Phenytoin for epilepsy

Phenytoin for epilepsy
Examples
How It Works
Why It Is Used
How Well It Works
Side Effects
What To Think About
References
Credits

Content provided by Healthwise

Examples

Brand Name	Chemical Name
Cerebyx	fosphenytoin

Brand Name	Chemical Name
Phenytek	phenytoin

Phenytoin requires several doses each day. It is available in liquid, capsule, and chewable tablet forms. It is also available as an injection (phenytoin sodium).

Fosphenytoin is an intravenous (IV) form of phenytoin that can be used in cases of status epilepticus.

How It Works

Phenytoin prevents seizures by reducing activity in certain areas of the brain.

Why It Is Used

Phenytoin is one of the drugs of choice for:

Generalized tonic-clonic seizures. Valproic acid is another drug of choice.
Partial seizures. Carbamazepine is another drug of choice.

Phenytoin should not be used to treat absence seizures or myoclonic seizures.

How Well It Works

Phenytoin is very effective for preventing generalized tonic-clonic seizures (although it does not prevent other types of generalized seizures).¹ It also does an excellent job of preventing all three types of partial seizures.

Side Effects

Common side effects of phenytoin include:

Swollen, tender gums.
Growth of facial and body hair.
Enlarged or rough facial features.
Acne.
Skin rash.

High levels of phenytoin in the body may also cause:

Drowsiness.
Double vision.
Dizziness.
Tremors or shaking.
Decreased coordination.
Confusion and inability to concentrate.
Osteoporosis.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Getting regular blood tests to monitor the level of medication in your blood can help keep your dose in the appropriate range.

Adverse effects. Phenytoin has side effects that may affect your appearance (excess hair, acne, enlarged or rough facial features). Many people may be unwilling to deal with these side effects. While most people tolerate the drug fairly well, at high levels it can affect your thinking (cognitive impairment). Because it can cause osteoporosis, phenytoin often is not the best choice for older people. In rare cases, phenytoin can affect blood counts, the liver, or the kidneys.
Risk of birth defects. Phenytoin has been shown to increase the risk of birth defects, especially heart defects, cleft lip and cleft palate, and milder defects affecting the face, skull, and fingers and toes.
Ease of use. Phenytoin requires several doses per day and comes in several forms.
Other concerns. Phenytoin may reduce the effectiveness of birth control pills.

It may take time and careful, controlled adjustments by you and your doctor to find the combination, schedule, and dosing of medication to best manage your epilepsy. The goal is to prevent seizures while causing as few unwanted side effects as possible. Once the most effective medication program is determined, it is important that you follow it exactly as prescribed.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

Citations
Tuder Smith C, et al. (2005). Phenytoin versus valproate monotherapy for partial onset seizures and generalized onset tonic-clonic seizures. Cochrane Database of Systematic Reviews (1). Oxford: Update Software.

Credits

Author	Monica Rhodes
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman
Primary Medical Reviewer	Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer	Steven C. Schachter, MD - Neurology
Last Updated	November 11, 2005

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Last updated:	November 11, 2005
Author:	Monica Rhodes
Reviewed By:	Michael J. Sexton, MD - Pediatrics, Steven C. Schachter, MD - Neurology
Editors:	Kathleen M. Ariss, MS, Pat Truman

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