Phenytoin (Dilantin) Uses, Dosage, Side Effects
Phenytoin is an anti-epileptic drug, also called an anticonvulsant. Learn about side effects, interactions and indications.
a blood thinner such as warfarin (Coumadin, Jantoven);
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To make sure phenytoin is safe for you, l your doctor if you have: liver disease; diabetes;
See also: Side effects (in more detail).
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
stomach acid reducers (such Tagamet, Prilosec, Zegerid, Zantac, Pepcid, or Axid); or.
Greater than or equal to 4 weeks: Initial: 5 mg/kg/day in 2 to 3 divided doses Usual: (may require up to every 8 hour dosing) 6 months to 3 years: 8 to 10 mg/kg/day 4 to 6 years: 7.5 to 9 mg/kg/day 7 to 9 years: 7 to 8 mg/kg/day 10 to 16 years: 6 to 7 mg/kg/day. Status Epilepticus: Loading Dose: Infants, Children: 15 to 20 mg/kg IV in a single or divided doses Anticonvulsant: Loading Dose: All ages: 15 to 20 mg/kg orally (based on phenytoin serum concentrations and recent dosing history). The oral loading dose should be given in 3 divided doses administered every 2 to 4 hours. Anticonvulsant: Maintenance Dose: (IV or oral) (Note: May initially divided daily dose into 3 doses/day, then adjust to suit individual requirements.) Less than or equal to 4 weeks: Initial: 5 mg/kg/day in 2 divided doses Usual: 5 to 8 mg/kg/day IV in 2 divided doses (may require dosing every 8 hours).
a vitamin D deficiency or any other condition that causes thinning of the bones;
Approval History Calendar Drug history at FDA.
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Follow your doctor's instructions about taking phenytoin while you are pregnant. The benefit of preventing seizures may outweigh any risks posed by taking phenytoin. Seizure control is very important during pregnancy.
confusion, dizziness, nervousness; or sleep problems (insomnia).
prochlorperazine (Compazine, Compro), promethazine (Pentazine, Phenergan, Anergan, Antinaus), and other phenothiazines;
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 phenytoin, DO NOT STOP TAKING the medicine without your doctor's advice. If you are pregnant, DO NOT START TAKING this medicine unless your doctor ls you to. You should not use phenytoin if you also take delavirdine (Rescriptor), or if you are allergic to phenytoin, ethotoin (Peganone), fosphenytoin (Cerebyx), or mephenytoin (Mesantoin). Seizure control is very important during pregnancy and the benefits of preventing seizures may outweigh any risks posed by using phenytoin.
Usual Adult Dose for Seizures:
Your doctor may recommend a blood test before you start the medication to determine your risk of this skin reaction. Patients of Asian ancestry may have a higher risk of developing a rare but serious skin reaction to phenytoin.
Pregnancy Category D Positive evidence of risk.
This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products.
birth control pills or hormone replacement therapy;
Neurosurgery Dilantin, Phenytoin Sodium, Phenytoin Sodium, Prompt, Phenytek, More.
Some clinicians recommend the use of fosphenytoin if IM administration is necessary.) If IM administration is not necessary, accepted protocol has been 100 to 200 mg IV at about 4 hour intervals during surgery and the immediate postoperative period. (Note: While the manufacturer recommends IM administration, this route may cause severe local tissue destruction and necrosis. Neurosurgery (prophylactic): 100 to 200 mg IM at about 4 hour intervals during surgery and the immediate postoperative period.
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.
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if you drink large amounts of alcohol.
Sometimes it is not safe to use certain medications at the same time. Phenytoin can also affect blood levels of certain other drugs, making them less effective or increasing side effects. Some drugs can raise or lower your blood levels of phenytoin, which may cause side effects or make the medicine less effective.
Call your doctor at once if you have:
See also: Pregnancy and breastfeeding warnings (in more detail).
fever, swollen glands, sore throat, trouble breathing, painful mouth sores, sores around your eyes;
Be careful if you drive or do anything that requires you to be alert. Phenytoin may impair your thinking or reactions.
l your doctor if you are using:. Many drugs can interact with phenytoin. Below is just a partial list.
a history of depression;
Phenytoin is used to control seizures. Phenytoin does not treat all types of seizures, and your doctor will determine if it is the right medicine for you.
FDA pregnancy category D. Phenytoin may cause harm to an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby.
Store at room temperature away from moisture, light, and heat.
You may report side effects to FDA at 1-800-FDA-1088. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.
Avoid taking antacids at the same time you take phenytoin. Antacids can make it harder for your body to absorb the medication.
Usual Pediatric Dose for Seizures:
Usual Pediatric Dose for Arrhythmias:
Alternatively, the dosage may need to be increased up to 200 mg orally 3 times a day, if necessary. 1 g orally divided in 3 doses (400 mg, 300 mg, 300 mg) given at 2 hour intervals. Loading dose: 10 to 15 mg/kg IV slowly. If seizure control is established with divided doses of three 100 mg capsules daily, once-a-day dosage with 300 mg of extended release phenytoin sodium may be considered. Initial dose: 100 mg extended release orally 3 times a day. Maintenance dose: 100 mg IV every 6 to 8 hours. Oral (except suspension) Loading dose: Only when indicated for inpatients. Then normal maintenance dosage started 24 hours after loading dose. An increase to five teaspoonfuls daily may be made, if necessary. Maintenance dose: 100 mg orally 3 to 4 times a day. IV: Do not exceed the infusion rate of 50 mg/min. Suspension: Patients who have received no previous treatment may be started on 125 mg (one teaspoonful) of the suspension three times daily, and the dose is then adjusted to suit individual requirements. IM: Avoid the IM route due to erratic absorption.
Seek emergency medical attention or call the Poison Help line at. Overdose symptoms may include twitching eye movements, slurred speech, loss of balance, tremor, muscle stiffness or weakness, nausea, vomiting, feeling light-headed, fainting, and slow or shallow breathing. An overdose of phenytoin can be fatal.
Usual Adult Dose for Status Epilepticus:
Any medical care provider who treats you should know that you take seizure medication. Wear a medical alert tag or carry an ID card stating that you take phenytoin.
Phenytoin can make birth control pills less effective. Ask your doctor about using non hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy while taking this medicine.
heart medication such as amiodarone (Cordarone, Pacerone), digoxin (digitalis, Lanoxin), furosemide (Lasix), or quinidine (Quin-G);
You should not use phenytoin if you also take delavirdine (Rescriptor), or if you are allergic to phenytoin or similar medicines such as ethotoin (Peganone), fosphenytoin (Cerebyx), or mephenytoin (Mesantoin).
Epilepsy gabapentin, Lyrica, Neurontin, Depakote, Keppra, carbamazepine, More.
Generic Name: phenytoin (oral) (FEN i toyn) Brand Names: Dilantin, Dilantin Infatabs, Dilantin-125, Phenytek, Dilantin Kapseals, Phenytoin Sodium, Prompt, Di-Phen.
porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system); or.
This is to track the outcome of the pregnancy and to evaluate any effects of phenytoin on the baby. If you become pregnant while taking phenytoin, your name may be listed on a pregnancy registry.
severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
seizure medicine (such as Carbatrol, Equetro, Tegretol, Solfoton, Depakene, or Depakote);
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IV: Loading dose: Manufacturer recommends 10 to 15 mg/kg by slow IV administration (at a rate not exceeding 50 mg/minute). Maintenance rate: 100 mg orally or IV every 6 to 8 hours Maximum rate: 50 mg/minute Maintenance dose: IV or Oral: 100 mg every 6 to 8 hours. Alternatively, generally accepted guidelines suggest 15 to 20 mg/kg by slow IV administration (at a rate not exceeding 50 mg/minute).
More than nine in 10 epilepsy patients who had brain surgery to try to control their seizures are happy they did so, a new survey reveals. The review appears.
Availability Rx Prescription only.
Follow all directions on your prescription label. Take phenytoin exactly as prescribed by your doctor. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Status Epilepticus lorazepam, Ativan, diazepam, Valium, Dilantin, Diastat, More.
Follow your doctor's instructions about tapering your dose. If you are taking phenytoin to treat seizures, do not stop using it suddenly, even if you feel fine. Stopping suddenly may cause increased seizures.
Usual Adult Dose for Neurosurgery:
While using phenytoin, you may need frequent blood tests. You may also need a blood test when switching from one form of medicine to another. Visit your doctor regularly.
l your doctor if this medicine does not seem to work as well in treating your condition.
Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check your progress at regular visits while you are using phenytoin. You may have thoughts about suicide while taking this medicine.
Version: 13.01. Revision Date:, 6:37:15 PM. Cerner Multum, Inc.
skin rash, easy bruising or bleeding, severe weakness; severe muscle pain;
Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one. Shake the oral suspension ( liquid ) well just before you measure a dose.
bone pain (especially in your hips, legs, or lower back), trouble with walking; or.
Alcohol use can increase your blood levels of phenytoin and may increase side effects. Daily alcohol use can decrease your blood levels of phenytoin, which can increase your risk of seizures. Avoid drinking alcohol while you are taking this medicine.
certain sedatives (Librium, Librax, Limbitrol, Valium) or antidepressants (Desyrel, Luvox, Zoloft, Prozac, Rapiflux, Sarafem, Selfemra, Symbyax);
This list is not complete and there are many other medicines that can interact with phenytoin. This includes prescription, over-the-counter, vitamin, and herbal products. l your doctor about all medications you use. Keep a list of all your medicines and show it to any healthcare provider who treats you. Do not start a new medication without ling your doctor.
Call your doctor for a new prescription. Do not use any phenytoin capsule that has changed colors. Do not crush, chew, break, or open an extended-release capsule. Swallow it whole.
Maintenance Dose: 5 to 10 mg/kg/day orally or IV in 2 to 3 divided doses. May repeat up to a loading dose of 15 mg/kg. Greater than 1 year: Loading Dose: 1.25 mg/kg IV every 5 minutes.
nausea, vomiting, upper stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);
tremors, slurred speech, loss of balance or coordination; rash; headache;
Get emergency medical help if you have any of these signs of an allergic reaction to phenytoin: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. You may be more likely to have an allergic reaction if you are African-American.
a history of suicidal thoughts or actions;
Usual Adult Dose for Arrhythmias:
theophylline (Elixophyllin, Theo-Dur, Theo-Bid, Theolair, Uniphyl).
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an antidepressant (such as Elavil, Vanatrip, Limbitrol, Sinequan, Silenor, Pamelor, Paxil, Zoloft, Desyrel, and others);
CSA Schedule N Not a controlled drug.
steroid medicines (prednisone and others);
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Phenytoin can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using this medicine.
Loading Dose: 1.25 mg/kg IV every 5 minutes. May repeat up to a loading dose of 15 mg/kg, or 250 mg orally 4 times a day for 1 day, then 250 mg twice daily for 2 days Maintenance Dose: 300 to 400 mg/day orally in divided doses 1 to 4 times a day.
If you become pregnant while taking phenytoin, DO NOT STOP TAKING the medicine without your doctor's advice. If you are pregnant, DO NOT START TAKING phenytoin unless your doctor ls you to.
antibiotics such as cycloserine (Seromycin), doxycycline (Doryx, Vibramycin, Adoxa), isoniazid (for treating tuberculosis), linezolid (Zyvox), rifampin (Rimactane, Rifadin, Rifamate), or sulfa drugs (Bactrim, Septra, Sulfatrim, SMX-TMP, and others);
Common phenytoin side effects may include: nausea, vomiting, constipation;
Skip the missed dose if it is almost time for your next scheduled dose. Take the missed dose as soon as you remember. Do not take extra medicine to make up the missed dose.
It works by slowing down impulses in the brain that cause seizures. Phenytoin is an anti-epileptic drug, also called an anticonvulsant.
aspirin or other salicylates;
Seizures diazepam, Valium, Keppra, levetiracetam, Dilantin, Trileptal, More.