Dilantin: Advanced Seizure Control for Neurological Stability
| Product dosage: 100mg | |||
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Synonyms
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Dilantin (phenytoin) is a cornerstone antiepileptic medication designed to manage and prevent tonic-clonic and complex partial seizures. With a well-established efficacy profile spanning decades, it functions by stabilizing neuronal membranes and reducing abnormal electrical activity in the brain. Trusted by neurologists worldwide, Dilantin offers a reliable option for maintaining seizure freedom and improving quality of life in appropriate patient populations.
Features
- Contains phenytoin sodium as the active ingredient
- Available in oral capsules, chewable tablets, and injectable formulations
- Extended-release formulation for consistent plasma levels
- FDA-approved for seizure prophylaxis and treatment
- Standardized dosing based on therapeutic drug monitoring
Benefits
- Effectively reduces the frequency and severity of seizures
- Helps restore normal neuronal excitability and synaptic transmission
- Supports long-term neurological stability when maintained within therapeutic range
- May improve overall quality of life by enabling daily activities with reduced seizure risk
- Offers flexible administration routes for acute and chronic management
- Well-documented efficacy across diverse patient demographics and seizure types
Common use
Dilantin is primarily indicated for the control of generalized tonic-clonic seizures and complex partial (psychomotor) seizures. It is also used prophylactically in neurosurgical settings to prevent postoperative seizures. Off-label applications include certain cardiac arrhythmias (particularly those associated with digitalis toxicity) and neuropathic pain syndromes, though these uses require careful specialist supervision.
Dosage and direction
Dosage must be individualized based on therapeutic drug monitoring (target serum concentration: 10–20 mcg/mL). Adults typically start with 100 mg orally three times daily, with adjustments made no more frequently than every 7–10 days. Pediatric dosing is weight-based (5 mg/kg/day divided into 2–3 doses). For intravenous administration, rates must not exceed 50 mg/min to avoid cardiovascular complications. Patients should take Dilantin at consistent times with or without food, though high-fat meals may alter absorption. Never crush or chew extended-release capsules.
Precautions
Regular serum level monitoring is essential due to Dilantin’s nonlinear pharmacokinetics. Use with caution in patients with hepatic impairment, hypoalbuminemia, or renal dysfunction. May cause gingival hyperplasia—maintain rigorous oral hygiene. Monitor for signs of hematologic toxicity (fever, sore throat, bruising). Vitamin D supplementation may be necessary with long-term use due to potential effects on bone metabolism. Abrupt discontinuation may precipitate status epilepticus.
Contraindications
Hypersensitivity to phenytoin, other hydantoins, or any component of the formulation. Contraindicated in patients with sinus bradycardia, sinoatrial block, second- or third-degree AV block, or Adams-Stokes syndrome. Avoid use in pregnancy unless clearly necessary due to well-established teratogenic risks (fetal hydantoin syndrome).
Possible side effect
Common: nystagmus, ataxia, slurred speech, dizziness, insomnia, transient nervousness. Gastrointestinal: nausea, vomiting, constipation. Dermatological: rash (discontinue if progressive or accompanied by fever), hirsutism. Serious: Stevens-Johnson syndrome, toxic epidermal necrolysis, hepatic necrosis, blood dyscrasias, lupus-like syndrome, lymphadenopathy. Chronic use: peripheral neuropathy, osteomalacia, coarsening of facial features.
Drug interaction
Strong interactions with warfarin (increased bleeding risk), oral contraceptives (reduced efficacy), and certain antidepressants. CYP450 enzymes: inhibitors (e.g., amiodarone, chloramphenicol) increase levels; inducers (e.g., carbamazepine, rifampin) decrease levels. Highly protein-bound—monitor when used with other protein-bound drugs (e.g., valproic acid, tolbutamide). Avoid alcohol due to unpredictable effects on metabolism.
Missed dose
If a dose is missed, take it as soon as remembered unless it is nearly time for the next dose. Do not double doses. Maintain consistent timing to avoid fluctuations in serum concentrations. Contact your neurologist if multiple doses are missed, as this may increase seizure risk.
Overdose
Symptoms include cerebellar signs (nystagmus, ataxia), hyperglycemia, hypotension, coma, and potentially fatal cardiovascular collapse. Serum levels >20 mcg/mL indicate toxicity; levels >30 mcg/mL constitute a medical emergency. Treatment is supportive: gastric lavage if recent ingestion, activated charcoal, cardiovascular monitoring, and possibly hemodialysis in severe cases.
Storage
Store at room temperature (15–30°C/59–86°F) in original container. Protect from light and moisture. Keep tightly closed. Do not freeze. Keep all medications out of reach of children and pets. Properly dispose of expired or unused medication through take-back programs.
Disclaimer
This information is for educational purposes and does not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment decisions. Individual responses to medication may vary. Never initiate or discontinue Dilantin without medical supervision.
Reviews
“Dilantin has provided remarkable seizure control for my complex partial seizures for over 15 years. While requiring careful level monitoring, it has allowed me to maintain employment and drive safely.” — Verified patient
“As a neurologist, I appreciate Dilantin’s predictable pharmacokinetics when properly monitored. It remains a valuable option for patients who don’t tolerate newer antiepileptics, though we always weigh benefits against potential long-term side effects.” — Board-certified neurologist