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General Medication Fact Sheet for Phenytoin
| Field | Information |
|---|---|
| Generic Name | Phenytoin |
| Brand Name Versions | Dilantin, Phenytek |
| Boxed/Label Warning | Rapid intravenous administration of phenytoin is associated with serious cardiovascular events, including bradycardia, hypotension, and ventricular fibrillation. The rate of administration should not exceed 50 mg/min in adults and 1-3 mg/kg/min in pediatric patients. |
| Purpose | Anticonvulsant used to control seizures |
| Mechanism of Action | Blocks voltage-gated sodium channels, stabilizing neuronal membranes |
| Dosage Forms | Oral capsules, oral tablets, injectable solution |
| Available Strengths | Capsules: 30 mg, 100 mg, 200 mg, 300 mg; Tablets: 50 mg |
| Dosage Frequency | Typically once to three times daily, as directed by a healthcare provider |
| Common Side Effects | Drowsiness, dizziness, headache, nausea, vomiting, constipation, gingival hyperplasia (gum overgrowth) |
| Serious Side Effects | Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), liver damage, blood dyscrasias |
| Drug Interactions | Warfarin, oral contraceptives, Carbamazepine, Valproic Acid, phenobarbital, rifampin, some antibiotics |
| Important Notes | Regular blood tests are needed to monitor phenytoin levels. Do not stop taking phenytoin suddenly without consulting your doctor. May cause birth defects if taken during pregnancy. |
| Storage | Store at room temperature away from moisture and light |
| Missed Dose | Take as soon as you remember, unless it is almost time for your next dose. Do not double the dose. |
| Alternatives | Carbamazepine, Valproic Acid, Lamotrigine, Levetiracetam |
Phenytoin Alternatives
| Medication | Mechanism of Action | Notes |
|---|---|---|
| Carbamazepine (Tegretol) | Blocks voltage-gated sodium channels | Used for various seizure types and neuropathic pain. |
| Valproic Acid (Depakote) | Increases GABA levels in the brain | Also used to treat bipolar disorder and migraine. |
| Lamotrigine (Lamictal) | Blocks voltage-sensitive sodium channels and inhibits glutamate release | Used for both seizures and bipolar disorder. |
| Levetiracetam (Keppra) | Binds to synaptic vesicle protein SV2A | Broad-spectrum anticonvulsant. |
Phenytoin Side Effects
| Common Side Effects | Serious Side Effects |
|---|---|
| Drowsiness | Stevens-Johnson syndrome |
| Dizziness | Toxic epidermal necrolysis |
| Headache | Drug reaction with eosinophilia and systemic symptoms (DRESS) |
| Nausea | Liver damage |
| Vomiting | Blood dyscrasias (e.g., anemia, leukopenia, thrombocytopenia) |
| Constipation | Suicidal thoughts |
| Gingival hyperplasia (gum overgrowth) | Purple Glove Syndrome (pain and swelling of hands) |
Phenytoin Dosage Guide
| Condition | Starting Dose | Maintenance Dose | Administration Notes |
|---|---|---|---|
| Seizures (Adult) | 100 mg three times daily | 300-400 mg daily (as a single dose or divided doses) | Individualize dosage; monitor blood levels. |
| Seizures (Pediatric) | 5 mg/kg/day in 2-3 divided doses | 4-8 mg/kg/day in 2-3 divided doses | Individualize dosage; monitor blood levels. |
| Status Epilepticus | 15-20 mg/kg IV (loading dose) | Maintenance dose as above, initiated after loading dose | Administer slowly via IV; monitor cardiac and respiratory function. |
Phenytoin Price With And Without Insurance
| Purchase Context | Estimated Price |
|---|---|
| With Insurance | $10 |
| Without Insurance (U.S.) | $10 – $30 |
| From CPS | $27.95 |
