If you take phenytoin during pregnancy, your baby is at risk for serious birth defects. RifAMPin: May decrease the serum concentration of Phenytoin. Management: Seek alternatives when possible. Use this medication regularly in order to get the most benefit from it. It is important to take all doses on time to keep the amount of medicine in your body at a constant level. Remember to use it at the same times each day. Dosage is based on your medical condition and response to therapy. TEN, use of this drug should not be resumed and alternative therapy should be considered. If a rash occurs, the patient should be evaluated for signs and symptoms of Drug Reaction with Eosinophilia and Systemic Symptoms see below.
Johnston, G. A. The specificity of strychnine as a glycine antagonist in the mammalian spinal cord. ARIPiprazole: CYP3A4 Inducers Strong may decrease the serum concentration of ARIPiprazole. Management: Double the oral aripiprazole dose and closely monitor. Carcinogenesis: See for information on carcinogenesis. Patients, their caregivers, and families should be counseled that AEDs, including phenytoin sodium, 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.
How should I take phenytoin Dilantin? Taking this medication after your evening meal or at may help if you have upset or with the medication. You may choose to take this medication at another time of day that is easier for you to remember. No matter what dosing schedule you use, it is very important that you take this medication at the same time each day, 24 hours apart. Ask your doctor or pharmacist if you have any questions. Doxycycline: Phenytoin may decrease the serum concentration of Doxycycline. Advise patients not to use capsules which are discolored.
The answer was very good. The comment was weak. Do not stop taking phenytoin without first talking to your healthcare provider. Stopping phenytoin suddenly can cause serious problems. Phenytoin may cause harm to the fetus. If you may become pregnant, discuss other possible treatment options with your doctor. If a decision is made to take phenytoin, use effective birth control while you are taking it. Talk with your doctor if you are planning to become pregnant, or if you have questions or concerns about this information. The cause of the interaction is not known. Contact your doctor if these problems occur.
Dronabinol: CYP3A4 Inducers Strong may decrease the serum concentration of Dronabinol. It is very important to continue taking this medication exactly as prescribed by your doctor. Intravenous administration should not exceed 50 mg per minute in adults. Wear medical alert jewelry or carry a card that says you take Dilantin. Ask where to get these items. What should I do if I think I or someone I know took too much Dilantin? Phenytoin is not effective for absence seizures. Abrupt withdrawal of phenytoin in epileptic patients may precipitate status epilepticus. When, in the judgment of the clinician, the need for dosage reduction, discontinuation, or substitution of alternative antiepileptic medication arises, this should be done gradually. However, in the event of an allergic or hypersensitivity reaction, rapid substitution of alternative therapy may be necessary. In this case, alternative therapy should be an antiepileptic drug not belonging to the hydantoin chemical class. ABCB1 Inducers may decrease the serum concentration of Ledipasvir. Caspofungin: Inducers of Drug Clearance may decrease the serum concentration of Caspofungin. This product can affect the results of certain lab tests. Make sure laboratory personnel and your doctors know you use this drug. Individual drug package inserts should be consulted. Naloxegol: CYP3A4 Inducers Strong may decrease the serum concentration of Naloxegol. Advise patients of the early toxic signs and symptoms of potential hematologic, dermatologic, hypersensitivity, or hepatic reactions.
Patients should be encouraged to enroll in the North American Antiepileptic Drug NAAED Pregnancy Registry if they become pregnant. This registry is collecting information about the safety of antiepileptic drugs during pregnancy. Tetrahydrocannabinol: May enhance the CNS depressant effect of CNS Depressants. Dilantin 30 mg extended capsules are available as a size 4 hemispherical Coni-Snap capsule with a white opaque body and pale pink opaque cap containing a white powder. Capsule is imprinted with black rectified radial print, "PD" on cap and "Dilantin 30 mg" on body. Suspension: Shake well prior to use; measure and administer dose using a calibrated oral dosing syringe or other accurate dose-measuring device. Absorption is impaired when phenytoin suspension is given concurrently to patients who are receiving continuous nasogastric feedings. A method to resolve this interaction is to divide the daily dose of phenytoin and withhold the administration of nutritional supplements for 1 to 2 hours before and after each phenytoin dose. The manufacturer recommends not to administer concomitantly with an enteral feeding preparation. Accordingly, at the first sign of acute toxicity, plasma levels are recommended. Dose reduction of phenytoin therapy is indicated if plasma levels are excessive; if symptoms persist, termination is recommended. See section. Busulfan: Phenytoin may decrease the serum concentration of Busulfan. ABCB1 Inducers may decrease the serum concentration of Dabigatran Etexilate. Management: Avoid concurrent use of dabigatran with p-glycoprotein inducers when possible. Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. CAPSULES, call your healthcare provider or local Poison Control Center right away. At first, 100 milligrams mg three times a day or 300 mg once a day. Your doctor may increase your dose as needed. For patients in the clinic or hospital except with a history of liver or kidney disease a loading dose of 1000 mg is divided into three doses 400 mg, 300 mg, 300 mg and given every 2 hours. Then, normal maintenance dose may be started 24 hours after the loading dose. The precise mechanism by which phenytoin exerts its therapeutic effect has not been established but is thought to involve the voltage-dependent blockade of membrane sodium channels resulting in a reduction in sustained high-frequency neuronal discharges. Lymph nodes may remain swollen or firm long after an initial infection is gone. This is especially true in children, whose glands may decrease in size while remaining firm and visible for many weeks. If you or your child develop a skin rash, hives, or any allergic reaction to phenytoin, check with your doctor as soon as possible. Table 3 includes commonly occurring drug interactions affected by phenytoin. However, this list is not intended to be inclusive or comprehensive. Individual drug package inserts should be consulted.
Macitentan: CYP3A4 Inducers Strong may decrease the serum concentration of Macitentan. Phenytoin serum level determinations may be necessary to achieve optimal dosage adjustments. Ticagrelor: CYP3A4 Inducers Strong may decrease serum concentrations of the active metabolites of Ticagrelor. CYP3A4 Inducers Strong may decrease the serum concentration of Ticagrelor. Enzalutamide: CYP3A4 Inducers Strong may decrease the serum concentration of Enzalutamide. Management: Consider using an alternative agent that has no or minimal CYP3A4 induction potential when possible. If this combination cannot be avoided, increase the dose of enzalutamide from 160 mg daily to 240 mg daily. IM: Avoid IM administration due to severe risk of local tissue destruction and necrosis; use fosphenytoin if IM administration necessary Boucher 1996; Meek 1999. ABCB1 Inducers may decrease the serum concentration of Sofosbuvir. CAPSULES can slow your thinking and motor skills.
Phenytoin is contraindicated in patients with a history of hypersensitivity to hydantoin products. Acetaminophen: Fosphenytoin-Phenytoin may decrease the serum concentration of Acetaminophen. Specifically, serum concentrations of acetaminophen may be decreased leading to decreased efficacy but the formation of the toxic N-acetyl-p-benzoquinone imine NAPQI metabolite may be increased leading to increased hepatotoxicity. There are many drugs which may increase or decrease phenytoin levels or which phenytoin may affect. Serum level determinations for phenytoin are especially helpful when possible drug interactions are suspected. Maintenance dose: 100 mg 3 to 4 times daily, doses up to 200 mg 3 times a day may be necessary. F; do not freeze. Protect from light. 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. Doxofylline: Fosphenytoin-Phenytoin may decrease the serum concentration of Doxofylline. Keep all follow-up visits with your healthcare provider as scheduled. Call your healthcare provider between visits as needed, especially if you are worried about symptoms. Reboxetine: CYP3A4 Inducers Strong may decrease the serum concentration of Reboxetine. Dilantin can be given diluted with normal saline. Check with your doctor before you drink alcohol while you are taking phenytoin suspension. Alcohol may increase or decrease the amount of medicine in your blood. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions.
Phenytoin is an anti-epileptic drug, also called an anticonvulsant. It works by slowing down impulses in the brain that cause seizures. The dose in pediatric patients is not known. Only DILANTIN extended phenytoin sodium capsules, USP are recommended for once-a-day dosing. Vitamin K Antagonists eg, warfarin: Phenytoin may enhance the anticoagulant effect of Vitamin K Antagonists. Vitamin K Antagonists may increase the serum concentration of Phenytoin. Management: Anticoagulant dose adjustment will likely be necessary when phenytoin is initiated or discontinued. It has been reported in the literature that the plasma clearance of phenytoin generally increased during pregnancy, reached a peak in the third trimester and returned to the level of pre-pregnancy after few weeks or months of delivery.
Phenytoin passes into milk. Consult your doctor before -feeding. Take phenytoin only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. Leucovorin Calcium-Levoleucovorin: May decrease the serum concentration of Phenytoin. Cobicistat: Fosphenytoin-Phenytoin may decrease the serum concentration of Cobicistat. Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk. Lofexidine: May enhance the CNS depressant effect of CNS Depressants. CYP2C9 Substrates: CYP2C9 Inducers Strong may increase the metabolism of CYP2C9 Substrates. Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling. There were four suicides in drug-treated patients in the trials and none in placebo-treated patients, but the number is too small to allow any conclusion about drug effect on suicide. The drop is caused by slower absorption, as compared to oral administration, due to the poor water solubility of phenytoin. Intravenous administration is the preferred route for producing rapid therapeutic serum levels. Special Senses: Altered taste sensation including metallic taste. RomiDEPsin: CYP3A4 Inducers Strong may decrease the serum concentration of RomiDEPsin. CAPSULES or breastfeed. You should not do both. Sukul, A. Strychnos nux-vomica extract and its ultra-high dilution reduce voluntary ethanol intake in rats. Phenytoin suspension may cause harm to the fetus. If you may become pregnant, discuss other possible treatment options with your doctor. If a decision is made to take phenytoin suspension, use effective birth control while you are taking it. Talk with your doctor if you are planning to become pregnant, or if you have questions or concerns about this information. How should I take Dilantin?
Status epilepticus injection only: Treatment of generalized tonic-clonic status epilepticus. Instruct patients to take phenytoin only as prescribed. If administration of Phenytoin Sodium Injection does not terminate seizures, the use of other anticonvulsants, intravenous barbiturates, general anesthesia and other appropriate measures should be considered. Maalox, Mylanta, Tums, others. Your doctor may tell you to allow some time to pass between taking the antacid and taking phenytoin. Isavuconazonium Sulfate: CYP3A4 Inducers Strong may decrease serum concentrations of the active metabolites of Isavuconazonium Sulfate. Specifically, CYP3A4 Inducers Strong may decrease isavuconazole serum concentrations. Al Sharpton: "Not even Putin can withstand our signature chanting, 'racist, sexist, anti-gay, Russian army go away'! This virus attacks the immune system, making it difficult for the body to fight off infection and some disease. Serious and sometimes fatal dermatologic reactions, including toxic epidermal necrolysis TEN and Stevens-Johnson syndrome SJS have been reported with phenytoin treatment. The onset of symptoms is usually within 28 days, but can occur later. Dilantin should be discontinued at the first sign of a rash, unless the rash is clearly not drug-related. Your dosage may have to be adjusted. Store phenytoin suspension at room temperature, between 68 and 77 degrees F 20 and 25 degrees C. Do not freeze. Store away from heat, moisture, and light. Do not store in the bathroom. Keep phenytoin suspension out of the reach of children and away from pets. CAPSULES while you are pregnant. Dosage should be individualized to provide maximum benefit.
Women who take phenytoin may experience an increase in seizure activity if they become pregnant. Discuss any questions or concerns with your doctor. If you think you may be pregnant, contact your doctor. Are breast feeding or plan to breastfeed. Phenytoin can pass into breast milk. You and your healthcare provider should decide if you will take phenytoin while you are breastfeeding. Paliperidone: Inducers of CYP3A4 Strong and P-glycoprotein may decrease the serum concentration of Paliperidone. Management: Avoid using the 3-month extended-release injectable suspension Invega Trinza with inducers of both CYP3A4 and P-glycoprotein during the 3-month dosing interval if possible. If combination is necessary, consider using extended-release tablets. Estriol Systemic: CYP3A4 Inducers Strong may decrease the serum concentration of Estriol Systemic. Orphenadrine: CNS Depressants may enhance the CNS depressant effect of Orphenadrine. Drugs which may either increase or decrease phenytoin serum levels include: phenobarbital, sodium valproate, and valproic acid. Similarly, the effect of phenytoin on phenobarbital, valproic acid, and sodium valproate serum levels is unpredictable. Phenytoin may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. These medicines can change the levels of Dilantin in your blood. Use phenytoin as directed by your doctor. Check the label on the medicine for exact dosing instructions. If you have diabetes, this drug may increase your blood sugar levels. Check your blood or urine glucose level frequently, as directed by your doctor. Promptly report any abnormal results as directed. Your medicine, exercise plan, or diet may need to be adjusted. Glands in the axillary lymph nodes may swell from an injury or infection to the arm or hand. When appropriate, counsel pregnant women and women of childbearing potential about alternative therapeutic options. Prophylactic dosage-100 to 200 mg 2 to 4 mL intramuscularly at approximately 4-hour intervals during surgery and continued during the postoperative period. Do not drink alcohol while you take Dilantin without first talking to your healthcare provider. Drinking alcohol while taking Dilantin may change your blood levels of Dilantin which can cause serious problems.
How are swollen lymph nodes treated? Some of these people developed suicidal thoughts and behavior as early as one week after they started taking the medication. There is a risk that you may experience changes in your mental health if you take an anticonvulsant medication such as phenytoin, but there may also be a risk that you will experience changes in your mental health if your condition is not treated. You and your doctor will decide whether the risks of taking an anticonvulsant medication are greater than the risks of not taking the medication. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: panic attacks; agitation or restlessness; new or worsening irritability, anxiety, or depression; acting on dangerous impulses; difficulty falling or staying asleep; aggressive, angry, or violent behavior; mania frenzied, abnormally excited mood; talking or thinking about wanting to hurt yourself or to end your life; withdrawing from friends and family; preoccupation with death and dying; giving away prized possessions; or any other unusual changes in behavior or mood. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own. If you take Dilantin during pregnancy, your baby is also at risk for bleeding problems right after birth. Your healthcare provider may give you and your baby medicine to prevent this. Do NOT take more than the recommended dose or change your dose without checking with your doctor. Hypotension does occur when the drug is administered rapidly by the intravenous route. Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose. Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Wolters Kluwer Health and Drugs. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Diabetes: Use with caution in patients with diabetes mellitus; phenytoin may inhibit insulin release and increase serum glucose in patients with diabetes. Susan Sarandon: "I don't vote with my vagina. Zonisamide: Phenytoin may decrease the serum concentration of Zonisamide. Amiodarone: Phenytoin may decrease the serum concentration of Amiodarone. Amiodarone may increase the serum concentration of Phenytoin.
Use with caution. May make these conditions worse. Tell your doctor if this medicine does not seem to work as well in treating your condition. Nisoldipine: CYP3A4 Inducers Strong may decrease the serum concentration of Nisoldipine. Methemoglobinemia Associated Agents. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Patients should consult with their physicians to weigh the risks and benefits of phenytoin during pregnancy. Patients who have received no previous treatment may be started on one 100-mg Dilantin Extended Phenytoin Sodium Capsule three times daily and the dosage then adjusted to suit individual requirements. For most adults, the satisfactory maintenance dosage will be one capsule three to four times a day. An increase up to two capsules three times a day may be made, if necessary. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you, your child, or your caregiver notice any of these side effects, tell your or your child's doctor right away. Fluorouracil Systemic: May increase the serum concentration of Phenytoin. Propacetamol: Fosphenytoin-Phenytoin may decrease serum concentrations of the active metabolites of Propacetamol. Specifically, serum concentrations of acetaminophen may be decreased leading to decreased efficacy but the formation of its toxic N-acetyl-p-benzoquinone imine NAPQI metabolite may be increased leading to increased hepatotoxicity. If you become pregnant while taking phenytoin, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of phenytoin on the baby. Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first. This information should not be used to decide whether or not to take phenytoin suspension or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about phenytoin suspension. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to phenytoin suspension. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using phenytoin suspension.
No. 3 capsules with a white, opaque body and a medium orange cap containing a white powder. Capsule is imprinted with black rectified radial print, "PD" on cap and "Dilantin 100 mg" on body. At first, 5 milliliters mL or one teaspoonful three times a day. Your doctor may adjust your dose as needed. Counsel patients that phenytoin may cause dizziness, gait disturbance, decreased coordination and somnolence. Advise patients taking phenytoin not to drive, operate complex machinery, or engage in other hazardous activities until they have become accustomed to any such effects associated with phenytoin. Most of the drug is excreted in the bile as inactive metabolites which are then reabsorbed from the intestinal tract and excreted in the urine. Urinary excretion of phenytoin and its metabolites occurs partly with glomerular filtration but, more importantly, by tubular secretion. Toremifene: CYP3A4 Inducers Strong may decrease the serum concentration of Toremifene. US FDA pregnancy category D: There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Pyridoxine: May increase the metabolism of Phenytoin. Chewable tablets: May chew thoroughly before swallowing or swallow whole. Trabectedin: CYP3A4 Inducers Strong may decrease the serum concentration of Trabectedin. Most important. A change in your diet, medicine, or dosage is likely to be necessary. Promptly consult your doctor or pharmacist. Nelfinavir: May decrease the serum concentration of Phenytoin. Phenytoin may decrease the serum concentration of Nelfinavir. Ixazomib: CYP3A4 Inducers Strong may decrease the serum concentration of Ixazomib. Prenatal exposure to this drug may increase the risks for congenital malformations and other adverse developmental outcomes. Increased frequencies of major malformations such as orofacial clefts and cardiac defects minor anomalies dysmorphic facial features, nail and digit hypoplasia growth abnormalities including microcephaly and mental deficiency have been reported among children born to epileptic women who took this drug alone or in combination with other antiepileptic drugs during pregnancy. Cai, B. C. Analgesic and anti-inflammatory properties of brucine and brucine N-oxide extracted from seeds of Strychnos nux-vomica. J Ethnopharmacol. Elvitegravir: Fosphenytoin-Phenytoin may decrease the serum concentration of Elvitegravir. You may experience an increased chance for bleeding, including bleeding from your gums, nosebleeds, unusual bruising, or dark stools, or an increased chance for clotting. US Media: Can Pope Francis possibly clear up Vatican bureaucracy and banking without blaming the previous administration?
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Acute alcoholic intake may increase phenytoin serum levels while chronic alcoholic use may decrease serum levels. The overall incidence of neonate malformations for offspring of mothers treated with anti-seizure medications is approximately 10%, or 2 to 3 fold the incidence in the general population although a definite causal relationship has not been established. Some MEDICINES MAY INTERACT with phenytoin suspension. Abrupt withdrawal of phenytoin in epileptic patients may precipitate status epilepticus. When, in the judgment of the clinician, the need for dosage reduction, discontinuation, or substitution of alternative anticonvulsant medication arises, this should be done gradually. However, in the event of an allergic or hypersensitivity reaction, more rapid substitution of alternative therapy may be necessary. In this case, alternative therapy should be an anticonvulsant drug not belonging to the hydantoin chemical class.
Your pharmacist can provide more information about phenytoin. The patient should be advised that, because these signs and symptoms may signal a serious reaction, they should report any occurrence immediately to a physician even if mild or when occurring after extended use. Venetoclax: CYP3A4 Inducers Strong may decrease the serum concentration of Venetoclax. Folic Acid: May decrease the serum concentration of Phenytoin.
Brentuximab Vedotin: CYP3A4 Inducers Strong may decrease the serum concentration of Brentuximab Vedotin. Specifically, concentrations of the active monomethyl auristatin E MMAE component may be decreased. Check your blood or urine glucose level frequently, as directed by your doctor. Promptly report any abnormal results as directed. While using phenytoin, you may need frequent blood tests. You may also need a blood test when switching from one form of phenytoin to another. Visit your doctor regularly. You should not become pregnant while you are taking phenytoin. Talk to your doctor about effective birth control methods that you can use during your treatment. If you become pregnant while taking phenytoin, call your doctor. Phenytoin may harm the fetus.
Calcifediol: CYP3A4 Inducers Strong may decrease the serum concentration of Calcifediol. Tropisetron: CYP3A4 Inducers Strong may decrease the serum concentration of Tropisetron. Rufinamide: May increase the serum concentration of Phenytoin. Phenytoin may decrease the serum concentration of Rufinamide. Therefore, it is very important that you follow the package instructions to find the first tablet, start with the first tablet in the pack, and take them in the correct order. Do not skip any doses. is more likely if you miss pills, start a new pack late, or take your pill at a different time of the day than usual.