Dilantin (Phenytoin) Patient Information: Missed a Dose and What Should I Avoid at RxList

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May 27, 2012

Dilantin

Seizures Symptoms and Types »

Generalized seizures

There are six types of generalized seizures. The most common and dramatic, and therefore the most well known, is the generalized convulsion, also called the grand-mal seizure. In this type of seizure, the patient loses consciousness and usually collapses. The loss of consciousness is followed by generalized body stiffening (called the "tonic" phase of the seizure) for 30 to 60 seconds, then by violent jerking (the "clonic" phase) for 30 to 60 seconds, after which the patient goes into a deep sleep (the "postictal" or after-seizure phase). During grand-mal seizures, injuries and accidents may occur, such as tongue biting and urinary incontinence.

Absence seizures cause a short loss of consciousness (just a few seconds) with few or no symptoms. The patient, most often a child, typically interrupts an activity and stares blankly. These seizures begin and end abruptly and may occur several times a day. Patients are usu...

Read the Seizures Symptoms and Types article »

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Dilantin Patient Information including If I Miss a Dose

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of phenytoin can be fatal.

Overdose symptoms may include twitching eye movements, slurred speech, loss of balance, tremor, muscle stiffness or weakness, nausea, vomiting, feeling light-headed, fainting, and slow or shallow breathing.

What should I avoid while taking phenytoin?

Avoid drinking alcohol. It can increase some of the side effects of phenytoin, and can also increase your risk of seizure.

Avoid taking antacids at the same time you take phenytoin. Antacids can make it harder for your body to absorb the medication.

Phenytoin can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What other drugs will affect phenytoin?

Drugs that can increase phenytoin levels in your blood include:

stomach acid reducers such as cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid), or nizatidine (Axid);
certain sedatives (such as Librium or Valium) or antidepressants (such as Prozac);
estrogen hormone replacement;
chlorpromazine (Thorazine), prochlorperazine (Compazine), thioridazine (Mellaril) and other phenothiazines;
disulfiram (Antabuse);
methylphenidate (Ritalin, Concerta, Daytrana); and
sulfa drugs such as Septra or Bactrim.

Drugs that can make phenytoin less effective in controlling seizures include carbamazepine (Tegretol, Epitol, Carbatrol), sucralfate (Carafate), and molindone (Moban).

Other drugs that can interact with phenytoin include:

phenobarbital (Luminal, Solfoton), valproic acid (Depakene) or divalproex sodium (Depakote);

steroid medicines (prednisone and others);
antidepressants such as amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Janimine, Tofranil), paroxetine (Paxil), and others;
antibiotics such as rifampin (Rimactane, Rifadin, Rifamate) or doxycycline (Doryx, Vibramycin, Adoxa, and others);
digoxin (digitalis, Lanoxin), furosemide (Lasix); and
theophylline (Elixophyllin, Theo-Dur, Theo-Bid, Theolair, Uniphyl).

This list is not complete and there are many other medicines that can interact with phenytoin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Where can I get more information?

Your pharmacist can provide more information about phenytoin.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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