What are the safe levels for Dilantin?
You should not use Dilantin if you are allergic to phenytoin, or if you have ever had:
- liver problems caused by phenytoin;
- an allergy to similar medicines such as ethotoin, fosDilantin, or meDilantin; or
- if you currently take delavirdine (Rescriptor).
Can you get high on Dilantin?
Excessive drowsiness is the sign of Dilantin toxicity, indicating that the Dilantin level in the body is too high. Involuntary Movements – Involuntary movements is another common symptom of Dilantin toxicity, where the patient may experience involuntary jerking movements.
Does Dilantin test positive for benzodiazepines or barbituates?
Phenytoin (Dilantin) is not a barbiturate, but one of the things it metabolizes into can suggest barbiturate in the initial screening. HOWEVER, the confirmatory GC/MS test will definitively rule out barbiturates. So no worries. Would it be in your best interest to disclose it before hand?
What is an acceptable Dilantin level?
When should I contact my healthcare provider?
- You have frequent or unexplained falls.
- You missed a dose of Dilantin.
- You have nausea, or you are vomiting.
- You have a decreased appetite.
- Your abdomen is bloated.
- You have questions or concerns about your condition or care.
What is a toxic level of Dilantin?
Twenty to 30 mg/L: Nystagmus. Thirty to 40 mg/L: Ataxia, slurred speech, tremor, nausea, and vomiting. Forty to 50 mg/L: Lethargy, confusion, hyperactivity. Greater than 50 mg/L: Coma and seizures.
What range of numbers should a Dilantin level fall between?
Although the reference range is between 10 and 20 µg/mL, about half of patients' seizures are controlled at values lower and higher than the therapeutic range. Some adverse effects of phenytoin are related to specific serum levels. Nystagmus is frequently observed at levels greater than 20 µg/mL.
What is the normal therapeutic level of phenytoin Dilantin?
The therapeutic range is 10-20 mcg/mL. Total phenytoin levels (mcg/mL) and typical corresponding signs and symptoms are as follows: Lower than 10 - Rare. Between 10 and 20 - Occasional mild nystagmus.
When should Dilantin levels be checked?
After a patient has received a loading dose of intravenous phenytoin, levels can be checked one hour after the dose. If loading is achieved by oral dosing, phenytoin levels can be checked 24 hours after the last dose10. This level can aid in determining maintenance dose or need to reload.
Why are Dilantin levels low?
2. Drugs which may decrease phenytoin levels include: carbamazepine, chronic alcohol abuse, reserpine, and sucralfate. Moban® brand of molindone hydrochloride contains calcium ions which interfere with the absorption of phenytoin.
How do I lower my Dilantin levels?
Serum levels of phenytoin are decreased by the following:Antineoplastic drugs.Calcium.Diazepam.Diazoxide.Ethanol (long-term use),Folic acid.Phenobarbital.Rifampin.More items...•
What are the symptoms of too much Dilantin?
SymptomsComa.Confusion.Staggering gait or walk (early sign)Unsteadiness, uncoordinated movements (early sign)Involuntary, jerky, repeated movement of the eyeballs called nystagmus (early sign)Seizures.Tremor (uncontrollable, repeated shaking of the arms or legs)Sleepiness.More items...
What are the long term effects of Dilantin?
Long-term side effects overgrowth of the gums. excessive hair on the face or body. acne. coarseness of facial features.
Why is phenytoin given at night?
Why Is Phenytoin Given At Night? Phenytoin is commonly administered in the evening or at night. So that by the morning, there is sufficient concentration of the drug in the tissues and blood. This would reduce the risk or chances of a morning epileptic seizure.
How many doses of dilantin are there?
Initially, one gram of DILANTIN (extended phenytoin sodium capsules, USP) is divided into three doses ( 400 mg, 300 mg, 300 mg) and administered at two-hour intervals. Normal maintenance dosage is then instituted 24 hours after the loading dose, with frequent serum level determinations.
How many doses of dilantin are needed for seizures?
For most adults, the satisfactory maintenance dosage will be one capsule three to four times a day. In adults, if seizure control is established with divided doses of three 100-mg DILANTIN (extended phenytoin sodium capsules, USP) daily, once-a-day dosage with 300 mg of DILANTIN (extended phenytoin sodium capsules, USP) may be considered .
Why is phenytoin decreased during pregnancy?
Decreased serum concentrations of phenytoin may occur during pregnancy because of altered phenytoin pharmacokinetics. Periodic measurement of serum phenytoin concentrations should be performed during pregnancy, and the DILANTIN dosage should be adjusted as necessary. Postpartum restoration of the original dosage will probably be indicated ...
How long does it take for phenytoin to work?
With recommended dosage, a period of seven to ten days may be required to achieve steady-state blood levels with phenytoin and changes in dosage (increase or decrease) should not be carried out at intervals shorter than seven to ten days.
Can you take dilantin once a day?
Only DILANTIN (extended phenytoin sodium capsules, USP) are recommended for once-a-day dosing. Inherent differences in dissolution characteristics and resultant absorption rates of phenytoin due to different manufacturing procedures and/or dosage forms preclude such recommendation for other phenytoin products. When a change in the dosage form or brand is prescribed, careful monitoring of phenytoin serum levels should be carried out.
Can you take phenytoin with renal disease?
This dosing regimen should be reserved for patients in a clinic or hospital setting where phenytoin serum levels can be closely monitored. Patients with a history of renal or liver disease should not receive the oral loading regimen.
Is phenytoin a free acid?
The free acid form of phenytoin is used in DILANTIN-125 Suspension and DILANTIN Infatabs. DILANTIN extended capsules and parenteral DILANTIN are formulated with the sodium salt of phenytoin. Because there is approximately an 8% increase in drug content with the free acid form over that of the sodium salt, dosage adjustments and serum level monitoring may be necessary when switching from a product formulated with the free acid to a product formulated with the sodium salt and vice versa.
Why is phenytoin high in the blood?
The high levels of the drug can be caused by liver disease, congenital enzyme deficiency or drug interactions resulting in metabolic interference.
What are the effects of phenytoin?
This may have various effects, some of which are listed below. – Swelling of the gums and/or lymph nodes. – Excess facial and body hair (hirsutism) – Insomnia. – Nausea and vomiting. – Alterations in sight, smell or taste.
What medications affect phenytoin levels?
– Medicines like antiepileptic drugs, antidepressants, antiviral agents and gastric acid-reducing agents can affect the levels of Phenytoin. – Discuss the details of all the medicines and supplements that you consume with your doctor before undertaking the test.
Why is phenytoin limited?
While the drug has multiple therapeutic uses, its application is limited because of various adverse effects and interactions with other drugs. Phenytoin is also used to prevent the occurrence of seizures during neurosurgery.
How is phenytoin test performed?
How is a Phenytoin test performed? The test is performed by a venipuncture collection of blood from a vein, usually by picking one from the arm. In this process, a needle is inserted into a vein to draw the required volume of blood. The process involves the following steps.
What happens if you take too much phenytoin?
Once the correct levels that are apt for the patient have been reached, the test is done at frequent intervals to make sure that the levels are within the right range .
Is phenytoin high in a test?
Just because the levels are high, it may not mean that there is a problem. Depending on the results and your condition, the doctor may adjust the dosage of Phenytoin as necessary.
What is the reference range for phenytoin?
Although the reference range is between 10 and 20 µg/mL, about half of patients' seizures are controlled at values lower and higher than the therapeutic range. Some adverse effects of phenytoin are related to specific serum levels. Nystagmus is frequently observed at levels greater than 20 µg/mL.
What does high phenytoin mean?
Beside above, what does high phenytoin level mean? The neurotoxic effects are concentration dependent and can range from mild nystagmus to ataxia, slurred speech, vomiting, lethargy and eventually coma and death. Paradoxically, at very high concentrations, phenytoin can lead to seizures. Greater than 50 mg/L: Coma and seizures.
Can dilantin cause dizziness?
This is more likely to happen when doses are increased or other medications are started or stopped. Common symptoms of Dilantin toxicity include dizziness, drowsiness, coordination problems, rapid eye movements, and extreme fatigue.
What is the phenytoin level?
Neonates: 8-15 µg/mL. Toxic phenytoin levels are defined as greater than 30 µg/mL.
What is the reference range for seizures?
Although the reference range is between 10 and 20 µg/mL, about half of patients’ seizures are controlled at values lower and higher than the therapeutic range. [ 6]
Why is phenytoin used in seizures?
Phenytoin is used as both an abortive and preventive medication in seizure management.
How long after phenytoin is administered?
Loading doses to achieve rapid therapeutic levels should be checked 1 hour after an intravenous loading dose and 24 hours after an oral loading dose. [ 4]
Is phenytoin bound to albumin?
Total phenytoin levels reflect both bound and unbound drug; because protein-bound phenytoin cannot cross the blood-brain barrier, only free phenytoin is active. In healthy adults, approximately 90% of phenytoin is bound to albumin. Corrected levels can be calculated using the Sheiner-Tozer method. [ 4, 6] Correction should be used in patients with uremia, hepatic disease, and AIDS. [ 6]
Is phenytoin safe for pregnant women?
In addition to monitoring renal function, hepatic function, and albumin levels, physicians should be aware of antifolate and anti–vitamin K properties of phenytoin in pregnant women. Folate levels and abnormal bleeding profiles should be considered in pregnant women and newborns, with supplementation as indicated. [ 7]
Is phenytoin a preventative or abortive medication?
Phenytoin is used as both an abortive and preventive medication in seizure management. Intravenous administration of phenytoin ceased seizure activity in 60%-80% of patients in status epilepticus within 20 minutes. Prophylactic indications include pregnancy-induced hypertension, postneurosurgery, cerebrovascular accidents, ...
How much dilantin is in the blood?
The suitable blood concentration of Dilantin usually ranges from 10 micrograms per milliliter to 20 micrograms per milliliter. When the level surpasses or reaches 30 micrograms per milliliter, then it can cause Dilantin toxicity in patients.
What is the toxicity of dilantin?
What is Dilantin Toxicity? Dilantin is the brand name of a prescription drug phenytoin which is widely used to treat episodes of seizures in people after brain surgery or epilepsy . Just like other medications, Dilantin is also known to cause severe toxicity in people.
How long does it take to recover from a dilantin overdose?
Doctors may also prescribe mild overdose supportive treatments to treat Dilantin toxicity and ensure faster recovery. In serious cases of Dilantin toxicity, where patients are unconscious, the doctors may offer aggressive treatment, which may take few days for patients to regain their consciousness. Rate of fatality is rare, but it can occur ...
How to tell if dilantin is toxic?
The most common signs of Dilantin toxicity includes lethargy, dizziness, drowsiness and rapid eye movements. People who presume to have Dilantin toxicity must contact their healthcare provider immediately to alleviate the symptoms and treat the condition. The symptoms of Dilantin toxicity can be subsided easily by reducing the daily doses ...
What are the symptoms of dilantin toxicity?
Some of the common symptoms of Dilantin toxicity include: Instinctive and Rapid Eye Movements – Nystagmus is the medical condition where you experience instinctive or rapid jerking movements of your eyes. It is the first sign of Dilantin toxicity.
What is the best treatment for dilantin toxicity?
To treat Dilantin toxicity doctors usually use activated charcoal, intravenous fluids, breathing aid with ventilator and if the symptoms are severe, gastric lavage. The functions of the heart and kidney are monitored regularly throughout the treatment phase with electrocardiogram and blood tests, respectively.
Is dilantin a symptomatic drug?
No antidote is available till now to prevent Dilantin toxicity but symptomatic treatment is offered. The vital symptoms of the toxicity and blood concentration level of Dilantin is monitored.
