Phenytoin

Drug Class:	Commonly Known As:	Category:
	Dilantin

Phenytoin - Side Effects, Precautions, and Contraindications

What side effects can Phenytoin cause?

Like all medications, Phenytoin may cause side effects but not everyone experiences them.

The common side effects of Phenytoin include:

Dizziness

Get up slowly from sitting or lying down position

Drowsiness

Avoid driving, operating machinery or doing strenuous physical activities
Avoid taking over-the-counter medicines (such as cold or allergy medicines) that could also add on to the drowsiness

Headache
Feeling tired, having difficulty in sleeping
Decrease in folic acid level in the body

Your doctor may prescribe folic acid supplements for you

If you are taking phenytoin for long term use, some of the following side effects might happen:

Growing of hair around face
Thickening of the lips, swollen gums

You can prevent this by maintaining good oral hygiene and use soft-bristled toothbrush

If the following serious side effects happen, you should consult your healthcare professional immediately:

Blistering, peeling, red skin rashes which may be signs of Stevens-Johnson syndrome (SJS) or Toxic Epidermal Necrolysis (TEN)

SJS and TEN are rare and serious skin reactions. Symptoms include face swelling, blisters on skin, skin rashes that spread within hours to days. It usually occurs within the first few months (monitor closely for the first 3 months) of treatment.
As SJS and TEN progress rapidly, please consult your healthcare professional if you show the first sign of rash.

Fever, chills, sore throat, mouth ulcers or sores
Slurred speech, feeling confused
Double vision
Unstable/unsteady movements
Unexplained bleeding or bruising
Sudden decrease in urination
Liver problems: Dark coloured urine or light-coloured stools, yellowing of your eyes or skin, severe loss of appetite, stomach pain, nausea, vomiting that does not go away

In rare cases, this medication may cause the following changes to a person's mental condition, especially in the first few weeks of treatment or during dose changes:

Worsening agitation, restlessness, violent behaviour, or
New or worsening thoughts of harming yourself or ending your life
Other changes in mood or behavior

Please inform your doctor as soon as possible, or for your family or caregiver to inform your doctor if you are unable to seek treatment on your own.

Do not stop taking this medication on your own without discussing with your doctor.

It is important to note that your doctor has prescribed this medication as he/she feels you will benefit more from taking this medication over the possible risks that it may cause, which have a low chance of occurring, and most people take this medication without any such problems.

The symptoms of a drug allergy include one or more of the following:

Swollen face/eyes/lips/tongue
Difficulty in breathing
Itchy skin rashes over your whole body

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

Before taking Phenytoin , what precautions must I follow?

Inform your healthcare professional if you have the following medical conditions before starting on Phenytoin:

Heart problems or irregular heartbeats
Low albumin (a type of protein) in the blood
Drug allergies

For female patients of child-bearing age: Discuss with your doctor regarding family planning if you will be starting or currently taking Phenytoin

Consult your healthcare professional immediately if your seizures get worse or become different after you have started this medication.

What food or medicine must I avoid when I take Phenytoin ?

Take antacids 2 hours before or after you take Phenytoin as it may reduce absorption of Phenytoin.
If you are on tube feeding, you should take Phenytoin 2 hours before or after your feeds.
Phenytoin may decrease the effectiveness of hormonal contraceptives (birth control pills, patches, rings, injections, implants, or intrauterine devices). Discuss with your healthcare professional regarding birth control while on Phenytoin.
Do not take alcohol with this medication as it can make you less alert.
Please consult your healthcare professional before using any other medications, including over-the-counter medications, supplements and herbal products as some of these may affect the medication in your body.