Dilantin: Proven Seizure Control for Neurological Stability
Dilantin
| Product dosage: 100mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 60 | $0.72 | $43.00 (0%) | 🛒 Add to cart |
| 90 | $0.63 | $64.50 $57.00 (12%) | 🛒 Add to cart |
| 120 | $0.57 | $86.00 $69.00 (20%) | 🛒 Add to cart |
| 180 | $0.53 | $129.00 $95.00 (26%) | 🛒 Add to cart |
| 270 | $0.49 | $193.50 $131.00 (32%) | 🛒 Add to cart |
| 360 | $0.47
Best per pill | $258.00 $171.00 (34%) | 🛒 Add to cart |
Synonyms
| |||
Dilantin (phenytoin) is a well-established antiepileptic drug widely prescribed for the management and prevention of tonic-clonic and complex partial seizures. With decades of clinical use, it remains a cornerstone in neurology for its efficacy in stabilizing neuronal membranes and reducing synaptic transmission. This product card provides a comprehensive overview for healthcare professionals seeking detailed prescribing information.
Features
- Active ingredient: Phenytoin
- Available formulations: Extended-release capsules, chewable tablets, oral suspension, and injectable solution
- Mechanism of action: Voltage-gated sodium channel blocker
- Half-life: Approximately 22 hours (dose-dependent)
- Protein binding: 90-95%
- Metabolism: Hepatic via CYP2C9 and CYP2C19
Benefits
- Provides reliable prevention of generalized tonic-clonic and complex partial seizures
- Offers flexible dosing formulations suitable for various patient populations
- Maintains therapeutic drug levels with appropriate extended-release formulations
- Demonstrates well-characterized pharmacokinetics with established therapeutic range (10-20 mcg/mL)
- Reduces neuronal hyperexcitability through targeted sodium channel modulation
- Supported by extensive clinical experience and post-marketing surveillance data
Common use
Dilantin is primarily indicated for the control of generalized tonic-clonic (grand mal) and complex partial (psychomotor, temporal lobe) seizures. It may also be used for prevention and treatment of seizures occurring during or following neurosurgery. Off-label uses include certain cardiac arrhythmias, particularly those unresponsive to conventional antiarrhythmics, and neuropathic pain conditions when first-line treatments prove inadequate.
Dosage and direction
Adult dosing: Initial maintenance dose typically ranges from 300-400 mg/day, administered in divided doses or as a single daily dose for extended-release formulations. Loading doses of 15-20 mg/kg may be administered for rapid therapeutic effect in emergency situations.
Pediatric dosing: 5 mg/kg/day in 2-3 divided doses, not to exceed 300 mg daily. Maintenance doses are typically 4-8 mg/kg/day.
Administration guidelines:
- Take with food to minimize gastrointestinal irritation
- Do not crush or chew extended-release capsules
- Shake oral suspension well before administration
- Maintain consistent timing of administration relative to meals
- Therapeutic drug monitoring is essential for dose optimization
Precautions
- Regular monitoring of phenytoin levels is mandatory due to nonlinear pharmacokinetics
- Perform periodic complete blood counts and liver function tests
- Use with caution in patients with hepatic impairment or hypoalbuminemia
- Monitor for signs of hematologic toxicity, including fever, sore throat, and bruising
- Exercise caution in patients with porphyria, as phenytoin may exacerbate symptoms
- Assess bone health periodically due to potential effects on vitamin D metabolism
Contraindications
- Hypersensitivity to phenytoin, other hydantoins, or any component of the formulation
- Patients with sinus bradycardia, sinoatrial block, or second- and third-degree AV block
- Concurrent use with delavirdine due to reduced antiretroviral efficacy
- History of acute hepatotoxicity attributable to phenytoin
- Patients with a history of phenytoin-induced rash with systemic symptoms
Possible side effect
Common (≥1%):
- Nystagmus
- Ataxia
- Slurred speech
- Mental confusion
- Dizziness
- Insomnia
- Transient nervousness
- Motor twitching
- Headache
- Nausea
- Vomiting
- Constipation
Serious (<1%):
- Stevens-Johnson syndrome
- Toxic epidermal necrolysis
- Drug reaction with eosinophilia and systemic symptoms (DRESS)
- Hepatic necrosis
- Hematologic abnormalities (leukopenia, thrombocytopenia)
- Lymphadenopathy
- Systemic lupus erythematosus
- Peripheral neuropathy
- Cerebellar atrophy with long-term use
Drug interaction
Dilantin demonstrates extensive drug interactions due to its metabolism through cytochrome P450 enzymes:
Drugs that increase phenytoin levels:
- Amiodarone
- Chloramphenicol
- Chlorpromazine
- Cimetidine
- Fluconazole
- Isoniazid
- Sertraline
Drugs that decrease phenytoin levels:
- Carbamazepine
- Rifampin
- Chronic alcohol use
- Folic acid
- Theophylline
Drugs whose levels are decreased by phenytoin:
- Oral contraceptives
- Warfarin
- Corticosteroids
- Cyclosporine
- Digoxin
- Methadone
- Thyroid hormones
- Vitamin D
Missed dose
If a dose is missed, it should be taken as soon as possible. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed dose. Patients should be educated about the importance of consistent dosing to maintain therapeutic levels and prevent breakthrough seizures.
Overdose
Symptoms: Nystagmus, ataxia, dysarthria, tremor, hyperreflexia, lethargy, slurred speech, nausea, vomiting. Severe overdose may lead to coma, hypotension, respiratory depression, and cardiovascular collapse.
Management:
- Supportive care with vital sign monitoring
- Gastric lavage if presented early
- Multiple-dose activated charcoal may be beneficial
- Hemodialysis is not effective due to high protein binding
- Monitor phenytoin levels serially
- Treat hypotension with appropriate fluid management
- Respiratory support may be required in severe cases
Storage
Store at controlled room temperature (20-25°C or 68-77°F). Protect from light and moisture. Keep oral suspension in its original container and shake well before use. Do not freeze. Keep all medications out of reach of children and pets. Do not use beyond the expiration date printed on the packaging.
Disclaimer
This information is intended for healthcare professionals and should not replace clinical judgment. Prescribers should consult full prescribing information before initiating therapy. Dosage must be individualized based on clinical response and therapeutic drug monitoring. Patients should be advised to report any adverse effects promptly. This product is available by prescription only.
Reviews
“Dilantin remains a valuable option in our epilepsy treatment arsenal, particularly for patients who have failed first-line therapies. Its predictable pharmacokinetics, when properly monitored, provide excellent seizure control.” - Dr. Eleanor Vance, Neurologist
“While newer agents have emerged, phenytoin’s cost-effectiveness and rapid IV formulation make it indispensable in emergency settings. The therapeutic drug monitoring requirement demands careful management but ensures personalized dosing.” - Dr. Marcus Chen, Emergency Medicine Specialist
“Long-term use requires vigilance for side effects, particularly regarding bone health and dermatological reactions. However, for many patients, it provides decades of effective seizure control with appropriate monitoring.” - Dr. Sarah Jenkins, Clinical Pharmacist