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Indication & Dosage |
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| Oral |
| TREATMENT OF EPILEPSY (PARTIAL SEIZURES WITH OR WITHO SECONDARY GENERALISATION) |
| Adult:
Initially, 3-4 mg/kg body wt once daily or in divided doses. Alternatively, 150-300 mg daily increased gradually to 600 mg daily if necessary. Maintenance: 200-500 mg daily. |
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| Oral |
| TREATMENT OF EPILEPSY (PARTIAL SEIZURES WITH OR WITHO SECONDARY GENERALISATION) |
| Child:
Initially, 5 mg/kg daily in 2-3 divided doses. Maintenance: 4-8 mg/kg daily in divided doses. Max dose: 300 mg daily. |
| Max Dosage: 300 mg daily. |
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| Intravenous |
| TREATMENT OF TONIC-CLONIC STATUS EPILEPTICUS |
| Adult:
Adjunctive therapy with a benzodiazepine (e.g. diazepam): 10-15 mg/kg by slow inj or intermittent infusion at a max rate of 50 mg/min. Maintenance: 100 mg IV (or orally) given every 6-8 hr. |
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| Intravenous |
| TREATMENT OF TONIC-CLONIC STATUS EPILEPTICUS |
| Adult:
Neonates: 20 mg/kg as a loading dose, then 2.5-5 mg/kg bid; 1 mth-12 yr: 18 mg/kg as a loading dose, then 2.5-5 mg/kg bid; >12 yr: 18 mg/kg as a loading dose, then up to 100 mg 3-4 times daily. |
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| Administration |
Should be taken with food. (When administering to patients on nasogastric or other enteral feeds, be consistent throughout therapy in relation to feed times. Do not switch dosage forms/ brands without prior consideration.) |
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| Precautions |
Impaired liver function; diabetes mellitus; hypotension; heart failure; myocardial infarction. Monitor ECG and BP; lactation; avoid extravasation and intra-arterial administration. Administer IV phenytoin slowly. |
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Potentially Life-threatening
Adverse Drug Reactions |
Dyskinesia; peripheral neuropathy; hirsutism; hypokalaemia; megalobalstic anaemia; hepatitis; thyroiditis; skin rashes; vertigo, ataxia, nystagmus, diplopia, gingival hypertrophy. |
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| Adverse Drug Reactions |
Very rarely, hepatitis. |
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| Interactions |
Lowered plasma levels with phenobarbitone, primidone, carbamazepine, clonazepam, digitalis, doxycycline, pyridoxine and corticosteroids. Phenytoin decreases blood levels of phenobarbitone, carbamazepine, digitalis, oral contraceptives, some antibacterials, anticoagulants, clonazepam and corticosteroids by induction of metabolism. Enhanced hypotensive effect of dopamine and lidocaine. Food alters serum concentrations of phenytoin. Decreased serum conc with enteral nutrition; decreases calcium, folic acid and vit D levels. May interfere with some thyroid function tests. |
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