Because most trials included in the analysis did not extend beyond 24 weeks, the risk of suicidal thoughts or behavior beyond 24 weeks could not be assessed.The risk of suicidal thoughts or behavior was generally consistent among drugs in the data analyzed. Other signs are tremor, hyperreflexia, lethargy, slurred speech, blurred vision, nausea, and vomiting. Phenytoin is an agent commonly prescribed for the treatment of seizure disorders. When, in the judgment of the clinician, the need for dosage reduction, discontinuation, or substitution of alternative anticonvulsant medication arises, this should be done gradually. Phenytoin systemic 100 mg (BERTEK 560 BERTEK 560) The initial symptoms are nystagmus, ataxia, and dysarthria. 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 As much as 25 times the therapeutic dose has been taken to result in a serum concentration over 100 mcg/mL with complete recovery.
Limited evidence suggests that HLA-B*1502 may be a risk factor for the development of SJS/TEN in patients of Asian ancestry taking other antiepileptic drugs associated with SJS/TEN, including phenytoin. What is the salt factor for phenytoin capsules/IV. Phenytoin is metabolized by hepatic cytochrome P450 enzymes CYP2C9 and CYP2C19, and is particularly susceptible to inhibitory drug interactions because it is subject to saturable metabolism. The finding of increased risk with AEDs of varying mechanisms of action and across a range of indications suggests that the risk applies to all AEDs used for any indication. Consideration should be given to avoiding phenytoin as an alternative for carbamazepine in patients positive for HLA-B*1502.The use of HLA-B*1502 genotyping has important limitations and must never substitute for appropriate clinical vigilance and patient management. Irreversible cerebellar dysfunction and atrophy have been reported.The adequacy of the respiratory and circulatory systems should be carefully observed and appropriate supportive measures employed. A recommended daily maintenance dosage is usually 4 to 8 mg/kg. Hemodialysis can be considered since phenytoin is not completely bound to plasma proteins. These symptoms may include, but are not limited to, fever, sore throat, rash, ulcers in the mouth, easy bruising, lymphadenopathy, facial swelling, and petechial or purpuric hemorrhage, and in the case of liver reactions, anorexia, nausea/vomiting, or jaundice. Call a healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you:How can I watch for early symptoms of suicidal thoughts and actions?Phenytoin can cause a type of serious allergic reaction that may affect different parts of the body such as your liver, kidneys, blood, heart, skin or other parts of your body. These can be very serious and cause death. Phenytoin should normally be gradually withdrawn to reduce the potential for increased seizure frequency and status epilepticus Counsel patients, their caregivers, and families that AEDs, including Phenytoin Infatabs, may increase the risk of suicidal thoughts and behavior and advise them of the need to be alert for the emergence or worsening of symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm. S = 0.92. No increases in tumor incidence were observed in rats. New York, NY: Pfizer Inc.; 2013. Because this disorder is variable in its expression, other organ systems not noted here may be involved. Phenytoin is a potent inducer of hepatic drug-metabolizing enzymes In carcinogenicity studies, phenytoin was administered in the diet to mice (10, 25, or 45 mg/kg/day) and rats (25, 50, or 100 mg/kg/day) for 2 years. Phenytoin was clastogenic in the in vitro sister chromatid exchange assay in CHO cells.Phenytoin has not been adequately assessed for effects on male or female fertility.Phenytoin Infatabs contain 50 mg phenytoin and are supplied in a yellow triangular scored chewable tablet as follows:Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].