Precautions and warnings

People with heart problems (such as slow heart rate or heart blocks), diabetes, liver issues, low blood protein, porphyria, or those who get seizures (especially petit mal) should use this medication with caution. It is also important to be careful in elderly or frail patients.

If the drug is given by IV, monitor blood pressure and ECG, especially in people with low blood pressure, heart failure, or recent heart attack. IV should be given slowly, because giving it too fast can cause low blood pressure, problems with the central nervous system, irregular heartbeats, or problems with heart signals.

Avoid giving this medicine by accident outside the vein or into an artery. Do not stop taking it suddenly unless absolutely necessary, because this can cause more seizures. This medicine can make it unsafe to drive or use machines.

Drug Interactions

Taking this drug with other sedatives or alcohol can make their effects stronger. It can also make the toxic effects of paracetamol and lithium worse. There's a higher risk of bone problems (osteomalacia) if used with acetazolamide.

Some drugs like acyclovir, cancer medicines, certain antibiotics, and medicines that increase the activity of liver enzymes (such as carbamazepine and rifampin), as well as folic acid and vigabatrin, can lower the amount or effect of this drug in your blood.

Other drugs like allopurinol, certain cancer medicines, cimetidine, medicines that slow down liver enzymes (such as fluconazole and delavirdine), as well as disulfiram, methylphenidate, metronidazole, omeprazole, SSRIs, trazodone, and trimethoprim, can increase the level of this drug in your blood.

This drug can also make your body break down other medicines faster, including drugs for irregular heart rhythm, seizures, mental health, blood pressure, antibiotics, steroids, doxycycline, estrogen, cholesterol medicines, methadone, theophylline, and antidepressants (TCAs).

It can lower the effects or levels of several medicines, including clozapine, ciclosporin, tacrolimus, several types of drugs broken down by specific liver enzymes (like bupropion, amiodarone, celecoxib, citalopram, certain benzodiazepines), as well as digoxin, itraconazole, levodopa, muscle relaxants, thyroid medicines, and topiramate.

It can also raise the levels or effects of dopamine and ticlopidine. Valproic acid can push this drug off its binding sites, changing the amount present in the blood, and can temporarily increase the risk of bleeding from warfarin, before eventually reducing this effect.

**Warning:**
This drug can dangerously increase the blood-pressure-lowering effects of dopamine and worsen the heart-depressing effects of lidocaine.

Contraindications

Pregnancy. Do not give by IV to patients with slow heart rate (sinus bradycardia), heart block, or Stokes-Adams syndrome.

Mode of actions

Phenytoin works to prevent seizures by helping control the movement of sodium ions in and out of nerve cells in the brain’s motor cortex. This helps stabilize nerve cells and reduces seizure activity. As an antiarrhythmic, phenytoin extends the time during which the heart’s cells cannot be reactivated, suppresses irregular heartbeats, and shortens the heart’s electrical action potential.

Dosage & Administration

Epilepsy
Adult: Initially, 3-4 mg/kg daily as single dose or in divided doses. Alternatively, 150-300 mg daily increased gradually to 600 mg daily if necessary. Maintenance: 200-500 mg daily.

Child: Initially, 5 mg/kg daily in 2-3 divided doses. Maintenance: 4-8 mg/kg daily in divided doses. Max dose: 300 mg daily.

Pregnancy & Lactation

This medicine is not allowed during pregnancy. Do not use it if you are pregnant. It can be absorbed through the skin and lungs caused can damage your unborn child’s organs and cause congenital disabilities. Strict effective birth control during treatment and for six months after stopping this medicine. If you do become pregnant, stop taking this medicine and discuss your doctor right away.

There is no specific information on whether this medicine passes into breast milk or not. Considering the possible risks for the children, breastfeeding while using this medicine is not recommended and at least two weeks after the last dose. Consult your doctor before breastfeeding.

Pack Size & Price