Meds and you

27 September 2013

Phenytoin sodium

Phenytoin sodium is an anticonvulsant. Anticonvulsants are drugs that are used to treat or prevent convulsions, i.e. the seizures seen in epilepsy.

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Phenytoin is the actve ingredient of Epanutin (Nappi Code: 723525-005), Epanutin syrup (Nappi Code: 723533-016), Epanutin injection (Nappi Code: 723576-009), Epanutin Infatabs (Nappi Code: 723568- 006), Norstan-Phenytoin (Nappi Code: 754870-015) and Phenytoin Sodium 100 (Nappi Code: 754870-016/015).

General information
Phenytoin sodium is an anticonvulsant. Anticonvulsants are drugs that are used to treat or prevent convulsions, i.e. the seizures seen in epilepsy.

In South Africa phenytoin sodium is registered for the treatment of grand mal epilepsy, epilepsy in which the attacks involve the loss of consciousness followed by generalized jerking, and psychomotor seizures, a seizure that starts in one particular part of the brain.

It is also used for the management of status epilepticus, a prolonged, life-threatening epileptic seizure that lasts for more than 30 minutes, and certain cardiac arrhythmias, especially in case of digitalis toxicity.

Phenytoin has a narrow therapeutic window, meaning that there is a thin line between being effective and harmful. It is advised that once a stabilised serum level has been achieved, patients should not be switched to a generic equivalent.

Do not stop using this antiepileptic drug abruptly as it may cause seizures. It is advised that you decrease your dose gradually, and only as directed by your doctor.

Phenytoin may deplete folic acid levels in your body if taken long-term. A folic acid supplement or plenty of fresh, green vegetables as part of your diet is advised.

Because phenytoin may cause dizziness, light-headedness and/or sedation, driving and any hazardous tasks should be avoided until you know how this medication affects you.

How does phenytoin sodium work?
Antiepileptic medication acts on the brain to increase the seizure threshold, and to prevent the spread of abnormal electrical activity in the brain.

Fast facts

Drug schedule: schedule 3
Available as: phenytoin sodium is available as tablets, injection, capsules and suspension.
What does it do? Phenytoin is an anticonvulsant drug.
Overdose risk: medium
Dependence risk: low
Is Phenytoin sodium available as a generic? yes
Is Phenytoin sodium available on prescription only? yes

User information

Onset of effect: the full effect of this drug may only be seen after a few days of treatment.
Duration of action: up to 24 hours
Dietary advice: because phenytoin may cause stomach upset, it should best be taken with food. A diet rich in fresh, green vegetables is also recommended to supplement folic acid.
Stopping this medicine: do not stop using phenytoin sodium abruptly as it may cause
seizures. It is advised that you decrease your dose gradually and only as directed by your doctor.
Prolonged use: periodic blood tests are required to monitor the levels of the drug in the body.

Special precautions
Consult your doctor before using this drug if:

  • you have diabetes


    • you have porphyria

    • you have kidney or liver disease

    Pregnancy:
    Breastfeeding: avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.
    Porphyria: avoid. It is unknown how this medication may affect your condition. Consult your doctor before use.
    Infants and children: this medication is safe for use in children at the recommended paediatric dose.
    The elderly: caution is advised in the elderly as side effects may be more frequent. A dose adjustment may be needed.
    Driving and hazardous work: caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how this medication affects you.
    Alcohol: avoid concomitant use of alcohol with this medication.

    Possible side effects

    Side Effect
    Frequency
    Consult your doctor

    Common
    Rare
    Only if severe
    In all cases
    nausea and vomiting
    X

    X

    tremor

    X
    X

    confusion

    X

    X
    dizziness

    X
    X

    speech disturbance

    X

    X
    drowsiness

    X
    X

    skin rash

    X
    X

    hair loss

    X
    X

    fever

    X

    X
    bleeding gums

    X

    X
    yellow tinge to eyes/skin

    X

    X

    Interactions

    Many other drugs may interact with phenytoin. It is important to consult your doctor or pharmacist before combining any drug with phenytoin.

    This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

    Disease interactions
    Consult your doctor before using this drug if you have diabetes, porphyria or if you have kidney or liver disease.

    Overdose action
    A small overdose is no cause for concern. In case of intentional large overdose seek emergency medical attention.

    Recommended dosage
    Adults: 200 mg up to 600 mg/day


 
 

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