specially marked measuring spoon, a plastic syringe,
or a small measuring cup to measure each dose accurately.
Swallow Dilantin Kapseals whole. Dilantin Infatabs can be either
chewed thoroughly and then swallowed, or swallowed whole. The Infatabs
are not to be used for once-a-day dosing.
Do not change from one form of Dilantin to another without consulting
your doctor. Different products may not work the same way.
Depending on the type of seizure disorder, your doctor may give
you another drug with Dilantin.
--If you miss a dose...
If you take one dose a day, take the dose you missed as soon as
you remember. If you do not remember until the next day, skip the
missed dose and go back to your regular schedule. Do not take 2
doses at once.
If you take more than 1 dose a day, take the missed dose as soon
as possible. If it is within 4 hours of your next dose, skip the
one you missed and go back to your regular schedule. Do not take
2 doses at once.
If you forget to take your medication 2 or more days in a row,
check with your doctor.
--Storage instructions...
Store at room temperature away from light and moisture.
What side effects may occur?
Side effects cannot be anticipated. If any develop or change in
intensity, inform your doctor as soon as possible. Only your doctor
can determine whether it is safe for you to continue taking Dilantin.
More common side effects may include:
Decreased coordination, involuntary eye movement, mental confusion,
slurred speech
Other side effects may include:
Abnormal hair growth, abnormal muscle tone, blood disorders, coarsening
of facial features, constipation, dizziness, enlargement of lips,
fever, headache, inability to fall asleep or stay asleep, joint
pain, nausea, nervousness, overgrowth of gum tissue, Peyronie's
disease (a disorder of the penis that causes the penis to bend on
an angle during erection, often making intercourse painful or difficult),
rapid and spastic involuntary movement, skin peeling or scaling,
skin rash, tremors, twitching, vomiting, yellowing of skin and eyes
Why should this drug not be prescribed?
If you have ever had an allergic reaction to or are sensitive to
phenytoin or similar epilepsy medications such as Peganone or Mesantoin,
do not take Dilantin. Make sure your doctor is aware of any drug
reactions you have experienced.
Special warnings about this medication
Tell your doctor if you develop a skin rash. If the rash is scale-like,
characterized by reddish or purplish spots, or consists of (fluid-filled)
blisters, your doctor may stop Dilantin and prescribe an alternative
treatment. If the rash is more like measles, your doctor may have
you stop taking Dilantin until the rash is completely gone.
Because Dilantin is processed by the liver, people with impaired
liver function, older adults, and those who are seriously ill may
show early signs of drug poisoning.
Practicing good dental hygiene minimizes the development of gingival
hyperplasia (excessive formation of the gums over the teeth) and
its complications.
Avoid drinking alcoholic beverages while taking Dilantin.
Possible food and drug interactions when taking this medication
If Dilantin is taken with certain other drugs, the effects of either
could be increased, decreased, or altered. It is especially important
to check with your doctor before combining Dilantin with the following:
Alcohol
Amiodarone (Cordarone)
Antacids containing calcium
Blood-thinning drugs such as Coumadin
Chloramphenicol (Chloromycetin)
Chlordiazepoxide (Librium)
Diazepam (Valium)
Dicumarol
Digitoxin (Crystodigin)
Disulfiram (Antabuse)
Doxycycline (Vibramycin)
Estrogens such as Premarin
Felbamate (Felbatol)
Fluoxetine (Prozac)
Furosemide (Lasix)
Isoniazid (Nydrazid)
Major tranquilizers such as Mellaril and Thorazine
Methylphenidate (Ritalin)
Molindone hydrochloride (Moban)
Oral contraceptives
Phenobarbital
Quinidine (Quinidex)
Reserpine (Diupres)
Rifampin (Rifadin)
Salicylates such as aspirin
Seizure medications such as Depakene, Depakote, Tegretol, and Zarontin
Steroid drugs such as prednisone (Deltasone)
Sucralfate (Carafate)
Sulfa drugs such as Gantrisin
Theophylline (Theo-Dur, others)
Tolbutamide (Orinase)
Trazodone (Desyrel)
Ulcer medications such as Tagamet and Zantac
Tricyclic antidepressants (such as Elavil, Norpramin, and others)
may cause seizures in susceptible people, making a dosage adjustment
of Dilantin necessary.
Hyperglycemia (high blood sugar) may occur in people taking Dilantin,
which blocks the release of insulin. People with diabetes may experience
increased blood sugar levels due to Dilantin.
Abnormal softening of the bones may occur in people taking Dilantin
because of Dilantin's interference with vitamin D metabolism.
Special information if you are pregnant or breastfeeding
If you are pregnant or plan to become pregnant, inform your doctor
immediately. Because of the possibility of birth defects with antiepileptic
drugs such as Dilantin, you may need to discontinue the drug. Do
not, however, stop taking it without first consulting your doctor.
Dilantin appears in breast milk; breastfeeding is not recommended
during treatment with this drug.
Recommended dosage
Dosage is tailored to each individual's needs. Your doctor will
monitor blood levels of the drug closely, particularly when switching
you from one drug to another.
ADULTS
Standard Daily Dosage
If you have not had any previous treatment, your doctor will have
you take one 100-milligram Dilantin capsule 3 times daily to start.
On a continuing basis, most adults need 1 capsule 3 to 4 times
a day. Your doctor may increase that dosage to 2 capsules 3 times
a day, if necessary.
Once-A-Day Dosage
If your seizures are controlled on 100-milligram Dilantin capsules
3 times daily, your doctor may allow you to take the entire 300
milligrams as a single dose once daily.
CHILDREN
The starting dose is 5 milligrams per 2.2 pounds of body weight
per day, divided into 2 or 3 equal doses; the most a child should
take is 300 milligrams a day. The regular daily dosage is usually
4 to 8 milligrams per 2.2 pounds. Children over 6 years of age and
adolescents may need the minimum adult dose (300 milligrams per
day).
Overdosage
An overdose of Dilantin can be fatal. If you suspect an overdose,
seek medical attention immediately.
Symptoms of Dilantin overdose may include:
Coma, difficulty in pronouncing words correctly, involuntary eye
movement, lack of muscle coordination, low blood pressure, nausea,
sluggishness, slurred speech, tremors, vomiting
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