Introduction About EPILET INJECTION

EPILET INJECTION contains phenytoin which belongs to the group of medicines called Anti-epileptic drugs. It is used to manage certain forms of epilepsy (fits or seizures) like grand mal fits, status epilepticus (seizures continue for hours or days) and to manage fits during or after neurosurgery.

Epilepsy can be defined as a chronic brain disorder which occurs when signals and chemicals of the brain cells are not working properly. EPILET INJECTION can also be used to rectify some heart rhythm abnormalities.

During EPILET INJECTION management, your doctor might ask you to take certain blood tests to monitor side effects. You will also be advised to maintain good oral hygiene and massage the gums to manage bleeding, tender or enlarged gums.

Before receiving EPILET INJECTION, inform your doctor if you have liver, kidney or heart problems, porphyria or diabetes. Avoid consumption of alcohol while receiving EPILET INJECTION as it may affect its blood concentration.

Ask your doctor before receiving EPILET INJECTION during pregnancy. EPILET INJECTION should be used in breastfeeding women only if the potential benefit justifies the potential risk to the foetus. EPILET INJECTION should be cautiously used in children and elderly patients.

The most common side effects of receiving EPILET INJECTION are rapid involuntary eye movements, slurred speech, impaired or decreased coordination, sleepiness and mental confusion. Contact your doctor if any of the symptoms deteriorate.

Uses Of EPILET INJECTION

EPILET INJECTION is used to:

• manage grand mal fits and status epilepticus
• prevent fits during or after neurosurgery
• rectify some heart rhythm abnormalities

How EPILET INJECTION Works

EPILET INJECTION reduces or manages fits by controlling the hyperactivity in the brain that can cause epilepsy or fits.

How to use EPILET INJECTION

EPILET INJECTION will be given to you only by a doctor or a nurse into a vein as an intravenous infusion. Your doctor will decide the right dose and duration for you according to your age, body weight and disease condition. Do not stop receiving EPILET INJECTION unless your doctor advises you to stop.

Side Effects Of EPILET INJECTION

How To Manage Side Effects

Skin rash:

Avoid hot bathing because hot water can irritate your skin further. Do not scratch the affected area. Use protective clothing when going outdoors. Regularly moisturize your skin. Consult your doctor if your skin rash gets worse.

Warning & Precautions

Pregnancy

EPILET INJECTION should be used with caution in pregnant women as it may cause harm to the unborn baby. Women of childbearing capability should use a suitable non-hormonal contraceptive method to avoid getting pregnant while receiving EPILET INJECTION. Consult your doctor before receiving it. Inform your doctor if you become pregnant during management with EPILET INJECTION.

Breastfeeding

EPILET INJECTION should be used in breastfeeding women only if the potential benefit justifies the potential risk to the foetus. Consult your doctor before receiving it.

Driving and Using Machines

Do not drive or operate any machines if you feel dizzy or drowsy after receiving EPILET INJECTION.

Alcohol

Avoid consumption of alcohol while receiving EPILET INJECTION because it may reduce the effectiveness of management or increase the side effects. EPILET INJECTION should be used with caution if the patient has consumed a large amount of alcohol recently or if they drink large amounts of alcohol regularly or if they have alcohol dependence. Consult your doctor before receiving it.

Kidney

EPILET INJECTION should be used with caution in patients having kidney disease. Consult your doctor before receiving it.

Liver

EPILET INJECTION is not recommended for use in patients who experienced prior acute liver toxicity due to phenytoin. EPILET INJECTION should be used with caution in patients with liver disease. Consult your doctor before receiving it.

Allergy

Do not receive EPILET INJECTION if you are allergic to Phenytoin or any of the other ingredients of this medicine or similar hydantoins such as ethotoin or methoin.

Heart Disease

EPILET INJECTION is not recommended in patients having abnormal heart rhythm and heart block, a slow heartbeat, heart problems that affect your heart rate or Adams-Stokes syndrome (suddenly passing out due to change in your heart rate). EPILET INJECTION should be used with caution in patients having low blood pressure, heart failure or heart rhythm problems. Consult your doctor before receiving it.

Interactions

A. Drug - Drug interactions:

Before receiving EPILET INJECTION, inform your doctor if you are taking any of the following medicines:

• medicines used for epilepsy or fits (Ex. carbamazepine, lamotrigine, phenobarbital, sodium valproate and valproic acid, topiramate, oxcarbazepine, ethosuximide,vigabatrin)

• medicines used to manage fungal infections (Ex. amphotericin B, voriconazole, miconazole, fluconazole, itraconazole, ketoconazole, posaconazole)
• medicines used to manage skin diseases (Ex. methoxsalen)
• medicines used for tuberculosis and other infections (Ex. chloramphenicol, isoniazid, rifampicin, sulfadiazine, sulfamethizole, sulfamethoxazole-trimethoprim, sulfaphenazole, sulfisoxazole, doxycycline, ciprofloxacin)
• medicines used for asthma and bronchitis (Ex. theophylline)
• medicines used for diabetes (Ex. tolbutamide, insulin)
• medicines used for pain and inflammation (Ex. phenylbutazone, aspirin, prednisolone)
• medicines used for stomach ulcers and heartburn (Ex. omeprazole, sucralfate, cimetidine, ranitidine, famotidine, antacids)
• medicines used for sleeplessness, depression and psychiatric disorders (Ex. chlordiazepoxide, clozapine, diazepam, disulfiram, lithium, methadone, fluoxetine, fluvoxamine, sertraline, haloperidol, levodopa, paroxetine, methylphenidate, phenothiazines, quetiapine, trazodone, reserpine, amitriptyline, viloxazine)
• medicines used to manage cancer (Ex. teniposide, fluorouracil, doxorubicin, methotrexate, capecitabine, bleomycin, carboplatin, cisplatin)
• medicines used for organ and tissue transplants, to manage rejection (Ex. ciclosporin, tacrolimus)
• medicines used for heart and circulation problems (Ex. dicoumarol, amiodarone, digitoxin, digoxin, nisoldipine, disopyramide, mexiletine, furosemide, quinidine, reserpine, diltiazem, nifedipine)
• hormone replacement therapies (Ex. oestrogens)
• medicines used to manage pregnancy (Ex. estradiol, dienogestrel)
• medicines used to lower high blood cholesterol and triglycerides (Ex. atorvastatin, fluvastatin, simvastatin)
• medicines used in the management of HIV infection (Ex delavirdine, efavirenz, fosamprenavir, indinavir, lopinavir, nelfinavir, ritonavir, saquinavir)
• medicines used to expel parasitic worms from the body (Ex. albendazole, praziquantel)
• medicines used to manage thyroid disorders (Ex. thyroxine)

• medicines used to relax the muscles (Ex. pancuronium, rocuronium, vecuronium)

• medicine used to manage severe pain (Ex. methadone, halothane)
• non-prescription medicines (Ex. folic acid, St John’s Wort, vitamin D)
• medicines used for blood thinning (Ex. warfarin, dicoumarol)

Overdosage:

EPILET INJECTION will be administered to you only by a doctor or a nurse in a hospital, so it is unlikely to receive an overdose. However, consult your doctor or nurse if you experience any unusual symptoms like nystagmus (involuntary eye movement), double vision, loss of control of the whole body, dysarthria (speech disorder), muscle spasms, lethargy, nausea and vomiting.

Synopsis

More Information

• Keep EPILET INJECTION out of reach of children
• Store EPILET INJECTION below 30°C

FAQs About EPILET INJECTION

What should I tell my doctor before receiving EPILET INJECTION?

Patients receiving EPILET INJECTION must inform their doctor about pre-existing conditions like kidney, liver, heart problems or diabetes. Patients should also tell if they are pregnant, breastfeeding or allergic to anything. Consult your doctor if you experience anything different.

Can I take other medicines with EPILET INJECTION?

Before taking EPILET INJECTION, inform your doctor if you are taking, have taken or might take any other medicine, including prescription, over the counter or any herbal medicine, as these might cause serious side effects by interacting with each other.

What if I forget to receive a dose of EPILET INJECTION?

It is unlikely that you forget to receive a dose of EPILET INJECTION since it is given to you by a doctor or nurse. If you think you have missed one, inform you doctor and take it as soon as you remember. However, omit the missed dose if it's almost time for the next one. Do not take EPILET INJECTION two times to make up for the missed dose.

What happens if I suddenly discontinue the use of EPILET INJECTION?

Suddenly stopping EPILET INJECTION may lead to seizures which can be life-threatening. Do not stop receiving EPILET INJECTION without consulting your doctor. If required, your doctor will reduce the dose slowly before stopping it completely.

Can I take EPILET INJECTION during pregnancy?

If you are pregnant, consult your doctor before receiving EPILET INJECTION. Your doctor may decide to change your management and closely monitor your unborn child. If you receive EPILET INJECTION during pregnancy your baby has a higher risk of having a birth defect. If you have childbearing capability and plan to become pregnant, discuss your management options and effective birth control methods with your doctor. Consult your doctor for further doubts.

References

1. KD Tripathi. Anti-epileptic drugs. Essentials of Medical Pharmacology. Eighth Edition, 2019. Page – 439.

2. E H Reynolds, D Chadwick, A W Galbraith, one drug (phenytoin) in the treatment of epilepsy. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. May 1976. [Accessed 22nd June 2022] https://pubmed.ncbi.nlm.nih.gov/57334/

3. Gupta M, Tripp J. Phenytoin. NIH National Library of Medicine, National center for biotechnology information. [Revised on 16th March 2022] [Accessed on 22nd June 2022] https://www.ncbi.nlm.nih.gov/books/NBK551520/

4. Delpharm Tours. Electronic Medicines Compendium (EMC). [Revised in December 2018 [Accessed 22nd June 2022] https://www.medicines.org.uk/emc/files/pil.4326.pdf

5. Hospira UK Limited. Electronic Medicines Compendium (EMC). [Revised in July 2019] [Accessed 22nd June 2022] https://www.medicines.org.uk/emc/files/pil.3794.pdf

6. Dailymed. Phenytoin sodium (phenytoin sodium injection). [Revised in December 2021] [Accessed 22nd June 2022] https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=31d00e75-4fe0-4aec-9cba-c86cb78762c5&type=display

Useful Diagnostic Tests

• Complete blood count
• Electroencephalogram (EEG)