Dilantin (Phenytoin Sodium) - Summary

DILANTIN SUMMARY

Phenytoin sodium is an antiepileptic drug. Phenytoin sodium is related to the barbiturates in chemical structure, but has a five-membered ring.

Dilantin is indicated for the control of generalized tonic-clonic (grand mal) and complex partial (psychomotor, temporal lobe) seizures and prevention and treatment of seizures occurring during or following neurosurgery.

Phenytoin serum level determinations may be necessary for optimal dosage adjustments (see DOSAGE AND ADMINISTRATION and CLINICAL PHARMACOLOGY sections).

See all Dilantin indications & dosage >>

NEWS HIGHLIGHTS

Published Studies Related to Dilantin (Phenytoin)

The effect of topical phenytoin on healing in diabetic foot ulcers: a randomized controlled trial. [2011.10]
AIM: The aim of the study was to evaluate the effect of topical phenytoin on healing in diabetic foot ulcers. A randomized, controlled, double-blind, clinical trial was conducted... CONCLUSIONS: There were no differences in diabetic foot ulcer closure rates or in diabetic foot ulcer area over time between the two groups. This study does not support the use of phenytoin in the treatment of diabetic foot ulcers. (c) 2011 The Authors. Diabetic Medicine (c) 2011 Diabetes UK.

Effects of lamotrigine and phenytoin on the pharmacokinetics of atorvastatin in healthy volunteers. [2011.07]
PURPOSE: Statins and antiepileptic drugs (AEDs) are frequently coprescribed to individuals with hypercholesterolemia and new-onset seizures...

Folic acid supplementation prevents phenytoin-induced gingival overgrowth in children. [2011.04.12]
OBJECTIVE: Gingival overgrowth is an important adverse effect of phenytoin (PHT) therapy, occurring in about half of the patients. This study aimed to evaluate the effect of oral folic acid supplementation (0.5 mg/day) for the prevention of PHT-induced gingival overgrowth (PIGO) in children with epilepsy aged 6-15 years on PHT monotherapy for 6 months... CONCLUSIONS: Oral folic acid was found to decrease the incidence of PIGO in children on PHT monotherapy, in a statistically significant and clinically relevant manner. Classification of evidence: This study provides Class I evidence that folic acid supplementation, 0.5 mg/day, is associated with prevention of gingival overgrowth in children taking PHT monotherapy.

Pregabalin effect on steady-state pharmacokinetics of carbamazepine, lamotrigine, phenobarbital, phenytoin, topiramate, valproate, and tiagabine. [2011.02]
By reducing neuronal excitability through selective binding to the alpha(2)delta subunit of voltage-dependent calcium channels, pregabalin effectively treats epilepsy, chronic pain, and anxiety disorders. To evaluate if pregabalin coadministration affects pharmacokinetics of other antiepileptic drugs, population pharmacokinetic analyses using NONMEM software were performed on data from three epilepsy trials involving seven antiepileptic drugs with pregabalin as add-on therapy...

Should phenytoin or barbiturates be used as second-line anticonvulsant therapy for toxicological seizures? [2010.10]
CONCLUSION: Despite the lack of high-quality clinical trial data, pharmacological knowledge and animal studies suggest that phenobarbital or thiopentone should be second-line agents for controlling toxicological seizures. The role of newer agents such as propofol and levetiracetam in toxicological seizures is currently unclear because of a lack of clinical or animal studies.

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Clinical Trials Related to Dilantin (Phenytoin)

Phenytoin as a Neuroprotective Agent Against Corticosteroid-Induced Functional Imaging Changes [Recruiting]
The purpose of this research is to determine if patients who receive phenytoin (also commonly known as Dilantin) before taking corticosteroids will show less memory impairment and hypomanic symptoms (feelings of agitation, overexcitement or hyperactivity) than those receiving placebo (an inactive substance). This research also seeks to determine if patients taking phenytoin before corticosteroids show more activity in the area of the brain involved with memory than those receiving placebo.

This research is being done because increased levels of cortisol (the body's natural corticosteroid) in the body are frequently associated with forgetfulness, and interventions that may prevent or reverse this effect are of great importance.

Bioequivalence Study Of Phenytoin Suspension Versus Epamin® In 34 Healthy Volunteers. [Recruiting]
Mexican healthy volunteers will receive the current form of the drug (under the name of Epamin) as well as Pfizer's compound (Phenytoin). Bioequivalence will be tested.

Phenytoin and Driving Safety [Recruiting]
Automobile driving is a crucial aspect of everyday life, yet vehicular crashes represent a serious public health problem. Patients with epilepsy are at elevated risk for automobile crashes, causing great personal suffering and financial costs to society. Most collisions involving epileptic drivers are not seizure related but may instead result from cognitive effects upon driving performance of epilepsy and antiepileptic drugs (AEDs). Several million American drivers take AEDs for treatment of medical conditions besides epilepsy and may also be at risk for cognitive impairments that can reduce driving performance. Empirical evidence of the effects of AEDs on driving performance would enable development of driving guidelines that could lower the risk of injurious motor vehicle collisions; however, this evidence is currently lacking. The broad goal of our project is to determine the specific effects of the most commonly utilized AED, phenytoin, by assessing driving performance and cognitive abilities in neurologically normal volunteers taking phenytoin in a randomized, double-blind, placebo-controlled, crossover study. Our proposed experiments will assess: (1) cognitive functions using standardized neuropsychological tests (of attention, perception, memory, and executive functions), (2) driving performance during phenytoin and placebo administration, and (3) the effects of phenytoin-related cognitive performance upon driving performance. To measure driving performance, we will use a state-of-the-art fixed-base interactive driving simulator that allows us to observe driver errors in an environment that is challenging yet safe for the driver and tester, under conditions of optimal stimulus and response control. The results of this study of 30 drivers treated with phenytoin and placebo will increase the understanding of the role of AED-related cognitive impairment on driving safety errors. A better understanding of the impact of AEDs upon driving performance is necessary to rationally develop interventions that could help prevent crashes by drivers treated with AEDs.

Study on the Efficacy of Phenytoin in the Prophylaxis of Seizures of Patients With Pneumococcal Meningitis at Least 50 Yrs Old. [Recruiting]
To evaluate the efficacy of the prophylaxis with phenytoin in the prevention of seizures in patients with pneumococcal meningitis. Hypothesis: Administration of prophylactic phenytoin will reduce the incidence of seizures in patients with pneumococcal meningitis older than 50 yrs.

Neuroprotection With Phenytoin in Optic Neuritis [Not yet recruiting]
Optic neuritis is caused by inflammation of the optic nerve and causes loss of vision in the affected eye. It is often associated with multiple sclerosis. Loss of vision after an attack of optic neuritis is caused by damage to the nerve fibres in the optic nerve. There are a number of factors that contribute to nerve fibre damage including increased levels of sodium within them, so blocking sodium entry could help to protect them against damage.

The purpose of this study is determine whether phenytoin (which blocks sodium entry into cells) can protect against loss of nerve fibres and prevent loss of vision after optic neuritis.

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Reports of Suspected Dilantin (Phenytoin) Side Effects

Convulsion (190),  Stevens-Johnson Syndrome (147),  Drug Ineffective (43),  Amnesia (41),  Anticonvulsant Drug Level Decreased (40),  Dizziness (39),  Headache (37),  Anticonvulsant Drug Level Increased (36),  Malaise (33),  Pain (31), more >>

PATIENT REVIEWS / RATINGS / COMMENTS

Dilantin review by 48 year old male patient
		Rating
Overall rating:
Effectiveness:		Highly Effective
Side effects:		Moderate Side Effects
		Treatment Info
Condition / reason:		Seizures
Dosage & duration:		100 mg x 5.5 taken am and pm for the period of many years now
Other conditions:		NA
Other drugs taken:		NA
		Reported Results
Benefits:		Dilantin provided Control of seizures (mostly petits) as these were more frequent. Generally, the drug is still as effective as when first introduced to me so there has been little need for increasing the dosage. It was imperative in my treatment, though, that the drug be NON GENERIC ONLY.
Side effects:		Dizziness
Comments:		Limit stimulants, plenty of rest, reduce stress, take meds

Dilantin review by 54 year old female patient
		Rating
Overall rating:
Effectiveness:		Ineffective
Side effects:		Moderate Side Effects
		Treatment Info
Condition / reason:		anticonvulsant
Dosage & duration:		100mg taken 3x day for the period of 4 days
Other conditions:		Taken after identified AVM, prior to surgery
Other drugs taken:		none at the time
		Reported Results
Benefits:		none, I was unable to take the drug to achieve the benefits as I had a reaction.
Side effects:		My first impression was of an over all dizzy feeling, with a full body red raised rash which appeared in 3 days.
Comments:		Had to discontinue using, took almost 2 weeks for the rash to finally dissipate.

Dilantin review by 54 year old female patient
		Rating
Overall rating:
Effectiveness:		Ineffective
Side effects:		Moderate Side Effects
		Treatment Info
Condition / reason:		anticonvulsant
Dosage & duration:		100mg taken 3x day for the period of 4 days
Other conditions:		Taken after identified AVM, prior to surgery
Other drugs taken:		none at the time
		Reported Results
Benefits:		none, I was unable to take the drug to achieve the benefits as I had a reaction.
Side effects:		My first impression was of an over all dizzy feeling, with a full body red raised rash which appeared in 3 days.
Comments:		Had to discontinue using, took almost 2 weeks for the rash to finally dissipate.