$Unique_ID{BRK02096}
$Pretitle{}
$Title{PHENYTOIN}
$Subject{Dilantin (Parke-Davis)
Dilantin Infatab (Parke-Davis)
Dilantin Kapseal (Parke-Davis)
Diphenylan (Lannett)
phenytoin (various manufacturers)}
$Volume{}
$Log{
Dilantin Kapseal*0209601.scf}

Copyright (C) 1991 Publications International, Ltd.


PHENYTOIN
------------------------------------------------------------------------------

BRAND NAMES (Manufacturers):
     Dilantin (Parke-Davis)
     Dilantin Infatab (Parke-Davis)
     Dilantin Kapseal (Parke-Davis)
     Diphenylan (Lannett)
     phenytoin (various manufacturers)
TYPE OF DRUG:
     Anticonvulsant
INGREDIENT:
     phenytoin
DOSAGE FORMS:
     Capsules (30 mg and 100 mg)
     Chewable tablets (50 mg)
     Oral suspension (30 mg and 125 mg per 5-ml spoonful, with 0.6% alcohol)
STORAGE:
     Phenytoin capsules, tablets, and oral suspension should be stored at room
       temperature in tightly closed, light-resistant containers.  This
       medication should never be frozen.

USES

     Phenytoin is used to control certain types of convulsions, or seizures.
It is not clear exactly how phenytoin works to control convulsions, but it
appears to prevent the spread of seizure activity in the brain.  Phenytoin may
also be used to treat other conditions as determined by your physician.

TREATMENT

     In order to avoid stomach irritation, and to increase this drug's
absorption, you can take phenytoin with food or with a full glass of water or
milk (unless your doctor directs you to do otherwise).
     The tablet form of this medication should be chewed before swallowing.
     The suspension form of this medication should be shaken well just before
measuring each dose.  The contents tend to settle on the bottom of the bottle,
so it is necessary to shake the container to distribute the ingredients evenly
and equalize the doses.  Each dose should then be measured carefully with a
specially designed 5-ml measuring spoon.  An ordinary kitchen teaspoon is not
accurate enough.
     Phenytoin works best when the level of medicine in your bloodstream is
kept constant.  It is best, therefore, to take the doses at evenly spaced
intervals day and night.  For example, if you are taking three doses a day,
the doses should be spaced eight hours apart.
     If you miss a dose of this medication, take the missed dose as soon as
possible, unless it is almost time for the next dose.  In that case, do not
take the missed dose at all; just return to your regular dosing schedule.  Do
not double the next dose.  If you miss two or more doses in a row, contact
your doctor.

SIDE EFFECTS

     Minor.

     Constipation, drowsiness (mild), headache, insomnia, nausea, or vomiting.
These side effects should disappear as your body adjusts to the medication.
     To relieve constipation, increase the amount of fiber in your diet (fresh
fruits and vegetables, salads, bran, and whole-grain breads), exercise, and
drink more water (unless your doctor directs you to do otherwise).

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
blurred vision, chest pain, confusion, dizziness, change in facial features,
gum enlargement, increased hair growth, joint pain, muscle twitching,
nervousness, numbness, rash, slurred speech, sore throat, swollen glands,
uncoordinated movements, unusual bleeding or bruising, change in the color of
your urine, or yellowing of the eyes or skin.

INTERACTIONS

     Phenytoin interacts with a number of other types of drugs:
     1. The effectiveness of phenytoin can be decreased by alcohol,
barbiturates, folic acid, tricyclic antidepressants, reserpine, molindone,
benzodiazepine tranquilizers, chloral hydrate, rifampin, phenothiazine
tranquilizers, and haloperidol.
     2. Phenytoin can decrease the effectiveness of calcifediol, warfarin,
quinidine, disopyramide, dexamethasone, doxycycline, levodopa, and oral
contraceptives (birth control pills).
     3. The active blood levels and side effects of phenytoin can be increased
by chloramphenicol, cimetidine, warfarin, disulfiram, isoniazid,
oxyphenbutazone, phenylbutazone, ibuprofen, amiodarone, trimethoprim,
sulfonamide antibiotics, tolbutamide, chlordiazepoxide, chlorpromazine,
diazepam, estrogens, ethosuximide, methylphenidate, and prochlorperazine.
     4. Valproic acid can either increase or decrease the effects of
phenytoin.
     5. The dosage of oral antidiabetic medications may need to be adjusted
when phenytoin is started.
     6. Phenytoin may decrease the absorption of furosemide from the
gastrointestinal tract, decreasing its effectiveness.
     7. Antacids, calcium, oxacillin, sucralfate, medicines for diarrhea, and
antineoplastics (anticancer drugs) may decrease the gastrointestinal
absorption and effectiveness of phenytoin.  Do not take phenytoin within two
to three hours of taking an antacid or antidiarrheal.
     Before starting to take phenytoin, BE SURE TO TELL YOUR DOCTOR about any
medications you are currently taking, especially any of those listed above.

WARNINGS

     * Tell your doctor about unusual or allergic reactions you have had to
any medications, especially to phenytoin, ethotoin, or mephenytoin.
     * Before starting to take this medication, be sure to tell your doctor if
you now have or if you have ever had blood disorders, diabetes mellitus, or
liver disease.
     * If this drug makes you dizzy or drowsy, do not take part in any
activity that requires alertness, such as driving a car or operating
potentially dangerous machinery.  Children should be careful while playing.
Before surgery or other medical or dental treatment, tell your doctor or
dentist you are taking phenytoin.
     * Do not stop taking this medication unless you first consult your
doctor.  If this drug is stopped abruptly, you may experience uncontrollable
seizures.  Your doctor may, therefore, want to reduce your dosage gradually.
Be sure you have enough on hand for holidays and vacations.
     * Although several generic versions of this drug are available, you
should not switch from one brand to another without your doctor's careful
assessment and complete approval.  If you have your medication refilled and it
looks different, be sure to consult with your pharmacist.
     * Therapy with phenytoin may cause your gums to enlarge enough to cover
your teeth.  This can be minimized, at least partially, by frequent brushing
and massaging of the gums with the rubber tip of a good toothbrush.
     * Be sure to tell your doctor if you are pregnant.  Birth defects have
been reported more often in infants whose mothers have seizure disorders.  It
is unclear if the increased risk of birth defects is associated with the
seizure disorders or with the anticonvulsant medications, such as phenytoin,
that are used to treat them.  The risks and benefits of treatment should,
therefore, be discussed throughly with your doctor.  Also, tell your doctor if
you are breast-feeding an infant.  Phenytoin anticonvulsant passes into breast
milk and can cause extreme drowsiness in the nursing infant.

----------------

The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
