What is Dilantin?
Dilantin (phenytoin) is an anti-epileptic drug, also called an anticonvulsant. It works by slowing down impulses in the brain that cause seizures.
Dilantin is used to control seizures. It does not treat all types of seizures, and your doctor will determine if it is the right medication for you.
Dilantin may also be used for purposes not listed in this medication guide.
Important information about Dilantin
You should not use Dilantin if you also take delavirdine (Rescriptor), or if you are allergic to phenytoin, ethotoin (Peganone), fosphenytoin (Cerebyx), or mephenytoin (Mesantoin). If you are pregnant, DO NOT START TAKING Dilantin unless your doctor tells you to. Dilantin may cause harm to an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby. If you become pregnant while taking Dilantin, DO NOT STOP TAKING the medicine without your doctor’s advice. Seizure control is very important during pregnancy and the benefits of preventing seizures may outweigh any risks posed by using Dilantin.
You may have thoughts about suicide while taking Dilantin. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.
Before taking Dilantin
You should not use Dilantin if you also take delavirdine (Rescriptor), or if you are allergic to phenytoin, ethotoin (Peganone), fosphenytoin (Cerebyx), or mephenytoin (Mesantoin).
To make sure you can safely take Dilantin, tell your doctor if you have any of these other conditions:
* liver disease; * lupus; * diabetes; * 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 drink large amounts of alcohol.
Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.
You may have thoughts about suicide while taking Dilantin. Tell your doctor if you have new or worsening depression or suicidal thoughts during the first several months of treatment, or whenever your dose is changed.
Patients of Asian ancestry may have a higher risk of developing a rare but serious skin reaction to Dilantin. Your doctor may recommend a blood test before you start the medication to determine your risk of this skin reaction.
FDA pregnancy category D. Dilantin may cause harm to an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby. If you are pregnant, DO NOT START TAKING Dilantin unless your doctor tells you to. If you become pregnant while taking Dilantin, DO NOT STOP TAKING the medicine without your doctor’s advice.
See also: Dilantin pregnancy and breastfeeding warnings (in more detail)
Seizure control is very important during pregnancy. The benefit of preventing seizures may outweigh any risks posed by taking Dilantin. Follow your doctor’s instructions about taking phenytoin while you are pregnant. Dilantin can make birth control pills less effective. To prevent pregnancy while you are taking this medicine, use a non-hormonal form of birth control (such as a condom or diaphragm with spermicide). Phenytoin can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using this medicine.
How should I take Dilantin?
Take Dilantin exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Do not crush, chew, break, or open an extended-release capsule. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time. Do not use any capsule that has changed colors. Call your doctor for a new prescription. Shake the Dilantin oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
To be sure Dilantin is helping your condition, your blood may need to be tested often. You may also need a blood test when switching from one form of phenytoin to another. Visit your doctor regularly.
If you are taking Dilantin to treat seizures, keep taking the medication even if you feel fine. You may have an increase in seizures if you stop taking Dilantin. Do not change your dose of Dilantin without your doctor’s advice. Tell your doctor if the medication does not seem to work as well in treating your condition. Wear a medical alert tag or carry an ID card stating that you take Dilantin. Any medical care provider who treats you should know that you are taking a seizure medication.
Store Dilantin at room temperature away from moisture, light, and heat.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of Dilantin can be fatal. Overdose symptoms may include twitching eye movements, slurred speech, loss of balance, tremor, muscle stiffness or weakness, nausea, vomiting, feeling light-headed, fainting, and slow or shallow breathing.
What should I avoid while taking Dilantin?
Avoid drinking alcohol while you are taking Dilantin. Alcohol use can increase your blood levels of this medicine and may increase side effects. Daily alcohol use can decrease your blood levels of phenytoin, which can increase your risk of seizures.
Avoid taking antacids at the same time you take Dilantin. Antacids can make it harder for your body to absorb the medication.
Dilantin may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
See also: Dilantin and alcohol (in more detail)
Dilantin side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Dilantin: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. You may be more likely to have an allergic reaction if you are African-American. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have a serious side effect while taking Dilantin such as:
* fever, swollen glands, body aches, flu symptoms; * skin rash, easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness; * upper stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes); * chest pain, irregular heart rhythm, feeling short of breath; * confusion, nausea and vomiting, swelling, rapid weight gain, urinating less than usual or not at all; * new or worsening cough with fever, trouble breathing; * tremor (uncontrolled shaking), restless muscle movements in your eyes, tongue, jaw, or neck; * patchy skin color, red spots, or a butterfly shaped skin rash over your cheeks and nose (worsens in sunlight); or * severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Less serious Dilantin side effects may include:
* slurred speech, loss of balance or coordination; * swollen or tender gums; or * headache, dizziness, nervousness, or sleep problems (insomnia).
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Dilantin side effects (in more detail)
What other drugs will affect Dilantin?
Many drugs can interact with Dilantin. Below is just a partial list. Tell your doctor if you are using:
* antibiotics such as cycloserine (Seromycin), doxycycline (Doryx, Vibramycin, Adoxa), isoniazid (for treating tuberculosis), linezolid (Zyvox), rifampin (Rimactane, Rifadin, Rifamate), or sulfa drugs (Bactrim, Septra, Sulfatrim, SMX-TMP, and others); * an antidepressant (such as Elavil, Vanatrip, Limbitrol, Sinequan, Silenor, Pamelor, Paxil, Zoloft, Desyrel, and others); * aspirin or other salicylates; * birth control pills or hormone replacement therapy; * a blood thinner such as warfarin (Coumadin, Jantoven); * certain sedatives (Librium, Librax, Limbitrol, Valium) or antidepressants (Desyrel, Luvox, Zoloft, Prozac, Rapiflux, Sarafem, Selfemra, Symbyax); * heart medication such as amiodarone (Cordarone, Pacerone), digoxin (digitalis, Lanoxin), furosemide (Lasix), or quinidine (Quin-G); * prochlorperazine (Compazine, Compro), promethazine (Pentazine, Phenergan, Anergan, Antinaus), and other phenothiazines; * steroid medicines (prednisone and others); * seizure medicine (such as Carbatrol, Equetro, Tegretol, Solfoton, Depakene, or Depakote); * stomach acid reducers (such Tagamet, Prilosec, Zegerid, Zantac, Pepcid, or Axid); or * theophylline (Elixophyllin, Theo-Dur, Theo-Bid, Theolair, Uniphyl).
This list is not complete and there are many other medicines that can interact with Dilantin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.