WebSite Denver: Dilantin-30

Generic Name: phenytoin (Oral route)

FEN-i-toin

Commonly used brand name(s)

In the U.S.

Dilantin

Dilantin-125

Dilantin Infatabs

Dilantin Kapseals

Diphen

Phenytek

In Canada

Dilantin-30

Available Dosage Forms:

Suspension

Tablet, Chewable

Capsule, Extended Release

Capsule

Therapeutic Class: Anticonvulsant

Chemical Class: Hydantoin (class)

Uses For Dilantin-30

Phenytoin is used to control seizures (convulsions) in the treatment of epilepsy. It is also used to prevent and treat seizures that occur during brain surgery. This medicine is an anticonvulsant that works in the brain tissue to stop seizures.

This medicine is available only with your doctor's prescription.

Before Using Dilantin-30

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of phenytoin in children.

Geriatric

No information is available on the relationship of age to the effects of phenytoin in geriatric patients. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require an adjustment in the dose for patients receiving phenytoin.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	D	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.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Boceprevir

Delavirdine

Nifedipine

Praziquantel

Ranolazine

Rilpivirine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Abiraterone

Apazone

Beclamide

Bortezomib

Cabazitaxel

Crizotinib

Dasatinib

Dronedarone

Erlotinib

Etravirine

Everolimus

Ezogabine

Imatinib

Infliximab

Irinotecan

Ixabepilone

Ketorolac

Lapatinib

Lidocaine

Linagliptin

Lopinavir

Maraviroc

Methotrexate

Naproxen

Nilotinib

Posaconazole

Rivaroxaban

Roflumilast

Romidepsin

St John's Wort

Sunitinib

Tacrolimus

Temsirolimus

Ticagrelor

Tolvaptan

Vandetanib

Vemurafenib

Voriconazole

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acetaminophen

Acetazolamide

Acyclovir

Amiodarone

Amitriptyline

Amprenavir

Aprepitant

Atorvastatin

Betamethasone

Bexarotene

Bleomycin

Busulfan

Capecitabine

Carbamazepine

Carboplatin

Caspofungin

Chloramphenicol

Cimetidine

Ciprofloxacin

Cisplatin

Clarithromycin

Clobazam

Clofazimine

Clopidogrel

Clozapine

Colesevelam

Cortisone

Cyclosporine

Desogestrel

Dexamethasone

Diazepam

Dicumarol

Dienogest

Digitoxin

Diltiazem

Disopyramide

Disulfiram

Doxepin

Doxorubicin Hydrochloride

Drospirenone

Estradiol Cypionate

Estradiol Valerate

Ethinyl Estradiol

Ethosuximide

Ethynodiol Diacetate

Etonogestrel

Felbamate

Fentanyl

Fluconazole

Fludrocortisone

Fluorouracil

Fluoxetine

Fluvoxamine

Folic Acid

Fosamprenavir

Gefitinib

Ginkgo

Ibuprofen

Imipramine

Isoniazid

Itraconazole

Levodopa

Levomethadyl

Levonorgestrel

Levothyroxine

Medroxyprogesterone Acetate

Meperidine

Mestranol

Methoxsalen

Methsuximide

Miconazole

Midazolam

Nafimidone

Nelfinavir

Nilutamide

Nisoldipine

Norelgestromin

Norethindrone

Norgestimate

Norgestrel

Oxcarbazepine

Paclitaxel

Pancuronium

Paroxetine

Phenprocoumon

Piperine

Prednisolone

Prednisone

Progabide

Quetiapine

Quinidine

Quinine

Remacemide

Rifampin

Rifapentine

Risperidone

Ritonavir

Rufinamide

Sabeluzole

Sertraline

Shankhapulshpi

Simvastatin

Sirolimus

Sulfamethizole

Sulfaphenazole

Sulthiame

Telithromycin

Tenidap

Theophylline

Tiagabine

Ticlopidine

Ticrynafen

Tirilazad

Tizanidine

Tolbutamide

Topiramate

Trazodone

Triamcinolone

Trimethoprim

Tubocurarine

Valproic Acid

Vecuronium

Verapamil

Vigabatrin

Viloxazine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Enteral Nutrition

Ethanol

Proper Use of phenytoin

This section provides information on the proper use of a number of products that contain phenytoin. It may not be specific to Dilantin-30. Please read with care.

Take this medicine 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.

This medicine may be used with other seizure medicines. Keep using all of your seizure medicines unless your doctor tells you to stop.

Do not change brands or dosage forms of phenytoin without first checking with your doctor. Different products may not work the same way. If you refill your medicine and it looks different, check with your pharmacist.

Swallow the tablet whole or chew it thoroughly before being swallowed together with a glass of water.

Measure the oral suspension with a marked measuring spoon, oral syringe, or medicine cup. Rinse the dosing spoon or cup with water after each use.

If you are receiving tube feeding preparations, it is best to take this medicine before or after a feeding.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For seizures:
- For oral dosage form (extended-release capsules):
  - Adults—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 two hours. Then, normal maintenance dose may be started 24 hours after the loading dose.
  - Teenagers and children above 6 years of age—300 mg per day. Your doctor may increase your dose as needed.
  - Children 6 years of age and below—Dose is based on body weight and must be determined by your doctor. At first, 5 milligrams (mg) per kilogram (kg) of body weight given in two or three divided doses per day. The doctor may adjust the dose as needed.
- For oral dosage form (suspension):
  - Adults—At first, 5 milliliters (mL) or 125 milligrams (mg) three times a day. Your doctor may increase your dose as needed.
  - Teenagers and children above 6 years of age—300 milligrams (mg) per day. Your doctor may increase your dose as needed.
  - Children 6 years of age and below—Dose is based on age and body weight and must be determined by your doctor. At first, 5 milligrams (mg) per kilogram (kg) of body weight given in two or three divided doses per day. Your doctor may adjust your dose as needed.
- For oral dosage form (tablets):
  - Adults—At first, 100 milligrams (mg) three times a day. Your doctor may increase your dose as needed.
  - Teenagers and children above 6 years of age—300 milligrams (mg) per day, given in two or three divided doses per day. Your doctor may increase your dose as needed.
  - Children 6 years of age and below—Dose is based on age and body weight and must be determined by your doctor. At first, 5 milligrams (mg) per kilogram (kg) of body weight given in two or three divided doses per day. The doctor may adjust the dose as needed.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Dilantin-30

It is very important that your doctor check your progress at regular visits while you are using this medicine to see if it is working properly and to allow for a change in the dose. Blood tests may be needed to check for any unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away. Your doctor may want you to join a pregnancy registry for patients taking a seizure medicine.

Lymph node problems may occur while using this medicine. Check with your doctor right away if you have swollen, painful, or tender lymph glands in your neck, armpit, or groin.

Do not stop taking this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping completely.

If you develop a skin rash, hives, or any allergic reaction to this medicine, stop taking the medicine and check with your doctor as soon as possible.

This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.

This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. 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 doctor or your child's doctor right away.

In some patients (usually younger patients), tenderness, swelling, or bleeding of the gums (gingival hyperplasia) may appear soon after phenytoin treatment is started. To help prevent this, brush and floss your teeth carefully and regularly and massage your gums. Also, see your dentist every 6 months to have your teeth cleaned. If you have any questions about how to take care of your teeth and gums, or if you notice any tenderness, swelling, or bleeding of your gums, check with your doctor or dentist.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.

Avoid drinking alcohol while you are receiving this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Dilantin-30 Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Decreased coordination

mental confusion

nervousness

slurred speech

trouble with breathing, speaking, or swallowing

unsteadiness, trembling, or other problems with muscle control or coordination

Rare

Inability to move the eyes

increased blinking or spasms of the eyelid

shakiness and unsteady walk shakiness in the legs, arms, hands, or feet

sticking out of the tongue

trembling or shaking of the hands or feet

twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs

uncontrolled twisting movements of the neck, trunk, arms, or legs

unusual facial expressions

Incidence not known

Abdominal or stomach pain

bleeding gums

blistering, peeling, or loosening of the skin

blisters, hives, or itching

bloating of the abdomen or stomach

blood in the urine or stools

bloody, black, or tarry stools

chest pain

chills

cough or hoarseness

dark urine

diarrhea

difficulty with moving

fainting spells

fever with or without chills

general feeling of discomfort or illness

general feeling of tiredness or weakness

hair loss

headache

high fever

irregular heartbeat

irritation in the mouth

joint or muscle pain

light-colored stools

lower back or side pain

muscle stiffness

nausea or vomiting

numbness, tingling, or pain in the hands or feet

painful or difficult urination

pale skin

pinpoint red spots on the skin

red skin lesions, often with a purple center

red, irritated eyes

redness and swelling of the gums

shortness of breath or troubled breathing

skin blisters

skin rash

sore throat

sores, ulcers, or white spots on the lips or in the mouth

swollen glands

swollen, painful, or tender lymph glands in the neck, armpit, or groin

unexplained bleeding or bruising

unusual bleeding or bruising

unusual tiredness

upper right abdominal pain

weakness

weight loss

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Sleeplessness

trouble with sleeping

unable to sleep

uncontrolled eye movements

Incidence not known

Difficulty having a bowel movement (stool)

enlarged lips

increased hair growth on the forehead, back, arms, or legs

pain of penis on erection

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Dilantin-30 side effects (in more detail)

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More Dilantin-30 resources

Dilantin-30 Side Effects (in more detail)
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Dilantin-30 Support Group
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Friday, October 14, 2016

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