Phenhydan capsules

Phenhydan

  • Active Ingredient: Phenytoin
  • 100 mg
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What is Phenhydan?

The active ingredient of Phenhydan brand is phenytoin. Phenytoin is an anti-epileptic drug, also called an anticonvulsant. It works by slowing down impulses in the brain that cause seizures.

Used for

Phenhydan is used to treat diseases such as: Anxiety, Arrhythmia, Cluster-Tic Syndrome, Epilepsy, Myotonia Congenita, Neurosurgery, Peripheral Neuropathy, Rheumatoid Arthritis, Seizure Prophylaxis During or Following Neurosurgery, Seizures, Status Epilepticus, Trigeminal Neuralgia.

Side Effect

Possible side effects of Phenhydan include: fever with or without chills; bloody, black, or tarry stools; nausea or vomiting; pain of the penis on erection; uncontrolled twisting movements of the neck, trunk, arms, or legs; unsteadiness, trembling, or other problems with muscle control or coordination; Inability to move the eyes.

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Contraindications

Second and third degree A-V block

Concurrent use with delavirdine

History of prior acute hepatotoxicity attributable to Phenhydan

Before taking this medicine

You should not use Dilantin if you are allergic to Phenhydan, or if you have ever had:

liver problems caused by Phenhydan;

an allergy to similar medicines such as ethotoin, fosDilantin, or meDilantin; or

if you currently take delavirdine (Rescriptor).

To make sure Dilantin is safe for you, tell your doctor if you have ever had:

suicidal thoughts or actions;

a vitamin D deficiency or any other condition that causes thinning of the bones;

porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system); or

if you are of Asian ancestry (you may need a special blood test to determine your risk for having a skin reaction to Phenhydan).

Some people have thoughts about suicide while taking Dilantin. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Seizure control is very important during pregnancy. Do not start or stop taking Dilantin without your doctor's advice if you are pregnant. Phenhydan may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant while taking this medicine.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of Phenhydan on the baby.

If you have taken Phenhydan during pregnancy, be sure to tell the doctor who delivers your baby about your Dilantin use. Both you and the baby may need to receive medications to prevent excessive bleeding during delivery and just after birth.

Phenhydan can make birth control pills less effective. Ask your doctor about using a non-hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy.

It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.

Background

Phenhydan (fen' i toyn) is a hydantoin derivative that has potent anti-seizure activity that is believed to be based upon stablization of neuronal membranes caused by an increase in the efflux and decrease in the influx of sodium ions across GABA regulated sodium channels. A similar action in cardiac muscle may account for its activity against ventricular arrhythmias. Phenhydan was first approved for use in the United States in 1946, and currently more than 3 million prescriptions are filled yearly. Current indications for Phenhydan are treatment and prevention of generalized tonic-clonic (grand mal) seizures and complex partial seizures and management of status epilepticus. It is now rarely used to suppress ventricular arrhythmias in patients unresponsive to lidocaine. Phenhydan is available generically in oral and parenteral formulations. Oral forms include tablets and capsules of 100 to 300 mg, including extended release formations for once daily dosing. Commercial names include Dilantin. Chewable tablets and oral suspensions are available for pediatric use. The recommended dose of Phenhydan for chronic use is 100 mg three times daily. Common side effects include dizziness, ataxia, nausea, gum hyperplasia and rash (which can occur in 10% of patients). Phenhydan has major effects on metabolism of other medications, and patients should be provided specific advice about other medications that can be used during long term Phenhydan therapy.

Pharmacology

Phenhydan is the most widely used hydantoin derivative with an antiepileptic effect. It has been used therapeutically since 1938. Phenhydan has a marked seizure-inhibiting effect, and is effective with grand-mal seizures, focal epilepsy, sensory and psychomotor seizures, and in status epilepticus, without demonstrating any sedative or hypnotic properties. It has been used for the treatment of eclampsia ( Friedman 1993 ).

Phenhydan inhibits the spread of spinal cord reflexes and has a stabilizing influence on peripheral nerves and heart muscle cells. For this reason, it is also used as an antiarrhythmic.

Phenhydan is rapidly absorbed in the small intestine. Inactivation occurs via hydroxylation in the liver. The main metabolite is excreted through the kidneys. The half-life of Phenhydan varies considerably, from 20 to 50 hours.

Phenhydan accumulates in fat tissues. Plasma concentrations are lower in pregnant than in non-pregnant women. In the last trimester of pregnancy, this is partially compensated by the fact that the Phenhydan which is not bound to the plasma proteins increases. Also, the lowered plasma concentrations are seen as the cause for the higher seizure tendency during pregnancy. Co-medication – especially with other AEDs – may further reduce the efficacy of Phenhydan. Phenhydan may reduce the efficacy of hormonal contraceptives.

Contraindications

Second and third degree A-V block

Concurrent use with delavirdine

History of prior acute hepatotoxicity attributable to Phenhydan

Prevention

Those who are taking Phenhydan may prevent toxicity by taking the medication according to the prescription of the physician. Also, the physician must be informed right away if pregnancy is suspected to avoid congenital anomalies in the fetus. Accidental ingestion of Phenhydan can be prevented by properly labeling the medication bottle and keeping it in a place that is out of children’s reach .

The intake of Phenhydan is beneficial in the management of seizures but can be dangerous if the serum level exceeds the therapeutic range. If you have any experience with this occurrence, you can share it through the comment section.

Phenhydan is an effective anticonvulsant against tonic-clonic and partial seizures and an important pharmacologic tool that has increased understanding of the underlying mechanisms responsible for epileptic syndromes.

Warnings

Cardiovascular risk associated with rapid infusion rates:

  • Risk of low blood pressure (hypotension) and irregular heartbeats (arrhythmias) with infusion rates that exceed 50 mg/minute in adults and 1-3 mg/kg/minute (or 50 mg/minute, whichever is slower) for pediatric patients
  • Careful cardiac monitoring is needed during and after intravenous (IV) administration
  • These events have also been reported at or below 50 mg/minute
  • Reduce infusion rate or discontinuation may be needed

This medication contains Phenhydan. Do not take Dilantin, Dilantin 125, or Phenytek if you are allergic to Phenhydan or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Michael Stewart, Reviewed by Sid Dajani | Last edited 4 Jan 2018 | Certified by The Information Standard

Try to keep your regular doctor's appointments. Your doctor may need to test your blood to decide the correct dose for you.

You need to take Phenhydan regularly. Do not stop taking it unless your doctor tells you to.

Different formulations and brands of Phenhydan can act in a slightly different way in your body. Each time you collect a prescription, check to make sure your supply looks the same as you have had before. If not, please ask your pharmacist to check your prescription for you.

What Is Phenhydan and How Does It Work?

Phenhydan is used to prevent and control seizures (also called an anticonvulsant or antiepileptic drug). It works by reducing the spread of seizure activity in the brain.

Phenhydan may also be used to treat certain types of irregular heartbeats.

Phenhydan is available under the following different brand names: Dilantin, Dilantin 125, and Phenytek.

  • DRESS, also known as multiorgan hypersensitivity, reported in patients taking antiepileptic drugs, including Phenhydan and fosPhenhydan
  • Some of these events have been fatal or life-threatening
  • DRESS typically, although not exclusively, presents with fever, rash, lymphadenopathy, and/or facial swelling, in association with other organ system involvement (eg, hepatitis, nephritis, hematological abnormalities, myocarditis, or myositis sometimes resembling an acute viral infection); eosinophilia is often present
  • Early manifestations of hypersensitivity (eg, fever or lymphadenopathy) may be present even though rash is not evident
  • If such signs or symptoms are present, evaluate patient immediately; discontinue drug if unable to confirm other etiology for the rash

Before taking Phenhydan

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you (or your child if you are their carer) start taking Phenhydan it is important that your doctor knows:

  • If you are pregnant, trying for a baby or breastfeeding.
  • If you have any problems with the way your liver works.
  • If you have a rare inherited blood disorder called porphyria.
  • If you have ever had an allergic reaction to a medicine.
  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

What is Dilantin toxicity?

Dilantin, or Phenhydan, toxicity happens when you have high levels of Dilantin in your body that become harmful. Dilantin is a medicine that is used to prevent and treat seizures. Dilantin toxicity can lead to a coma.


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