Symptoms of phenytoin toxicity include nystagmus, diplopia, slurred speech, ataxia, confusion, and hyperglycaemia. Side effects of phenytoin. Significant: Bone effects (e.g. Phenytoin is used to control seizures (convulsions) in the treatment of epilepsy. Phenytoin or Dilantin Side Effects Produce SJS and TEN . If you have epilepsy, it's best to stay on the same brand of phenytoin, as other brands may not work as well for you. adverse effect or a serious elect rocardiographic change. The most common side effect related to phenytoin in children is jerky movements of the eyes called nystagmus. In Meyler's Side Effects of Drugs (Sixteenth Edition), 2016. (Source: K.D.Tripathi Essentials of Medical Pharmacology 7th Edition) One of its main advantages over benzodiazepines is the less sedative effect. For more information, ask your healthcare provider or pharmacist. These may be avoidable if the dosage is increased slowly. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Other side effects not listed may also occur in some patients. Phenytoin has major effects on metabolism of other medications, and patients should be provided specific advice about other medications that can be used during long term phenytoin … COMMON side effects If experienced, these tend to have a Severe expression i . Phenytoin toxicity as manifested as a syndrome of cerebellar, vestibular, ocular effects, notably nystagmus, diplopia, slurred speech, and ataxia; also with mental confusion, dyskinesias, exacerbations of seizure frequency, hyperglycaemia. As with most medication, side effects are associated with the use of Phenytoin. These may be avoidable if the dosage is increased slowly. Various lymph node abnormalities have been associated with phenytoin therapy. Medically reviewed by Drugs.com. Serious skin side effects can rarely occur during treatment with Phenytoin Sodium Flynn Hard Capsules. Parke-Davis, Morris Plains, NJ. Take this medicine at the same time regularly for a better seizure control. You may report side effects to FDA at 1-800-FDA-1088. It is also used to prevent seizures during or after surgery. In some children, Phenytoin causes problems with thinking or behavior, mood change, slow or clumsy movements, or a loss of energy. Phenytoin may cause swelling and bleeding of the gums. Hematologic effects reported with use including agranulocytosis, leukopenia, pancytopenia, neutropenia, thrombocytopenia, and anemias. Solutions for inj may cause local irritation or phlebitis. Check with your doctor immediately if any of the following side effects occur while taking phenytoin: Some side effects of phenytoin may occur that usually do not need medical attention. Available for Android and iOS devices. Massage your gums and brush and floss your teeth regularly to minimize this problem. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Phenytoin systemic 100 mg (BERTEK 560 BERTEK 560), We comply with the HONcode standard for trustworthy health information -, trouble with breathing, speaking, or swallowing, unsteadiness, trembling, or other problems with muscle control or coordination, increased blinking or spasms of the eyelid, shakiness in the legs, arms, hands, or feet, trembling or shaking of the hands or feet, twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs, uncontrolled twisting movements of the neck, trunk, arms, or legs, blistering, peeling, or loosening of the skin, red skin lesions, often with a purple center, sores, ulcers, or white spots on the lips or in the mouth, swollen, painful, or tender lymph glands in the neck, armpit, or groin, feeling of constant movement of self or surroundings, increased hair growth on the forehead, back, arms, or legs. "Product Information. None of thos e patients developed a cardiovascular. Phenytoin should be introduced in small dosages with gradual increments until control is achieved or until toxic effects appear. Phenytoin side effects Get emergency medical help if you have signs of an allergic reaction to phenytoin (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering … Side effects of phenytoin … Phenobarbital and phenytoin have good antiepileptic effect, but clinically significant untoward effects occur during their long-term use. License: Except as otherwise noted, this work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License. Portions of this document last updated: April 01, 2021. Our general interest e-newsletter keeps you up to date on a wide variety of health topics. Dupuytren's contracture and drug rash with eosinophilia and systemic symptoms (DRESS), erythema multiforme, SJS/TEN risk in patients of Asian ancestry who have HLA-B 1502[Ref], Frequency not reported: Decreased serum T4 and FT4, increased serum estradiol levels, gynecomastia, alterations in vitamin D metabolism[Ref], Common (1% to 10%): Tongue disorder, dry mouth, vomiting, constipation, Uncommon (0.1% to 1%): Dyspepsia, diarrhea, anorexia, GI hemorrhage, increased salivation, tenesmus, tongue edema, dysphagia, flatulence, gastritis, ileus, Frequency not reported: Hypoesthesia of the tongue, gingival hyperplasia[Ref], Uncommon (0.1% to 1%): Urinary retention, oliguria, dysuria, vaginitis, albuminuria, genital edema, polyuria, urethral pain, urinary incontinence, vaginal moniliasis, Frequency not reported: Feeling of warmth or tingling in the groin, Peyronie's disease[Ref], Uncommon (0.1% to 1%): Thrombocytopenia, anemia, leukocytosis, cyanosis, hypochromic anemia, leukopenia, lymphadenopathy, petechia, Frequency not reported: Granulocytopenia, agranulocytosis, pancytopenia (with or without bone marrow suppression), aplastic anemia[Ref], Uncommon (0.1% to 1%): Liver function tests abnormal, kidney failure, Frequency not reported: Toxic hepatitis, hepatocellular damage[Ref], Frequency not reported: Hypersensitivity syndrome, periarteritis nodosa, Postmarketing reports: Anaphylactoid reaction, anaphylaxis[Ref], Uncommon (0.1% to 1%): Sepsis, flu syndrome, cryptococcosis, Frequency not reported: Immunoglobulin abnormalities[Ref], Common (1% to 10%): Injection site reaction, injection site pain, Uncommon (0.1% to 1%): Injection site inflammation, injection site edema, injection site hemorrhage[Ref], Uncommon (0.1% to 1%): Generalized edema, cachexia, diabetes insipidus, Frequency not reported: Hyperglycemia, appetite disorder, hypokalemia[Ref], Common (1% to 10%): Back pain, chills, myasthenia, Uncommon (0.1% to 1%): Myopathy, leg cramps, arthralgia, myalgia, muscular weakness, muscle twitching, muscle spasms, Frequency not reported: Systemic lupus erythematosus, polyarthritis, Purple Glove Syndrome[Ref], Very common (10% or more): Nystagmus (59%), dizziness (31%), somnolence (27%), ataxia (18%), Common (1% to 10%): Headache, stupor, incoordination, paresthesia, extrapyramidal syndrome, tremor, vertigo, brain edema, tinnitus, taste perversion (including metallic taste), taste loss, reflexes decreased, reflexes increased, migraine, slurred speech, dysarthria, intracranial hypertension, hyperesthesia, hyporeflexia, Uncommon (0.1% to 1%): Twitching, Babinski sign positive, circumoral paresthesia, hemiplegia, hypotonia, convulsion, meningitis, CNS depression, hypokinesia, hyperkinesia, brain edema, paralysis, aphasia, coma, myoclonus, acute brain syndrome, encephalitis, subdural hematoma, encephalopathy, akathisia, Frequency not reported: CNS depression, dyskinesia (including chorea), dystonia and asterixis similar to those induced by phenothiazines or other neuroleptic drugs, drowsiness, motor twitching, tonic seizures, sensory peripheral polyneuropathy (in patients receiving long-term therapy)[Ref], Common (1% to 10%): Diplopia, amblyopia, blurred vision, visual impairment, Uncommon (0.1% to 1%): Photosensitivity reaction, photophobia, eye pain, mydriasis, visual field defect[Ref], Common (1% to 10%): Asthenia, deafness, accidental injury, fever, face edema, hyperacusis, parosmia, ear pain, Uncommon (0.1% to 1%): Kidney failure[Ref], Uncommon (0.1% to 1%): Pharyngitis, sinusitis, hyperventilation, rhinitis, apnea, aspiration pneumonia, asthma, dyspnea, atelectasis, cough increased, sputum increased, epistaxis, hypoxia, pneumothorax, hemoptysis, bronchitis, Postmarketing reports: Respiratory arrest (sometimes fatal)[Ref], Common (1% to 10%): Agitation, thinking abnormal, nervousness, depression, Uncommon (0.1% to 1%): Confusion, insomnia, depersonalization, psychosis, emotional lability, personality disorder, hostility, amnesia, neurosis, euphoric mood[Ref], 1. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Applies to phenytoin: compounding powder, injectable solution, oral capsule, oral capsule extended release, oral suspension, oral tablet chewable, Common (1% to 10%): Hypotension, vasodilation, tachycardia, Uncommon (0.1% to 1%): Shock, cardiac arrest, syncope, cerebral hemorrhage, palpitation, sinus bradycardia, atrial flutter, bundle branch block, cardiomegaly, cerebral infarct, postural hypotension, pulmonary embolus, QT interval prolongation, thrombophlebitis, ventricular extrasystoles, congestive heart failure, Frequency not reported: Cardiovascular collapse, severe cardiotoxic reactions with atrial and ventricular conduction depression (including bradycardia and all degrees of heart block), asystole ventricular fibrillation, periarteritis nodosa[Ref], Very common (10% or more): Rash (more serious and rare forms have included bullous, exfoliative or purpuric dermatitis, lupus erythematosus, Stevens-Johnson syndrome and toxic epidermal necrolysis), pruritus, Common (1% to 10%): Maculopapular rash, urticaria, sweating, skin discoloration, contact dermatitis, pustular rash, skin nodule, ecchymosis, Frequency not reported: Hirsutism, hypertrichosis, coarsening of the facial features, enlargement of the lips, Peyronie's disease. Dilantin (Phenytoin) is an antiepileptic or anticonvulsant drug used to control seizures in certain types of epilepsy. This medicine is available only with your doctor's prescription. All rights reserved. For commercial use or customized versions, pl Drug information provided by: IBM Micromedex. Other side effects from high doses include unsteadiness in the feet and hands, sleepiness, and vomiting. Phenytoin: Belongs to the class of hydantoin derivatives antiepileptics., Pharmacogenomics: Individuals who are carriers of human leukocyte antigen (HLA)-B*15:02 may be at risk of phenytoin induced cutaneous adverse reactions such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, FREE book offer — Mayo Clinic Health Letter, Time running out - 40% off Online Mayo Clinic Diet ends soon. Get emergency medical help if you have signs of an allergic reaction to phenytoin (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling). Check with your doctor immediately if any of the following side effects occur: More common. gabapentin, clonazepam, lorazepam, lamotrigine, diazepam, topiramate, Lyrica, pregabalin, Ativan, levetiracetam. May render OCPs ineffective because of induction of hepatic metabolism Phenytoin's inhibitory effect is dependent on the voltage and frequency of neural cell firing by selectively blocking the neurons that are firing at high frequency. Prolonged use may produce subtle effects on mental function and cognition, especially in children. What are the side effects of Dilantin (Phenytoin (Injection))? Phenobarbital may cause hyperactivity, behavioral problems, sedation, and even dementia; these effects are dose related to some extent. Last updated on July 11, 2020. • Phenytoin administration has been associated with toxic effects. The more common side effects that can occur with phenytoin include: problems … The choice between phenytoin and carbamazepine will be influenced by individual needs and responses. Decreased coordination mental confusion nervousness slurred speech trouble with breathing, speaking, or swallowing unsteadiness, trembling, or other problems with muscle control or coordination Rare. Phenytoin. Phenytoin also may affect cognitive functioning at higher levels. Options: Show MedDRA Preferred Terms, display all 25 labels. dose-related side effects 3. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. Phenytoin Side Effects Headache, nausea, vomiting, constipation, dizziness, feeling of spinning, drowsiness, trouble sleeping, or nervousness may occur. Antiepileptic medications have been associated with an increased risk of suicidal thinking and behavior. CABENUVA may cause serious side effects, including: Allergic reactions. Phenytoin is reported to cause a range of deleterious and erratic side effects at therapeutic and toxic doses. Copyright © 2021 IBM Watson Health. ([2006]): 3. Check with your doctor immediately if any of the following side effects occur: Some side effects may occur that usually do not need medical attention. Phenytoin is a potent inducer of hepatic drug-metabolizing enzymes. If you suddenly stop taking phenytoin, your seizures may worsen. Copy link. Phenytoin Dosing and titration . Potentially serious side effects include sleepiness, self harm, liver problems, bone marrow suppression, low blood pressure, and toxic epidermal necrolysis. Side effects . Although not all of these side effects may occur, if they do occur they may need medical attention. Other side effects include: hepatic necrosis, ataxia, confusion, constipation, depression, dizziness, drowsiness, fatigue, hypertrichosis, mental status changes, myasthenia, nervousness, numbness, tremor, tremor of hands, vertigo, excitement, irritability, mood changes, and restlessness. These movements often do not interfere with a child's vision. May render OCPs ineffective because of induction of hepatic metabolism Phenytoin has major effects on metabolism of other medications, and patients should be provided specific advice about other medications that can be used during long term phenytoin therapy. Phenytoin can cause serious side effects including: 1. You may report side effects to the FDA at 1-800-FDA-1088. More common side effects. These movements often do not interfere with a child's vision. Some side effects can be serious. Increased risk of suicidal thoughts or behavior reported. Call your doctor for medical advice about side effects. SJS is a disorder that alters skin tissue and mucous membranes and often produces painful blistering rashes and skin burns. Read more about the prescription drug PHENYTOIN - INJECTION. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Cutaneous side effects are the most common side effects causing discontinuation of carbamazepine; Cross-reaction exists between carbamazepine and amitriptyline; Phenytoin: Erythroderma (redness of the entire skin) Facial pustules (acne medicamentosa) Hyperpigmentation (darkening of the skin) Hypertrichosis (excess hair growth) Lupus-like symptoms Inability to move the eyes This is not a complete list of side effects and others may occur. The apparent stimulatory effect has prompted its assessment in wound healing. Phenytoin is a potent inducer of hepatic drug-metabolizing enzymes. Reactions include nystagmus, ataxia, slurred speech, decreased coordination, somnolence, and mental confusion. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Phenytoin. Get medical assistance immediately … See below for a comprehensive list of adverse effects. Feeling sick (nausea) or being sick (vomiting) Stick to simple meals - avoid rich or spicy food: Constipation: Eat a well-balanced diet and drink plenty of water each day: Feeling dizzy or sleepy; eyesight problems such as double vision Nervous System: The most common adverse reactions encountered with phenytoin therapy are nervous system reactions and are usually dose-related. If you are of such origin and have been tested previously carrying this genetic variant (HLA-B*1502), discuss this with your doctor before taking Phenytoin Sodium Flynn Hard Capsules. If you experience any of the following symptoms, stop taking phenytoin and call your doctor: swelling of the face, eyes, throat, tongue, or lips; difficulty swallowing or breathing; Phenytoin may cause other side effects. It takes around 4 weeks for phenytoin to work. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Hypersensitivity rashes are usually like measles or rarely severe exfoliative, purpuric, bullous, lupus erythemato-sus, Steven Johnson’s lesions and toxic epidermal necrolysis lesions. Although not all of these side effects may occur, if they do occur they may need medical attention. Post Author: Med Explosion! Since phenytoin is highly protein-bound and free (unbound) phenytoin is the component producing the pharmacological effect, any factor which changes the protein binding of phenytoin would be expected to alter the free drug levels. The most common side effect related to phenytoin in children is jerky movements of the eyes called nystagmus. Phenytoin induces CYP3A4 activity and is a substrate and inducer of CYP2C9 and CYP2C19. Phenytoin can also cause other side effects. According to the People's Pharmacy, phenytoin was first discovered in 1908, although it was not used to treat seizure disorders until 1938.
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