$Unique_ID{BRK03292} $Pretitle{} $Title{phenytoin} $Subject{Dilantin Parke-Davis Infatab Kapseal Diphenylan Lannett Anticonvulsant phenytoin convulsions seizures brain} $Volume{} $Log{ Dilantin Kapseal*0329201.scf} Copyright (C) 1993 Publications International, Ltd. phenytoin ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) Dilantin (Parke-Davis) Dilantin Infatab (Parke-Davis) Dilantin Kapseal (Parke-Davis) Diphenylan (Lannett) phenytoin (various manufacturers) TYPE OF DRUG Anticonvulsant INGREDIENT phenytoin DOSAGE FORMS Capsules (30 mg and 100 mg) Chewable tablets (50 mg) Oral suspension (30 mg and 125 mg per 5-ml spoonful, with 0.6% alcohol) STORAGE Phenytoin capsules, tablets, and oral suspension should be stored at room temperature in tightly closed, light-resistant containers. This medication should never be frozen. USES Phenytoin is used to control certain types of convulsions, or seizures. It is not clear exactly how phenytoin works to control convulsions, but it appears to prevent the spread of seizure activity in the brain. Phenytoin may also be used to treat other conditions as determined by your physician. TREATMENT To avoid stomach irritation and increase this drug's absorption, take phenytoin with food or with a full glass of water or milk (unless your doctor directs you to do otherwise). The tablet form of this medication should be chewed before swallowing. The suspension form of this medication should be shaken well just before measuring each dose. The contents tend to settle on the bottom of the bottle, so it is necessary to shake the container to distribute the ingredients evenly and equalize the doses. Each dose should then be measured carefully with a specially designed 5-ml measuring spoon. Phenytoin works best when the level of medicine in your bloodstream is kept constant. It is best, therefore, to take the doses at evenly spaced intervals day and night. For example, if you are taking three doses a day, the doses should be spaced eight hours apart. If you miss a dose of this medication, take the missed dose as soon as possible, unless it is almost time for the next dose. In that case, do not take the missed dose at all; just return to your regular dosing schedule. Do not double the next dose. If you miss two or more doses in a row, contact your doctor. SIDE EFFECTS Minor. Constipation, drowsiness (mild), headache, insomnia, nausea, or vomiting. These side effects should disappear as your body adjusts to the medication. To relieve constipation, increase the amount of fiber in your diet (fresh fruits and vegetables, salads, bran, and whole-grain breads), exercise, and drink more water (unless your doctor directs you to do otherwise). Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about blurred vision, chest pain, confusion, dizziness, change in facial features, gum enlargement, increased hair growth, joint pain, muscle twitching, nervousness, numbness, rash, slurred speech, sore throat, swollen glands, uncoordinated movements, unusual bleeding or bruising, change in the color of your urine, or yellowing of the eyes or skin. INTERACTIONS Phenytoin interacts with a number of other types of drugs: 1. The effectiveness of phenytoin can be decreased by concurrent use of alcohol, barbiturates, folic acid, tricyclic anti-depressants, reserpine, molindone, benzodiazepine tranquilizers, chloral hydrate, rifampin, phenothiazine tranquilizers, and haloperidol. 2. Phenytoin can decrease the effectiveness of calcifediol, warfarin, quinidine, disopyramide, dexamethasone, doxycycline, levodopa, and oral contraceptives. 3. The active blood levels and side effects of phenytoin can be increased by chloramphenicol, cimetidine, warfarin, disulfiram, isoniazid, oxyphenbutazone, phenylbutazone, ibuprofen, amiodarone, trimethoprim, sulfonamide antibiotics, tolbutamide, chlordiazepoxide, chlorpromazine, diazepam, estrogens, ethosuximide, methylphenidate, and prochlorperazine. 4. Valproic acid can either increase or decrease the effects of phenytoin. 5. The dosage of oral antidiabetic medications may need to be adjusted when phenytoin is started. 6. Phenytoin may decrease the absorption of furosemide from the gastrointestinal tract, decreasing its effectiveness. 7. Antacids, calcium, oxacillin, sucralfate, medicines for diarrhea, and antineoplastics (anticancer drugs) may decrease the gastrointestinal absorption and effectiveness of phenytoin. Do not take phenytoin within two to three hours of taking an antacid or antidiarrheal. Before starting to take phenytoin, BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking, especially any of those listed above. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to phenytoin, ethotoin, or mephenytoin. * Before starting to take this medication, be sure to tell your doctor if you now have or if you have ever had blood disorders, diabetes mellitus, or liver disease. * If this drug makes you dizzy or drowsy, do not take part in any activity that requires alertness, such as driving a car or operating potentially dangerous machinery. Children should be careful while playing. * Before surgery or other medical or dental treatment, tell your doctor or dentist you are taking phenytoin. * Do not stop taking this medication unless you first consult your doctor. If this drug is stopped abruptly, you may experience uncontrollable seizures. Your doctor may, therefore, want to reduce your dosage gradually. Be sure you have enough on hand for holidays and vacations. * Although several generic versions of this drug are available, you should not switch from one brand to another without your doctor's careful assessment and complete approval. If you have your medication refilled and it looks different, be sure to consult with your pharmacist. * Therapy with phenytoin may cause your gums to enlarge enough to cover your teeth. This can be minimized, at least partially, by frequent brushing and massaging of the gums with the rubber tip of a good toothbrush. * Be sure to tell your doctor if you are pregnant. Birth defects have been reported more often in infants whose mothers have seizure disorders. It is unclear if the increased risk of birth defects is associated with the seizure disorders or with the anticonvulsant medications, such as phenytoin, that are used to treat them. Discuss this with your doctor. Also, tell your doctor if you are breast-feeding an infant. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.