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Introduction About EPTOIN INJECTION
EPTOIN 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. EPTOIN INJECTION can also be used to rectify some heart rhythm abnormalities.
During EPTOIN 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 EPTOIN INJECTION, inform your doctor if you have liver, kidney or heart problems, porphyria or diabetes. Avoid consumption of alcohol while receiving EPTOIN INJECTION as it may affect its blood concentration.
Ask your doctor before receiving EPTOIN INJECTION during pregnancy. EPTOIN INJECTION should be used in breastfeeding women only if the potential benefit justifies the potential risk to the foetus. EPTOIN INJECTION should be cautiously used in children and elderly patients.
The most common side effects of receiving EPTOIN 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 EPTOIN INJECTION
EPTOIN INJECTION is used to:
- manage grand mal fits and status epilepticus
- prevent fits during or after neurosurgery
- rectify some heart rhythm abnormalities
How EPTOIN INJECTION Works
EPTOIN INJECTION reduces or manages fits by controlling the hyperactivity in the brain that can cause epilepsy or fits.
How to use EPTOIN INJECTION
EPTOIN 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 EPTOIN INJECTION unless your doctor advises you to stop.
Side Effects Of EPTOIN INJECTION
Common
- nystagmus (rapid involuntary eye movements)
- slurred speech
- impaired or decreased coordination
- sleepiness
- mental confusion
Rare
- serious forms of allergic reactions
- Drug Reaction with Eosinophilia and Systemic Symptoms (an extensive skin rash)
- angioedema (swelling beneath the skin)
- dyskinesias (impaired voluntary movement), including chorea (jerky involuntary movements of the shoulders, hips and face), dystonia (muscular spasm and abnormal posture), shaking and asterixis (inability to maintain sustained posture with subsequent brief jerky involuntary movements)
- certain types of dermatitis
Stop receiving EPTOIN INJECTION and contact your doctor immediately if you experience any of the following side effects:
- severe allergic reactions (swelling of the eyelids, face, lips, rash or itching especially affecting the whole body, breathing problems, sudden wheeziness)
- purple glove syndrome (discolouration of the skin, swelling and pain in the area of injection which then radiates down to the arms, hands and fingers)
- serious skin reactions (Ex. Stevens-Johnson syndrome, toxic epidermal necrolysis accompanied by blistering of mouth and tongue)
- blood abnormalities (bruising, fever, severe sore throat, paleness, decreased red blood cells, white cells and platelets)
- hypersensitivity reactions (skin rash, fever, swollen glands, increased white blood cells, swollen organs such as liver, lungs, heart, kidneys and large intestine)
- inflammatory disease called systemic lupus erythematosus (painful and swollen joints)
- have confusion or mental illness which could be a sign of a high amount of medicine in the blood
- chest pains and palpitations
- swollen lymph nodes
- thoughts of harming or killing self
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
EPTOIN 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 EPTOIN INJECTION. Consult your doctor before receiving it. Inform your doctor if you become pregnant during management with EPTOIN INJECTION.
Breastfeeding
EPTOIN 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 EPTOIN INJECTION.
Alcohol
Avoid consumption of alcohol while receiving EPTOIN INJECTION because it may reduce the effectiveness of management or increase the side effects. EPTOIN 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
EPTOIN INJECTION should be used with caution in patients having kidney disease. Consult your doctor before receiving it.
Liver
EPTOIN INJECTION is not recommended for use in patients who experienced prior acute liver toxicity due to phenytoin. EPTOIN INJECTION should be used with caution in patients with liver disease. Consult your doctor before receiving it.
Allergy
Do not receive EPTOIN 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
EPTOIN 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). EPTOIN INJECTION should be used with caution in patients having low blood pressure, heart failure or heart rhythm problems. Consult your doctor before receiving it.
Others
Before receiving EPTOIN INJECTION, inform your doctor if you have:
- porphyria (an inherited disease affecting the nervous system and skin, characterised by abdominal pain, vomiting or muscle weakness)
- diabetes (high blood sugar levels)
Use in paediatrics:
EPTOIN INJECTION can be used for newborns, infants and children but consult your child’s doctor for advice.
Use in geriatrics:
EPTOIN INJECTION should be used with caution in elderly patients. Consult your doctor before receiving it.
Interactions
A. Drug - Drug interactions:
Before receiving EPTOIN 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:
EPTOIN 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
| Drug | : | Phenytoin |
| Pharmacological Category | : | Anti-epileptic drugs |
| Therapeutic Indication | : | Seizures (fits) |
| Dosage Forms | : | Injection, Tablet, Capsule, Syrup, Suspension |
More Information
- Keep EPTOIN INJECTION out of reach of children
- Store EPTOIN INJECTION below 30°C
FAQs About EPTOIN INJECTION
What should I tell my doctor before receiving EPTOIN INJECTION?
Patients receiving EPTOIN 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 EPTOIN INJECTION?
Before taking EPTOIN 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 EPTOIN INJECTION?
It is unlikely that you forget to receive a dose of EPTOIN 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 EPTOIN INJECTION two times to make up for the missed dose.
What happens if I suddenly discontinue the use of EPTOIN INJECTION?
Suddenly stopping EPTOIN INJECTION may lead to seizures which can be life-threatening. Do not stop receiving EPTOIN INJECTION without consulting your doctor. If required, your doctor will reduce the dose slowly before stopping it completely.
Can I take EPTOIN INJECTION during pregnancy?
If you are pregnant, consult your doctor before receiving EPTOIN INJECTION. Your doctor may decide to change your management and closely monitor your unborn child. If you receive EPTOIN 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)
Author Details
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