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Dilantin (Phenytoin): Your Comprehensive Guide to Seizure Control
Dilantin, also known generically as Phenytoin, is a trusted and widely prescribed anti-seizure medication. This comprehensive guide provides essential information for patients and caregivers considering or currently using Dilantin. We aim to equip you with the knowledge needed to understand its uses, dosage, precautions, potential side effects, and interactions, empowering you to manage your health effectively.
What is Dilantin Used For? Common Uses & Applications
Dilantin (Phenytoin) is primarily indicated for the management and prevention of seizures. Its primary uses include:
- Epilepsy (Seizures): Dilantin is a cornerstone treatment for various types of epilepsy, helping to reduce the frequency and severity of seizures. It works by stabilizing nerve activity in the brain.
- Prevention of Post-Traumatic Epilepsy: Following a traumatic brain injury, Dilantin can be prescribed to prevent the development of epilepsy.
- Epilepsy Following Neurosurgery: Similar to post-traumatic epilepsy, Dilantin can help prevent seizures following neurosurgical procedures.
- Ventricular Arrhythmias: In certain cases, Dilantin is used to treat ventricular arrhythmias, particularly those induced by cardiac glycoside intoxication. This is an off-label use.
- Meniere's Syndrome: Some forms of Meniere's syndrome, a disorder of the inner ear, may be treated with Dilantin to manage associated symptoms. This is an off-label use.
- Trigeminal Neuralgia: Dilantin may be used as an adjunctive therapy for trigeminal neuralgia, a chronic pain condition affecting the trigeminal nerve. This is an off-label use.
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Dilantin Dosage and Administration: A Detailed Guide
The correct dosage of Dilantin is crucial for achieving optimal seizure control and minimizing potential side effects. Always follow your doctor's specific instructions. Never adjust your dosage without consulting your healthcare provider.
- General Dosage Guidelines: The dosage of Dilantin varies depending on the individual, the condition being treated, and other factors. For epilepsy, adults typically start with a dose of 5 mg per kilogram of body weight per day. Children usually require 4-7 mg per kilogram per day.
- Dividing the Dose: The total daily dose is generally divided into one or two administrations per day.
- Food Interactions: Taking Dilantin with food can help minimize gastrointestinal side effects.
- Special Populations: Elderly patients, debilitated individuals, and those with kidney or liver disease may require dosage adjustments.
- Dilantin Suspension and Tube Feedings: Avoid administering Dilantin suspension concurrently with tube feedings, as this can interfere with absorption.
- Importance of Adherence: Do not stop taking Dilantin abruptly, even if you feel well. Sudden cessation can trigger seizures.
- Extended-Release Capsules: Swallow extended-release capsules whole. Do not chew, crush, or break them.
- Dilantin Suspension: Shake the suspension well before each use. Use a calibrated measuring spoon or oral syringe to ensure accurate dosing.
- Dosage Forms: Dilantin is available in various forms, including capsules, tablets, and oral suspension. Choose the formulation that best suits your needs and as directed by your healthcare provider.
Important Precautions Before Taking Dilantin
Before starting Dilantin therapy, inform your doctor about all your medical conditions and medications. Key precautions include:
- Liver or Kidney Disorders: Dilantin is metabolized by the liver and eliminated by the kidneys. Impairment in these organs can affect drug levels.
- Vitamin D Deficiency: Dilantin can interfere with vitamin D metabolism, potentially leading to bone problems.
- Diabetes: Dilantin can affect blood sugar control.
- Porphyria: Dilantin can exacerbate porphyria, a group of genetic disorders.
- Pregnancy and Breastfeeding: Dilantin can harm a developing fetus. Discuss the risks and benefits with your doctor if you are pregnant or planning to become pregnant. It can also pass into breast milk.
- Asian Ancestry: Individuals of Asian descent may be at higher risk of developing serious skin reactions to Dilantin.
- Contraception: Dilantin can reduce the effectiveness of hormonal contraceptives. Use non-hormonal methods of birth control while taking Dilantin.
- Driving and Operating Machinery: Dilantin can cause drowsiness and impair coordination. Exercise caution when driving or operating machinery.
- Antacids: Avoid taking Dilantin with antacids, as they can interfere with absorption.
- Allergies: Inform your doctor of any known allergies to medications, especially to hydantoins.
Contraindications: When Dilantin Should Not Be Used
Dilantin is contraindicated in certain conditions. Do not use Dilantin if you have:
- Liver and Kidney Diseases: Severe impairment of liver or kidney function.
- Leukopenia: Low white blood cell count.
- Heart Failure: Severe heart failure.
- Cachexia: Severe wasting syndrome.
- Porphyria: Certain types of porphyria.
- Concomitant Use with Certain Medications: Isoniazid, teturamom, or aspirin. Always inform your doctor of all medications you are taking.
- Hypersensitivity: Known hypersensitivity (allergy) to phenytoin or any of the inactive ingredients in the formulation.
Possible Side Effects of Dilantin: What to Watch Out For
Dilantin, like all medications, can cause side effects. It is important to be aware of potential side effects and to report any concerning symptoms to your doctor.
- Common Side Effects: Dizziness, agitation, tremor, ataxia (loss of coordination), nystagmus (involuntary eye movements), fever, nausea, vomiting.
- Connective Tissue Changes: Coarsening of facial features, Dupuytren's contracture (thickening and tightening of tissue in the hand).
- Allergic Reactions: Rash, itching, hives, swelling. Seek immediate medical attention if you experience signs of an allergic reaction.
- Gingival Hyperplasia: Overgrowth of the gums, particularly with prolonged use. Good oral hygiene is essential.
- Osteopathy and Hypocalcemia: Bone problems and low calcium levels, especially with long-term use.
- Megaloblastic Anemia: A type of anemia.
- Rare Side Effects: Lymphadenopathy (swollen lymph nodes), hirsutism (excessive hair growth).
- Blood Sugar Changes: Dilantin can raise blood glucose levels, so caution is advised in patients with diabetes.
- Bone Weakness: Interference with vitamin D synthesis can lead to weakened bones.
- Suicidal Behavior: There is an increased risk of suicidal thoughts and behavior in patients treated with Dilantin. Report any changes in mood or behavior to your doctor immediately.
- Neurological Effects: Confusion, memory problems, difficulty concentrating.
- Skin Reactions: In rare cases, severe skin reactions, such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN), can occur. These are medical emergencies and require immediate treatment.
Dilantin Drug Interactions: What You Need to Know
Dilantin can interact with a variety of other medications. It is crucial to inform your doctor about all prescription, over-the-counter, and herbal medications you are taking.
- Anticoagulants: Dilantin can increase the effects of coumarin anticoagulants (e.g., warfarin), increasing the risk of bleeding. Conversely, anticoagulants can increase Dilantin levels, potentially leading to toxicity.
- Medications that Decrease Dilantin Levels: Digoxin, carbamazepine, clonazepam, corticosteroids (prednisone), cyclosporine, disopyramide, doxycycline, estrogens, felodipine, levodopa, lidocaine, methadone, mexiletine, oral contraceptives, paroxetine, quinidine, tacrolimus, theophylline, phenobarbital, and warfarin.
- Tricyclic Antidepressants: Amitriptyline (Elavil, Endep), Desipramine (Norpramin, Pertofrane), Amoxapine (Asendin), Clomipramine (Anafranil), Imipramine (Tofranil), Nortriptyline (Pamelor, Aventyl), Doxepin (Adapin, Sinequan), Protriptyline (Vivactil), Trimipramine (Surmontil). Large doses can lower the seizure threshold, while small doses can increase it. Some can slow down Dilantin metabolism, increasing toxicity.
- Other Medications that Increase Dilantin Toxicity: Isonicotinic acid, certain antibiotics (chloramphenicol), sulfonamides, aminasine.
- Diuretics and Antihypertensives: Dilantin can increase the hypotensive effects of diuretics and other anti-hypertension medications.
- Other Interactions: Strengthens the action of anapryline and antiarrhythmic medications, thyroid hormone replacement drugs. Decreases activity of medications for diabetes, affects metabolism of corticosteroids and tetracycline (Vibramycin), influences absorption of diuretics (Furosemide).
- Laboratory Test Interactions: Dilantin may increase levels of bilirubin, cholesterol, glucose, alkaline phosphatase, and liver transaminases in blood tests.
What to Do If You Miss a Dose of Dilantin
If you miss a dose of Dilantin, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and return to your regular dosing schedule. Do not double the dose to catch up.
Dilantin Overdose: Symptoms and What to Do
An overdose of Dilantin can be serious. Symptoms of an overdose may include:
- Ataxia (loss of coordination)
- Nystagmus (involuntary eye movements)
- Diplopia (double vision)
- Extrapyramidal disorder (movement problems)
- Hyperkinesia (excessive muscle activity)
- Sensory neuropathy (nerve damage)
- Aggravation of seizures
- Sopor (abnormally deep sleep)
- Coma
- Increased blood glucose levels (in non-diabetic patients)
- In children, levels over 20 mg/l can lead to acute toxicity: nystagmus, ataxia, mental disorders, joint pain, bradycardia, ventricular fibrillation, atrial flutter, asystole, and coma.
If you suspect a Dilantin overdose, seek immediate medical attention. Contact emergency services or go to the nearest hospital.
Proper Storage of Dilantin
Store Dilantin tablets, capsules, and suspension at room temperature, between 15-30°C (59-86°F). Protect from light and moisture. Keep out of reach of children.
Buy Dilantin Online: Convenient Access to Your Medication
Looking for a convenient way to access your Dilantin prescription? Buy Dilantin online from a trusted and reputable online pharmacy. Ensure the pharmacy requires a valid prescription and is licensed to dispense medications in your jurisdiction.
Dilantin for Sale: Finding the Best Prices
When searching for "Dilantin for sale," prioritize safety and quality over price. Compare prices from reputable pharmacies, but be wary of extremely low prices, as this could indicate counterfeit or substandard medication. Cheap Dilantin may not be safe or effective.
Dilantin Price: Understanding the Cost
The Dilantin price can vary depending on the dosage, quantity, and pharmacy. Check with your insurance provider to determine your coverage. Generic phenytoin is often more affordable than brand-name Dilantin.
Dilantin Reviews: What Patients Are Saying
Reading Dilantin reviews can provide valuable insights into the experiences of other patients. However, remember that everyone responds to medication differently. Discuss any concerns you have with your doctor.
Dilantin Generic: A Cost-Effective Alternative
Dilantin generic refers to phenytoin medications manufactured by companies other than the original brand manufacturer. Generic medications contain the same active ingredient and are bioequivalent to the brand-name drug. They are typically more affordable.
Dilantin Side Effects Long Term: Important Considerations
Long-term use of Dilantin may lead to certain side effects. Regular monitoring by your healthcare provider is essential to detect and manage any potential issues.
Frequently Asked Questions (FAQ) About Dilantin
- Q: Can I drink alcohol while taking Dilantin?
A: It is generally recommended to avoid alcohol while taking Dilantin, as alcohol can interfere with the medication's effectiveness and increase the risk of side effects. - Q: Can Dilantin cause weight gain?
A: Weight gain is not a common side effect of Dilantin, but some individuals may experience changes in appetite or metabolism. - Q: How long does it take for Dilantin to start working?
A: Dilantin typically starts working within a few days to a week, but it may take several weeks to achieve optimal seizure control. - Q: Can I take Dilantin with other medications?
A: Dilantin can interact with many other medications. It is essential to inform your doctor about all medications you are taking. - Q: What should I do if I experience side effects from Dilantin?
A: Report any side effects to your doctor promptly. They can assess the situation and recommend appropriate management strategies. - Q: Is it safe to take Dilantin during pregnancy?
A: Dilantin can harm a developing fetus. Discuss the risks and benefits with your doctor if you are pregnant or planning to become pregnant. - Q: How does Dilantin work to control seizures?
A: Dilantin works by stabilizing nerve activity in the brain, reducing the likelihood of seizures. It primarily blocks sodium channels in neurons, which helps to prevent the rapid and excessive firing of nerve cells that can lead to seizures.
Disclaimer: This information is for informational purposes only and should not be considered medical advice. Always consult with your healthcare provider for diagnosis and treatment of any medical condition.