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The active ingredient Phenytoin is used to treat epilepsy, cardiac arrhythmias and nerve pain (neurogenic pain). Since it is essential for some diseases, the World Health Organization Phenytoin has added to the list of essential medicines. Here you can read everything worth knowing about Phenytoin: action, application and side effects
How Phenytoin acts
The disease decreases.
In the heart of sodium ions are used for signal transfer. By blocking the sodium channels can here Phenytoin finish caused by too rapid signals arrhythmia and so normalize the heart rhythm.
Experts believe that the relief of nerve pain (neurogenic pain) by Phenytoin is due to a blockage of the sodium channel: This inhibits the transmission of pain signals
income, reduction and elimination of Phenytoin
After taking the drug is absorbed in the intestine. Because it is not readily soluble in water, it is conveyed (albumin) in the blood by means of transport proteins. Phenytoin is metabolized in the liver and then largely excreted in the bile in the faeces. The time until the half of the dose is excreted again, depends on the blood levels of the active ingredient material, but is usually between 20 and 60 hours.
When will Phenytoin used?
The active ingredient Phenytoin is approved as an antiepileptic used to treat certain seizure-forms. These include focal introduced generalizing and generalized tonic-clonic seizures, simple and complex partial seizures and combinations of these types of seizures. Phenytoin may also be used in acute attacks, as well as a “status epilepticus”, ie an extra-long seizure. In addition, it is also used to prevent and treat seizures during neurosurgical operations and allowed with severe brain trauma.
As a means of second choice Phenytoin may be administered for the relief of nerve pain.
The treatment of cardiac arrhythmias with Phenytoin is a so-called “off-label use”, ie an application outside the scope of accreditation.
How Phenytoin is applied
For the treatment and prevention of epileptic seizures Phenytoin is usually taken in one to three divided doses per day, wherein the daily total dosage is 300 milligrams Phenytoin. At the beginning of treatment, the metering “einschleichend”, it is therefore only administered a very low dose that is then slowly increased. Higher dosages may be necessary in more severe forms of disease. The dose is increased – especially if the dosage is increased quickly – however, must be done only under medical supervision. The tablets should be swallowed with a glass of water. Prolonged ingestion the total daily dose can be divided into one or two doses.
The application period depends on the reason of taking, they can take place (for symptom control in epilepsy), both short-term (in neurosurgical operations) or long term.
What are the side effects Phenytoin?
Many adverse drug reactions are dose-dependent manner when treated with Phenytoin. Therefore, the dosage is usually selected by the physician so that if possible few or no side effects occur.
In a hundred to thousands of patients may experience as an excessive pigmentation and increased hair to skin lesions. Likewise, a gingival overgrowth is possible.
Rare Phenytoin side effects include blood disorders, severe arrhythmia, abnormal liver function, and allergic reactions (swelling). When allergic reactions occur, Phenytoin should not taken and a doctor can be contacted.
What is to consider when taking this medicine?
In addition, consumed drugs could interact with Phenytoin. This is often the case when both drugs are transported via the same path, or degraded in the body. As a result, Phenytoin can be either accelerated or delayed but dismantled.
To see an increased breakdown of Phenytoin and thus reduce its impact, it can by combining with certain antibiotics (Ciprofloxacin, rifampicin), antiepileptics (vigabatrin, primidone), HIV drugs (lopinavir, ritonavir) and other active ingredients (Dexamethasone , Theophylline) come. Alcohol abuse and (vitamin B9) may reduce the effect of Phenytoin.
In a delayed degradation of Phenytoin his blood levels may increase dangerously. This is possible as with concurrent use of certain antibiotics (Chloramphenicol, Erythromycin, sulfonamides), agents used to treat epilepsy (valproate, Topiramate, Oxcarbazepine), analgesics (aspirin, phenylbutazone, propyphenazone), antidepressants (Fluoxetine, Amitriptyline, Imipramine) and agents to treat fungal infections (ketoconazole, Fluconazole, amphotericin B).
Phenytoin Dregt ain formation of drug-degrading enzyme cytochrome P450 3A4. Thereby, drugs that are metabolized by this enzyme degraded faster. This affects a number of different drugs, which is why the co-administration of Phenytoin and other drugs should always be previously discussed with the doctor or pharmacist.
The antiepileptic drug Phenytoin may not be stopped suddenly, because it may lead to a epilepticus seizure clustering and the occurrence of a state otherwise.
Phenytoin may result in a dose-dependent malformations of the child in the womb. In pregnant women with epilepsy, therefore the dose depending on the severity of the disease should be reduced to the maximum in order as secure as possible to achieve seizure freedom. Additionally, Phenytoin should in pregnancy not be combined with other anti-epileptic drugs.
Phenytoin comes only in small amounts in breast milk, which is why weaning is not necessary. The infant, however, should always be monitored, that it continuously increases the weight and is not overly tired.
Patients who are descended from Thais, or Han Chinese, an increased risk of a severe allergic skin reaction (Stevens-Johnson syndrome) may contribute to the treatment with Phenytoin.
Children and adolescents below 50 kilogram of body weight can be treated with a suitably adapted dosage.
How to obtain drugs with Phenytoin
The active ingredient Phenytoin is available by doctor’s prescription in the pharmacy. Because of the multiple interactions should be asked at the beginning of treatment and any change in the medication the doctor or pharmacist for advice.
Since when Phenytoin is known?
Phenytoin was first produced in 1908 by the German chemist Heinrich chemically Biltz, who sold his development at the pharmaceutical company Parke-Davis. Only in 1938, scientists discovered the good cramp-suppressive effectiveness of Phenytoin. In contrast to the anti-epileptic drug phenobarbital but lacks the strong soporific side effect. It was approved in the United States 1953rd Since the patent has expired long, there is on the German pharmaceutical market now numerous generics with the active ingredient Phenytoin .