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Phenytoin
Phenytoin is primarily used as an antiseizure medication. It's a valuable tool in the management of epilepsy as it controls seizures by reducing abnormal electrical activity in the brain. Common side effects include dizziness, unsteady movement, and sleepiness. Drug efficacy is usually judged against these side effects, ensuring benefits outweigh the potential discomfort.
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Frequently Asked Questions
Can I discontinue Phenytoin without consulting my healthcare provider?
No, you should not stop taking Phenytoin without your healthcare provider's advice. Sudden discontinuation can lead to withdrawal symptoms and recurrence of seizures.
Can I drink alcohol while taking Phenytoin?
Alcohol has the potential to increase the risk of seizures, so it's advisable to limit or avoid alcohol while taking Phenytoin.
Can I have a cup of coffee while on Phenytoin?
Caffeine won't interfere with Phenytoin, but it may contribute to your jitteriness or nervousness. Be mindful of your caffeine intake.
Can Phenytoin affect my mood?
Yes, it can cause mood changes in some people. If you experience marked changes in mood or behavior, inform your healthcare provider immediately.
Can Phenytoin cause weight gain?
Yes, it may cause mild to moderate weight gain in some individuals.
I missed a dose, what should I do?
If it is close to the next dose, skip the missed dose. If there's substantial time before the next dose, take the missed dose as soon as you remember. However, never double up doses.
Comprehensive Drug Guide
How Does Phenytoin Work?
Phenytoin stabilizes neuronal membranes and reduces seizure activity by limiting the rapid, sporadic firing of electrical signals in the brain, which could trigger a seizure.
What is Phenytoin Used For?
FDA indications: Phenytoin is primarily used for the management of seizures and convulsions in patients diagnosed with epilepsy. It's also used to prevent seizures during or after brain surgery.
Offlabel uses: While Phenytoin's primary role is in seizure control, it's also used for neuropathic pain management and arrhythmias in certain cases.
Common Dosages
Capsule: 30mg, 100mg
Chewable tablets: 50mg
Extendedrelease capsules: 30mg, 100mg
Suspension: 125mg/5mL
Injection: 50mg/mL
Typical Dosing
FDA Approved Indications
- For seizures: 5mg/kg per day in 23 divided doses.
- After surgery: Maybe go up to 10mg/kg per day
Off-Label Uses
- For offlabel uses:
- Neuropathic pain: 100200mg per day
- Arrhythmias: The dose varies as per the severity of the condition and the doctor's insight.
Who Shouldn't Take Phenytoin?
- People allergic to Phenytoin
- Individuals suffering from liver disease
- Patients with a history of bone marrow suppression
- Pregnant women, particularly during the first trimester
Advice From The Pharmacist
- Try to take Phenytoin at the same every day to avoid missing a dose and ensure consistent levels in the blood.
- Don't stop your medication suddenly without consulting your doctor first.
- Avoid alcohol as it may increase the risk of seizures.
- Regular exercise helps counteract the side effects of weight gain and mood swings.
- Stay hydrated and maintain a balanced diet to keep your energy levels steady.
Side Effects of Phenytoin
Common Side Effects
- The most common side effects include nausea, dizziness, unsteady movements, and sleepiness.
Uncommon/Severe Side Effects
- Rare side effects:
- On rare occasions, patients may suffer from liver damage, bone marrow suppression, or severe skin reactions.
- Severe side effects:
- In case of severe or persistent side effects, immediately consult your healthcare provider.
Risks and Warnings of Phenytoin
- Phenytoin may not be suitable for everyone, especially those with a history of liver disease or bone marrow suppression. Speak with your healthcare provider if you fall into any of these categories.
- Don't fall pregnant while taking Phenytoin. It's linked to birth defects and is classified as Category D for pregnancy safety.
- Phenytoin may interact with several medications, including omeprazole, fluoxetine, and rifampin. Always discuss other medications you're taking with your healthcare provider to avoid any potential interaction.
- As always, be sure to report any new or worsening symptoms to your healthcare provider promptly.
Interactions with Phenytoin
Common Drug Interactions
- Antifungal medicines like fluconazole
- Proton pump inhibitors like omeprazole
- Antidepressants like fluoxetine
- Antibiotics like rifampin
Alternatives to Phenytoin
- Valproate
- Lamotrigine
- Carbamazepine
- Topiramate
- Levetiracetam
