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Dilantin (phenytoin)
Dilantin Information
Dilantin is approved
for use as an anti-seizure medication (anticonvulsant), especially to prevent
tonic-clonic (grand mal) seizures and complex partial seizures (psychomotor
seizures). It may be used alone or with Phenobarbital or other anticonvulsants.
Dilantin Warnings
Dilantin can increase
the metabolism (elimination) of many drugs, reducing their concentrations in
the body. Drugs that may be affected include: digoxin, carbamazepine,
clonazepam, corticosteroids (e.g.prednisone), cyclosporine, disopyramide,
doxycycline, estrogens, felodipine, levodopa, lidocaine, methadone, mexiletine,
oral contraceptives, paroxetine, quinidine, tacrolimus, theophylline,
phenobarbital, and warfarin. Dilantin can interact with these drugs not only
when it is added to therapy but also when it is discontinued. In the latter case,
the concentration of the other drugs may increase.
Dilantin's metabolism may be
affected by other drugs. Drugs that can reduce the amount of Dilantin in the
body include rifampin and phenobarbital. Drugs that increase Dilantin
concentrations include Amiodarone, chloramphenicol,cimetidine, disulfiram,
fluconazole, fluoxetine, isoniazid (INH), omeprazole, and paroxetine.
Thus,
measuring levels of Dilantin in the blood may be necessary when patients begin
or discontinue other medications. There appears to an increased risk of
malformations and birth defects in women taking Dilantin .
Thus Dilantin should
be used in pregnancy only if the physician feels that the potential benefit
outweighs the risk. Dilantin is secreted into breast milk. Nursing is not recommended
for persons taking Dilantin .
Dilantin Side effects
Many varied adverse
effects can occur during Dilantin therapy including dizziness, drowsiness,
difficulty focusing (vision), unsteady gate, tiredness, abnormal involuntary
movements, nausea, vomiting, constipation, abdominal pain, and loss of
appetite. Children and young adults can develop overgrowth of the gums during
long-term therapy which requires regular treatment by a dentist.
Good oral
hygiene and gum massage may reduce the risk. Rashes can occur in between 1 in
20 and 1 in 10 persons; some may be severe. Also, dark coloration of the skin
may develop Dilantin can produce unusual growth of hair in some patients. This
reaction most commonly affects the arms and legs but can also affect the trunk
and face; it may be irreversible. Various lymph node reactions have been
reported with Dilantin therapy. Lymph nodes may swell up, sometimes painfully.
Dilantin may cause serum glucose to rise.
Thus, blood sugar should be monitored
closely when Dilantin is administered to patients with diabetes. Dilantin can
potentially injure the liver although this is an uncommon occurrence. Dilantin
can cause the platelet or white blood cell counts to drop, increasing the risk
of bleeding or infection, respectively. Dilantin also can cause anemia. Because
it interferes with vitamin D metabolism, Dilantin can cause weakening of the
bones (osteomalacia). Dilantin can cause sexual dysfunction including decreased
libido, impotence, and priapism (painful, prolonged erections).
Dilantin Overdose
If overdose is
suspected, contact your local poison control center or emergency room
immediately.
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