Dilantin is a medication with the active ingredient phenytoin. It is also known by other names such as Phenytek and Epanutin. Dilantin is used to control seizures in people with epilepsy. It helps to stabilize electrical activity in the brain.
The fiscal range for Dilantin stands at £0.39 to £0.58 per pills. The crux of the pricing revolves around pack dimensions and ingredient quality (60 or 360 mg).
The active ingredient in Dilantin is phenytoin, an antiepileptic drug. Phenytoin stabilizes neuronal membranes by increasing efflux or decreasing influx of sodium ions across cell membranes during the generation of nerve impulses.
Phenytoin is absorbed slowly from the gastrointestinal tract, with a bioavailability range of 70% to 100%. Peak serum levels typically occur within 4 to 12 hours after oral administration. It is highly protein-bound, primarily to albumin, and has a half-life of 22 hours on average.
Dilantin is available in several dosage forms including extended-release capsules, chewable tablets, and an injectable solution. The extended-release capsules come in strengths of 30 mg and 100 mg, while chewable tablets are 50 mg each.
Dilantin is primarily indicated for the control of generalized tonic-clonic seizures and complex partial seizures. It is also used in the prevention and treatment of seizures occurring during or following neurosurgery and other surgical procedures involving the central nervous system.
Dilantin works by selectively inhibiting the hyperexcitability of neurons that cause seizures. This inhibition occurs mainly through voltage-dependent blockade of sodium channels, which stabilizes the threshold against hyperexcitability.
Administer Dilantin consistently with respect to time and in relation to meals to maintain stable drug levels. Swallow extended-release capsules whole; do not crush or chew. Chewable tablets should be chewed completely before swallowing.
Common side effects of Dilantin include dizziness, drowsiness, and coordination problems. Gastrointestinal symptoms such as nausea and vomiting may also occur. Side effects often diminish as the body adjusts to the medication.
Dilantin has a broad interaction profile with other medications. It can reduce the efficacy of oral contraceptives, and concomitant use with other antiepileptic drugs can influence phenytoin levels. Caution is advised when combining with warfarin, as it may alter anticoagulant effects.
Regular monitoring of phenytoin plasma levels is essential to ensure therapeutic effectiveness and avoid toxicity. Therapeutic levels generally range from 10 to 20 micrograms/ml. Adjustments in dosage may be required based on blood level results.
Use of Dilantin during pregnancy demands careful consideration, due to potential risks to the fetus. Phenytoin can cross the placental barrier and is associated with congenital malformations. Risk-benefit analysis is crucial.
Store Dilantin at room temperature, away from light and moisture. Keep out of reach of children. Ensure that the container is tightly closed when not in use to maintain medication efficacy.
If a dose of Dilantin is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. Avoid doubling up on doses to compensate for the missed one.
The effectiveness of Dilantin may be reduced by certain factors including chronic alcohol consumption, which can induce the metabolism of phenytoin. Hepatic enzyme inducers such as rifampin may also decrease phenytoin levels.
In the event of an overdose, symptoms can include nystagmus, ataxia, and lethargy. Immediate medical attention is required. Treatment of phenytoin overdose typically involves supportive care and possibly activated charcoal if presented within a short timeframe.
Patients should be advised on the importance of adherence to the prescribed dosage regimen and the potential for side effects. They should also be made aware of the signs of toxicity and instructed to report any unusual symptoms promptly to their healthcare provider.
Before starting Dilantin, the healthcare provider should be informed of any history of allergies, especially to phenytoin or other hydantoins. Patients with a history of liver disease, blood disorders, or porphyria should inform the physician, as these conditions may affect therapy.
Patients on long-term Dilantin therapy may experience cognitive impairment, including issues with memory, attention, and problem-solving. These effects should be monitored periodically by healthcare professionals.
Dilantin can interfere with certain laboratory tests, including serum calcium and glucose measurements. It is essential to inform laboratory personnel of Dilantin use to prevent misinterpretation of test results.
Abrupt discontinuation of Dilantin can lead to withdrawal symptoms and exacerbation of seizures. Any reduction in dosage or discontinuation must be done gradually and under medical supervision to minimize these risks.
Genetic polymorphisms in drug-metabolizing enzymes like CYP2C9 and CYP2C19 can lead to variability in phenytoin pharmacokinetics among different individuals. Genetic testing may provide additional insights into optimal dosage requirements for patients.
Hydration status can affect phenytoin levels. Dehydration can result in increased serum concentrations, while over-hydration can lower them. Regular monitoring and maintenance of appropriate hydration levels are advised during therapy.
Patients should be counseled on maintaining good oral hygiene, as gingival hyperplasia is a potential side effect. Regular dental check-ups and proper brushing techniques can help mitigate this risk.