Dilantin (Phenytoin Sodium)

Indications

Dilantin, known by its generic name, phenytoin sodium, is a prescription medication used to treat and control certain types of seizures in people with epilepsy. It belongs to a group of drugs known as anticonvulsants. It works by reducing abnormal electrical activity in the brain.

Phenytoin is indicated for the control of tonic-clonic (grand mal) and psychomotor (temporal lobe) seizures. It has been used for over 50 years and is considered one of the most effective treatments for controlling epileptic seizures.

Uses and Dosage

Dilantin comes in the form of extended-release capsules and chewable tablets taken orally. The extended-release capsules typically are prescribed once daily or in divided doses, depending on the directions of your physician. Swallow the capsule whole and drink a full glass of water right after. Do not chew or split the capsules.

• The typical dosing for phenytoin for adult is to start the dose from 1 capsule (100 mg) by mouth 3 times a day, up to a maximum of 2 capsules (200 mg) by mouth 3 times a day;
• For Children starting dose of 5 mg/kg by mouth per day, up to a maximum of 300 mg per day. For long-term dosing, 4 mg/kg to 8 mg/kg per day is typically used. Your provider will adjust the dose based on blood levels of the medication.

The chewable tablet is usually taken two to three times a day, depending on the directions of your physician. It is important to take this medication as prescribed, as missing doses or taking it too frequently can lead to an increased risk of side effects. It is best to take this medication with a meal to avoid stomach upset.

• The recommended dosage of phenytoin tablets is 100 mg taken orally three times a day. Tablets can be chewed thoroughly before swallowing, or swallowed whole with water.

Side effect

Common Side Effects of Phenytoin Sodium:

• Nausea
• Headache
• Dizziness
• Feeling of spinning
• Drowsiness
• Vomiting
• Insomnia or trouble sleeping
• Nervousness
• Constipation
• Swelling or bleeding of the gums

Serious Side Effects of Phenytoin Sodium:

• High blood sugar levels
• Slow heartbeat
• Unusual eye movements
• Loss of coordination
• Trouble speaking
• Confusion
• Muscle twitching
• Double or blurred vision
• Facial changes
• Tingling of extremities
• Excessive hair growth
• Unusual tiredness
• Increased thirst or urination
• Bone or joint pain
• Easy bruising or bleeding
• Mental or mood changes

Form and strength

Dilantin (Phenytoin Sodium) is available in the following forms and strength:

Dilantin: ER (Extended Release) Capsule

• 30mg
• 100mg

Phenytoin Sodium: Tablet

• 100 mg

Caution

• Abrupt withdrawal of phenytoin in epileptic patients may precipitate status epilepticus, so when the need arises to reduce the dosage, discontinue it, or substitute an alternative anticonvulsant medication, this should be done gradually by discussing with your doctor.
• In the case of an allergic or hypersensitivity reaction, substitute the anticonvulsant with one not belonging to the hydantoin chemical class more rapidly.
• Taking antiepileptic drugs (AEDs) such as Dilantin can increase the risk of suicidal thoughts or behavior in patient, as early as one week after beginning the medication. Therefore, you need to get monitoring by your doctor.
• You should not take Dilantin if you are also taking delavirdine (Rescriptor), or if you are allergic to phenytoin, ethotoin (Peganone), fosphenytoin (Cerebyx), or mephenytoin (Mesantoin). Taking Dilantin alongside delavirdine, or if you have an allergy to any of the other medications mentioned, can be dangerous and should be avoided.
• If you are pregnant, do not start taking Dilantin unless your doctor tells you to. Phenytoin may cause harm to an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby.
• If you become pregnant while taking Dilantin, do not stop taking the medicine without your doctor's advice. Seizure control is especially important during pregnancy and the benefits of preventing seizures may outweigh any risks posed by using phenytoin.
• Dilantin may make you dizzy or drowsy. Do not drive, use machinery, or do anything that requires alertness until you can do it safely. Avoid alcohol and marijuana (cannabis) and talk to your doctor if you are using marijuana. Alcohol may also affect the blood levels of this drug.

Frequently Asked Questions (FAQ)

How do I take Dilantin?

Dilantin should be taken exactly as prescribed by your doctor. It is usually taken once or twice a day, with or without food.

How long does it take for phenytoin (Dilantin) to start working?

It takes about 7 to 10 days for the levels of phenytoin in your body to stabilize (reach "steady state") at a normal starting dose. Then your provider will gradually increase the dose to an appropriate amount. It can take up to 4 weeks before you start to feel the full benefit of this drug.

Is phenytoin (Dilantin) an addictive medication?

No, this medication has not been shown to be addictive. It also does not produce a "high" feeling.

Resources

• https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/008762s055,010151s042lbl.pdf
• https://medlineplus.gov/druginfo/meds/a682022.html
• https://www.webmd.com/drugs/2/drug-4157/dilantin-oral/details
• https://www.dilantin.com/
• https://www.drugs.com/dilantin.html
• https://www.goodrx.com/phenytoin/what-is