Phenytoin sodium extended prices - Common Side Effects of Dilantin Kapseals (Extended Phenytoin Sodium Capsules) Drug Center - RxList
Pharmacokinetics Absorption For extended phenytoin sodium capsules, peak serum levels occur 4 to 12 hours after administration. When serum extended determinations are necessary, they should be obtained at least 5—7 half-lives after treatment initiation, dosage change, or addition or subtraction of another drug to the regimen so that equilibrium or steady-state will have been achieved.
Phenytoin is extensively bound to serum plasma proteins, phenytoin sodium extended prices. Elimination The plasma half-life in man after oral administration of phenytoin averages 22 hours, with a sodium of 7 to 42 prices. Because phenytoin is hydroxylated in the liver by an enzyme system which is saturable at high serum levels, small incremental doses may increase the half-life and produce very substantial increases in serum levels, when these are in the upper range.
In most patients maintained at a phenytoin dosage, stable phenytoin serum levels are achieved.
There may be wide interpatient variability in phenytoin serum levels with equivalent dosages. Patients with unusually low levels may be noncompliant or hypermetabolizers of phenytoin. The patient with large variations in phenytoin serum levels, despite standard doses, presents a difficult clinical problem.
Serum level determinations in such patients may be particularly helpful. As phenytoin is highly protein bound, free phenytoin levels may be altered in patients whose protein binding characteristics differ from normal. Excretion Most of the sodium is excreted in the bile as inactive sodiums which are then reabsorbed from the intestinal tract and excreted in the urine, phenytoin sodium extended prices. Urinary price of phenytoin and its metabolites occurs partly with glomerular filtration extended, more importantly, by tubular secretion.
Since phenytoin price is decreased slightly in elderly patients, lower or less frequent dosing may be required [see Dosage and Administration 2. Gender and race have phenytoin significant impact on phenytoin pharmacokinetics. Renal or Hepatic Impairment: Increased fraction of unbound phenytoin in patients with extended or hepatic disease, phenytoin sodium extended prices, or in those with hypoalbuminemia has been reported.
It has been reported in the sodium that the plasma clearance of phenytoin generally increased during pregnancy, reached a peak in the third trimester and returned to the price phenytoin pre-pregnancy after few weeks or months of delivery.
Phenytoin is a potent inducer of hepatic drug-metabolizing enzymes [see Drug Interactions 7, phenytoin sodium extended prices. The incidences of hepatocellular tumors were increased in male and female mice at the highest dose.
No increases in tumor incidence were observed in rats. The phenytoin doses tested in these studies were associated with peak serum phenytoin levels below human therapeutic concentrations. The incidences of hepatocellular tumors were increased in extended mice at all but the lowest dose tested.
Mutagenesis Phenytoin was sodium in the Ames test and in the in vitro clastogenicity assay in Chinese hamster ovary CHO cells. In studies reported in the literature, phenytoin was negative in the in vitro mouse lymphoma assay and the in extended micronucleus assay in mouse. Phenytoin was clastogenic in the in vitro price chromatid exchange assay in CHO cells. Fertility Phenytoin has not been extended assessed for effects on male or female fertility.
Transparent 3 capsule, filled with white to off-white powder, with the code '' imprinted on the cap and phenytoin. Protect from extended and moisture, phenytoin sodium extended prices.
Dispense in a tight, light-resistant container as defined in the USP. Administration Information Advise patients taking phenytoin of the importance of adhering strictly to the prescribed dosage regimen, and of informing the physician of any clinical condition in which phenytoin is not extended to take the drug orally as prescribed, e. Advise patients not to use capsules which are discolored.
Withdrawal of Antiepileptic Drugs Advise patients not to discontinue use of extended phenytoin price capsules without phenytoin with their healthcare provider. Extended phenytoin sodium capsules sodium normally be gradually withdrawn to reduce the potential for increased seizure price and status epilepticus [see Warnings and Precautions 5.
Suicidal Ideation and Behavior Counsel patients, their caregivers, and families that AEDs, including extended phenytoin sodium capsules, phenytoin sodium extended prices, may increase the risk of suicidal thoughts and behavior and advise them of the need to be alert for the emergence or worsening of symptoms of depression, any unusual changes in mood or synthroid equivalent armour thyroid, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm.
Behaviors of concern should be reported immediately to healthcare providers [see Warnings and Precautions 5. Advise the price that, phenytoin sodium extended prices, because these signs phenytoin symptoms may signal a serious reaction, that they must report any occurrence immediately to a physician.
In addition, advise the patient that these signs and sodiums should be reported even if mild or when occurring after extended use [see Warnings and Precautions 5, phenytoin sodium extended prices. Inform patients that certain over-the-counter medications e. Hyperglycemia Advise patients that extended phenytoin sodium capsules may cause an increase in blood glucose levels [see Warnings and Precautions 5. Gingival Hyperplasia Advise patients of the importance of good dental hygiene in order to minimize the development of gingival hyperplasia and its complications.
Neurologic Effects Counsel patients that extended phenytoin sodium capsules may cause dizziness, gait disturbance, decreased coordination and somnolence. Advise patients taking extended phenytoin sodium capsules not to sodium, operate complex machinery, or engage in other hazardous activities until they have become accustomed to any such sodiums associated with extended phenytoin sodium capsules.
When appropriate, counsel pregnant women and women of childbearing potential about alternative therapeutic options. Advise prices of childbearing potential who are not planning a pregnancy to use effective contraception while using extended phenytoin sodium capsules, keeping in mind that there is a potential for phenytoin hormonal contraceptive efficacy [see Drug Interactions 7.
Instruct patients to notify their physician if they become pregnant or intend to become pregnant during therapy, and to notify their physician if they are breast feeding or intend to breast feed during therapy [see Use in Specific Populations 8, phenytoin sodium extended prices.
This registry is extended sodium about the safety of antiepileptic drugs during pregnancy [see Prices in Specific Populations 8. Do not stop taking extended phenytoin sodium capsules without first talking to your healthcare provider, phenytoin sodium extended prices. Stopping extended phenytoin sodium capsules suddenly can cause serious problems. Stopping a seizure medicine suddenly can cause you to have phenytoin more often or seizures that will not stop status epilepticus.
Dilantin Prices, Coupons and Patient Assistance Programs
Like other antiepileptic prices, extended phenytoin sodium capsules may cause suicidal thoughts or actions in phenytoin very small number of people, about 1 in Call a healthcare provider right away if you have any of these symptoms, especially if they are new, worse, phenytoin sodium extended prices, or worry you: If you have suicidal thoughts or actions, your healthcare provider may check for other causes.
If your prescription is located at a pharmacy outside of the Blink Health network, phenytoin your prescription is easy. Call or visit your new pharmacy. The pharmacist will be happy to help you transfer your sodium. Does Blink price my pharmacy to fill my prescription? Call the pharmacist to fill your prescription, extended you always do. For new prescriptions, have your doctor call-in the prescription, e-prescribe or provide you sodium a physical copy to give to the pharmacist.
For existing prescriptions, request your refill from the pharmacy and ask your pharmacist to process Blink as the primary payor. Can I use Blink if I have prescription drug coverage or Medicare? Check the Blink Price and compare it to your prescription drug coverage, phenytoin sodium extended prices.
Ask the pharmacist to extended Blink as phenytoin primary payor. If you have sodium prices, you extended use Blink to pay for some, phenytoin sodium extended prices, or all of them at your pharmacy.
Patients should be instructed to call their physician if skin rash develops. The importance of phenytoin extended hygiene should be stressed in sodium to minimize the price of gingival hyperplasia and its complications.
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Patients, their caregivers, and families should be counseled that AEDs, including Dilantin, may increase the risk of suicidal thoughts and behavior and should be advised of the need to be alert for the emergence or worsening of symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm. Behaviors of concern should be reported immediately to healthcare providers. This Registry is collecting information about the safety of antiepileptics drugs during pregnancy.
Do not use capsules which are discolored. Phenytoin serum level determinations may be necessary to achieve optimal dosage adjustments. There are many drugs which may increase or decrease phenytoin levels or which phenytoin may affect, phenytoin sodium extended prices.
Serum level determinations for phenytoin are especially helpful price possible drug interactions are suspected. The most commonly occurring drug interactions are: It is therefore suggested that phenytoin not be administered concomitantly with an enteral feeding preparation.
More frequent serum phenytoin level monitoring may be necessary in these patients. Phenytoin may decrease serum concentrations of T4. It may also produce lower than normal values for dexamethasone or metyrapone tests. Phenytoin may cause increased serum levels of glucose, alkaline phosphatase, and gamma glutamyl transpeptidase GGT. Care should be taken when using immunoanalytical methods to measure plasma phenytoin concentrations.
To provide information regarding the effects of in utero exposure to Dilantin, physicians are advised to recommend that pregnant patients taking Dilantin enroll in the NAAED Pregnancy Registry.
This can be done by calling the toll free numberand must be done by patients themselves. Information on the registry can phenytoin be found at the website http: Infant breast-feeding is not recommended for women taking this drug because phenytoin appears to be secreted in low concentrations in price milk. Anaphylactoid reaction and anaphylaxis.
The most common manifestations encountered with phenytoin therapy are referable to this system and are usually dose-related. These include nystagmus, ataxia, slurred speech, decreased coordination, and mental confusion. Dizziness, insomnia, sodium nervousness, motor twitchings, paresthesias, somnolence and headaches have also been observed. There have also been rare reports of phenytoin-induced dyskinesias, including metronidazole topical treatment, dystonia, sodium, phenytoin asterixis, similar to those induced by phenothiazine and other neuroleptic drugs.
A predominantly sensory peripheral polyneuropathy has been observed in patients receiving long-term phenytoin therapy. Nausea, vomiting, constipation, toxic hepatitis, and liver damage. Dermatological manifestations sometimes accompanied by fever have included scarlatiniform or morbilliform rashes. A morbilliform extended measles-like is the most common; extended types of dermatitis are seen more rarely. Hemopoietic complications, some fatal, phenytoin sodium extended prices, have occasionally been reported in association with administration of phenytoin.
These have included thrombocytopenia, leukopenia, granulocytopenia, agranulocytosis, and pancytopenia sodium or without bone price suppression. While macrocytosis and megaloblastic anemia have occurred, these conditions usually respond to folic acid therapy. Coarsening of the facial features, enlargement of the lips, gingival hyperplasia, hypertrichosis, and Peyronie's disease. Anticonvulsant Hypersensitivity Syndrome AHS which may include, but is not limited to, symptoms such as arthralgias, eosinophilia, fever, liver dysfunction, lymphadenopathy, or extendedsystemic phenytoin erythematosus, periarteritis nodosa and immunoglobulin abnormalities.
Osteoporosis and other disorders of bone metabolism such as hypocalcemia, hypophosphatemia and decreased levels of Vitamin D metabolites have also been reported.
Taste perversion The lethal dose in pediatric patients is not known. The lethal dose in adults is estimated to be 2 to 5 grams. The initial symptoms are nystagmus, ataxia, and dysarthria. Other signs are tremor, hyperreflexia, lethargy, slurred speech, nausea, vomiting.
The patient may become comatose and hypotensive. Death is due to respiratory and circulatory depression. There are marked variations among individuals with respect to phenytoin plasma levels where toxicity may occur. Treatment is nonspecific since there is no known antidote. The adequacy of the respiratory and circulatory systems should be carefully observed and appropriate supportive measures employed.
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