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D-Toin 100
Drug International Ltd.
Generic: Phenytoin Sodium
Safety Advices
বাংলা
English
UNSAFE
It is unsafe to consume alcohol with D-Toin 100.
CONSULT YOUR DOCTOR
D-Toin 100 is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.
SAFE IF PRESCRIBED
D-Toin 100 is safe to use during breastfeeding. Human studies suggest that the drug does not pass into the breastmilk in a significant amount and is not harmful to the baby.
Please consult your doctor.
UNSAFE
D-Toin 100 may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.
CAUTION
D-Toin 100 should be used with caution in patients with kidney disease. Dose adjustment of D-Toin 100 may be needed. Please consult your doctor.
CAUTION
D-Toin 100 should be used with caution in patients with liver disease. Dose adjustment of D-Toin 100 may be needed. Please consult your doctor.
Medicine Overview of D-Toin 100mg Tablet
Introduction
D-Toin 100 is a prescription medicine used to treat and prevent epilepsy (seizures). It controls seizures by decreasing the abnormal and excessive activity of the nerve cells in the brain. It is given when this medicine cannot be given orally, like in hospitalised patients. D-Toin 100 is given under the supervision of a healthcare professional and should not be self administered. It is advisable to take it at the same time each day as this helps to maintain constant level of medicine in the body. If you have missed a dose, take it as soon as you remember it. You...
... Show moreUses of D-Toin 100
- Epilepsy/Seizures
Side effects of D-Toin 100
Common
- Rash
- Headache
- Dizziness
- Vomiting
- Nausea
- Slurred speech
- Vertigo
- Confusion
- Nervousness
- Constipation
- Tremor
- Altered walking
How to use D-Toin 100
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How D-Toin 100 works
D-Toin 100 is an antiepileptic medication. It controls seizures or fits by decreasing the abnormal and excessive activity of the nerve cells in the brain.
Quick Tips
- Take your medication regularly as directed by your doctor as missing doses can trigger seizures.
- Do not change the brand of your medicine and make sure that you have sufficient amount of medicine present with you.
- Some healthy tips to prevent seizures:
- It may cause dizziness and sleepiness. Do not drive or do anything that requires mental focus until you know how it affects you.
- It may increase blood sugar levels. Inform your doctor if you are taking any medicines to treat diabetes.
- It may cause swollen gum (gum hypertrophy), hence take care of oral or dental hygiene.
- Talk to your doctor if you notice sudden mood changes or develop suicidal thoughts.
- Do not stop taking the medication suddenly without talking to your doctor as it may increase the seizure frequency.
Brief Description
Indication
Epilepsy, Tonic-clonic status epilepticus
Administration
IV Preparation
Load IV in 250 mL NS; monitor BP
IV/IM Administration
Administer slowly; no more than 50 mg/min in adults and no more than 1-3 mg/kg/min in pediatric patients
Adult Dose
Status epilepticus
Load 10-15 mg/kg or 15-20 mg/kg at 25-50 mg/min, THEN
Maintenance: 100 mg IV q6-8hr PRN
Administer IV slowly; not to exceed 50 mg/min
Child Dose
Status Epilepticus
15-20 mg/kg IV in single or divided dose; if necessary may administer additional dose of 5-10 mg/kg 10 min after loading dose
Maintenance: 4-8 mg/kg/day IV divided twice daily
Contraindication
Pregnancy. IV admin in sinus bradycardia, heart block, or Stokes-Adams syndrome.
Mode of Action
Phenytoin acts as an anticonvulsant by increasing efflux or decreasing influx of sodium ions across cell membranes in the motor cortex during generation of nerve impulses; thus stabilising neuronal membranes and decreasing seizure activity. It acts as an antiarrhythmic by extending the effective refractory period and suppressing ventricular pacemaker automaticity, shortening action potential in the heart.
Precaution
Cardiovascular disease, e.g. sinus bradycardia, heart blocks; DM; hepatic impairment; hypoalbuminemia; porphyria; seizures (may increase frequency of petit mal seizures); debilitated patients; elderly. Caution in IV admin in hypotension, heart failure or MI, monitor BP and ECG during therapy. IV must be given slowly (too rapid admin may cause hypotension, CNS depression, cardiac arrhythmias and impaired heart conduction). Extravasation and intra-arterial admin must be avoided. Do not discontinue abruptly (may increase seizure frequency), unless safety concerns require a more rapid withdrawal. May impair ability to drive or operate machinery.
Lactation: Excreted in breast milk; not recommended
Side Effect
Hypersensitivity, lack of appetite, headache, dizziness, tremor, transient nervousness, insomnia, GI disturbances (e.g. nausea, vomiting, constipation), tenderness and hyperplasia of the gums, acne, hirsutism, coarsening of the facial features, rashes, osteomalacia. Phenytoin toxicity as manifested as a syndrome of cerebellar, vestibular, ocular effects, notably nystagmus, diplopia, slurred speech, and ataxia; also with mental confusion, dyskinesias, exacerbations of seizure frequency, hyperglycaemia. Solutions for inj may cause local irritation or phlebitis. Prolonged use may produce subtle effects on mental function and cognition, especially in children.
Potentially Fatal: Toxic epidermal necrolysis, Stevens-Johnson syndrome.
Interaction
Effects with other sedative drugs or ethanol may be potentiated. Enhances toxic effects of paracetamol, lithium. Increased risk of osteomalacia with acetazolamide. Decreased serum levels/effects with acyclovir, antineoplastics, benzodiazeines, ciprofloxacin, CYP2C9 inducers (e.g. carbamazepine), CYP2C19 inducers (e.g. rifampin), folic acid, vigabatrin. Increased serum concentrations with allopurinol, capecitabine, cimetidine, CYP2C9 inhibitors (e.g. fluconazole), CYP2C19 inhibitors (e.g. delavirdine), disulfiram, methylphenidate, metronidazole, omeprazole, SSRI, trazodone, trimethoprim. Increases metabolism of antiarrhythmics, anticonvulsants, antipsychotics, beta-blockers, calcium channel blockers, chloramphenicol, corticosteroids, doxycycline, oestrogens, HMG-CoA reductase inhibitors, methadone, theophylline, TCAs. Decreases levels/effects of clozapine, ciclosporin, tacrolimus, CYP2B6 substrates (e.g. bupropion, selegiline), CYP2C8 substrates (e.g. amiodarone), CYP2C9 substrates...
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