Phenytoin t 1 2
Other important side effects caused by phenytoin include sexual dysfunction, such as: Antiepileptic medications have been associated with an increased risk of suicidal thinking and behavior.
Anyone considering the use of antiepileptic drugs must balance this risk of suicide with the clinical need for the antiepileptic drug. Patients who begin antiepileptic therapy should be closely observed for clinical worsening, suicidal thoughts or unusual changes in behavior.
What is the dosage for Dilantin? Warnings for other groups For pregnant women: Phenytoin may cause serious birth defects. You should use effective birth control while taking this medication. This drug should be used during pregnancy only if the potential benefit justifies the potential risk. If you become pregnant while taking this drug, talk to your doctor about registering with the North American Antiepileptic Drug Pregnancy Registry.
The purpose of this registry is to collect information about the safety of anti-seizure medications used during pregnancy. When to call the doctor Tell your doctor if your seizures get worse or if you have any new types of seizures while taking this drug. For women who are breastfeeding: Antacids administered in a peptic ulcer regimen may decrease the AUC of a single dose of phenytoin.
Patients should be cautioned against concomitant use of antacids and phenytoin. Consider using other options if possible.
This is accomplished by reducing the amplitude of sodium-dependent action potentials through enhancing steady state inactivation.
Sodium channels exist in three main conformations: Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose. Tell your doctor if this medicine does not seem to work as well in treating your condition. Wear a medical alert tag or carry an ID card stating that you take phenytoin. Any medical care provider who treats you should know that you take seizure medication.
Phenytoin can cause swelling in your gums. Brush and floss your teeth and visit your dentist regularly to help prevent this problem. Store at room temperature away from moisture, light, and heat. Dosage Information in more detail What happens if I miss a dose? Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. Because this disorder is variable in its expression, other organ systems not noted here may be involved.
It is important to note that early manifestations of hypersensitivity, such as fever or lymphadenopathy, may be present even though rash is not evident. If such signs or symptoms are present, the patient should be evaluated immediately. Additionally, consider alternatives to structurally similar drugs such as carboxamides e. Similarly, if there is a history of hypersensitivity reactions to these structurally similar drugs in the patient or immediate family members, consider alternatives to DILANTIN.
Other common manifestations include jaundice , hepatomegaly , elevated serum transaminase levels, leukocytosis , and eosinophilia. The clinical course of acute phenytoin hepatotoxicity ranges from prompt recovery to fatal outcomes. These have included thrombocytopenia , leukopenia , granulocytopenia , agranulocytosis , and pancytopenia with or without bone marrow suppression.
There have been a number of reports suggesting a relationship between phenytoin and the development of lymphadenopathy local or generalized including benign lymph node hyperplasia , pseudolymphoma, lymphoma , and Hodgkin's disease.
Although a cause and effect relationship has not been established, the occurrence of lymphadenopathy indicates the need to differentiate such a condition from other types of lymph node pathology. In all cases of lymphadenopathy, follow-up observation for an extended period is indicated and every effort should be made to achieve seizure control using alternative antiepileptic drugs. Local Toxicity Including Purple Glove Syndrome Soft tissue irritation and inflammation has occurred at the site of injection with and without extravasation of intravenous phenytoin.
Soft tissue irritation may vary from slight tenderness to extensive necrosis , and sloughing. The syndrome may not develop for several days after injection.
Although resolution of symptoms may be spontaneous, skin necrosis and limb ischemia have occurred and required such interventions as fasciotomies, skin grafting, and, in rare cases, amputation.
Because of the risk of local toxicity, intravenous DILANTIN should be administered directly into a large peripheral or central vein through a large-gauge catheter.
Prior to the administration, the patency of the IV catheter should be tested with a flush of sterile saline. Each injection of parenteral DILANTIN should then be followed by a flush of sterile saline through the same catheter to avoid local venous irritation caused by the alkalinity of the solution. Renal Or Hepatic Impairment Or Hypoalbuminemia Because the fraction of unbound phenytoin is increased in patients with renal or hepatic disease, or in those with hypoalbuminemia , the monitoring of phenytoin serum levels should be based on the unbound fraction in those patients.
Exacerbation Of Porphyria In view of isolated reports associating phenytoin with exacerbation of porphyria , caution should be exercised in using this medication in patients suffering from this disease. Prenatal exposure to phenytoin may increase the risks for congenital malformations and other adverse developmental outcomes [see Use In Specific Populations].
Increased frequencies of major malformations such as orofacial clefts and cardiac defects , and abnormalities characteristic of fetal hydantoin syndrome, including dysmorphic skull and facial features, nail and digit hypoplasia , growth abnormalities including microcephaly , and cognitive deficits, have been reported among children born to epileptic women who took phenytoin alone or in combination with other antiepileptic drugs during pregnancy.
Not indicated for the treatment of absence seizures or phenytoin due to hypoglycemia or other metabolic causes. Consider therapy modification Sofosbuvir: Chloramphenicol Systemic may increase the serum concentration of Phenytoin. There is a variety of opinions on how to administer phenytoin with enteral feedings. Phenytoin may decrease the serum concentration of Disopyramide. Phenytoin must be administered slowly. Phenytoin may decrease the serum concentration of ClonazePAM. Consider therapy modification Calcifediol: Hepatotoxicity associated with antiepileptic drugs. Dosage adjustments may be necessary. Fosphenytoin-Phenytoin may decrease the serum concentration of Cobicistat. Avoid concomitant use of strong CYP3A4 inducers and sirolimus if possible. Phenytoin also can cause anemia, phenytoin t 1 2. Consider therapy modification Carbonic Anhydrase Inhibitors:
Amiodarone may increase the serum concentration of Phenytoin. J Hepatol ; phenytoin Consider using an alternative H2-antagonist to avoid this interaction. Elimination The serum half-life in man after intravenous administration ranges from 10 to 15 hours. Consider therapy modification Lumacaftor: This may lead to loss of efficacy or, phenytoin t 1 2, if bazedoxifene is combined with estrogen therapy, an increased risk of phenytoin hyperplasia. Avoid use of erlotinib with phenytoin when possible. Vesicant intravenous administration ; ensure proper catheter or needle position prior to and during infusion. There have been a number of reports suggesting a relationship between phenytoin and the development of lymphadenopathy local or generalized including benign lymph node hyperplasiapseudolymphoma, lymphomaand Hodgkin's disease. Phenytoin can potentially injure the liver although this is an uncommon occurrence.
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