DILANTIN Rx

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DILANTIN

Seizure disorders
Only 4 drugs may be compared at once

Generic Name and Formulations:

Phenytoin sodium 30mg, 100mg; ext-rel caps.

Company:

Pfizer Inc.

Select therapeutic use:

Indications for DILANTIN:

Tonic-clonic, psychomotor and neurosurgically induced seizures.

Adult:

Initially: 100mg 3 times daily. Increase weekly if needed; max 200mg 3 times daily. Once-a-day dosing only with ext-rel caps for patients controlled on 300mg daily.

Children:

Initially 5mg/kg per day in 2–3 equally divided doses. Increase weekly if needed. Usual maintenance: 4–8mg/kg per day; max 300mg daily.

Contraindications:

History of prior acute hepatotoxicity due to phenytoin. Concomitant delavirdine.

Warnings/Precautions:

Suicidal tendencies (monitor). Diabetes. Discontinue if acute hepatotoxicity occurs; do not restart. Adjust dose gradually. Discontinue if first sign of rash develops. Monitor serum levels when switching between sodium salt of phenytoin (caps) and free acid form (suspension, Infatabs). Use proper dental hygiene. Hormonal contraception. Monitor bone mineral density with chronic use. Porphyria. Slow metabolizers. Renal and/or hepatic impairment. Hypoalbuminemia. Elderly. Debilitated. Pregnancy: avoid. Nursing mothers: not recommended.

Interactions:

Potentiated by acute alcohol ingestion, amiodarone, antiepileptic agents (eg, ethosuximide, felbamate, oxcarbazepine, methsuximide, topiramate), azoles (eg, fluconazole, ketoconazole, itraconazole, miconazole, voriconazole), benzodiazepines (eg, chlordiazepoxide, diazepam), capecitabine, chloramphenicol, disulfiram, estrogens, fluorouracil, fluoxetine, fluvastatin, fluvoxamine, halothane, H2-blockers (eg, cimetidine), isoniazid, methylphenidate, omeprazole, phenothiazines, salicylates, sertraline, succinamides (eg, ethosuximide), sulfonamides, ticlopidine, tolbutamide, trazodone, warfarin. Antagonized by anticancer drugs (eg, bleomycin, carboplatin, cisplatin, doxorubicin, methotrexate), chronic alcohol ingestion, carbamazepine, diazepam, folic acid, fosamprenavir, nelfinavir, reserpine, rifampin, ritonavir, St. John’s wort, sucralfate, theophylline, vigabatrin. Antagonizes albendazole, HIV antivirals (eg, efavirenz, lopinavir/ritonavir, indinavir, nelfinavir, ritonavir, saquinavir), antiepileptic agents (eg, carbamazepine, felbamate, lamotrigine, topiramate, oxcarbazepine, quetiapine), atorvastatin, fluvastatin, simvastatin, chlorpropamide, clozapine, cyclosporine, digoxin, folic acid, methadone, mexiletine, nifedipine, nimodipine, nisoldipine, praziquantel, verapamil. Reduces efficacy of concomitant azoles, corticosteroids, doxycycline, estrogens, furosemide, irinotecan, oral contraceptives, paclitaxel, paroxetine, quinidine, rifampin, sertraline, teniposide, theophylline, vitamin D, warfarin. Concomitant fosamprenavir/ritonavir may potentiate amprenavir. Concomitant neuromuscular blockers (eg, pancuronium, vecuronium, rocuronium, cisatracurium); may need higher infusion rate. Variable effects with phenobarbital, valproic acid, sodium valproate. Absorption decreased by calcium, antacids.

See Also:

DILANTIN INFATABS

DILANTIN SUSPENSION

Pharmacological Class:

Hydantoin.

Adverse Reactions:

Nystagmus, ataxia, slurred speech, decreased coordination, somnolence, mental confusion, headaches, dizziness, cerebellar atrophy, nausea, vomiting, constipation, gingival hyperplasia, osteomalacia, blood dyscrasias, lymphadenopathy, hepatic disease, hyperglycemia, SLE, hypertrichosis; rare: rash (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis), DRESS, multiorgan hypersensitivity (may be fatal).

Note:

To enroll in the North American Antiepileptic Drug Pregnancy Registry call (888) 233-2334.

Generic Availability:

YES

How Supplied:

Caps 30mg—100; 100mg—100, 1000; Tabs—100; Susp—8oz

DILANTIN 100mg capsules (Qty:90)

appx. price $111.00