Introduction About EPTOIN ORAL SUSPENSION

EPTOIN ORAL SUSPENSION 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) during or after brain surgeries or severe head injuries. A seizure results from an excessive discharge of specific nerve cells and is characterized by changes in electrical activity (detected by electroencephalogram (EEG)). EPTOIN ORAL SUSPENSION is also used in the management of trigeminal neuralgia (facial neve pain).

During management with EPTOIN ORAL SUSPENSION, your doctor might ask you to take several blood tests, to monitor any side effects, and to check the amount of phenytoin in your blood to make dose adjustments. You should brush and floss your teeth and see a dentist regularly while taking EPTOIN ORAL SUSPENSION, to manage overgrowth of gums.

Before taking EPTOIN ORAL SUSPENSION, inform your doctor if you have porphyria, liver or kidney disease, alcohol dependence, depression or high blood sugar levels. Avoid consumption of alcohol while taking EPTOIN ORAL SUSPENSION as it may affect its blood concentration.

EPTOIN ORAL SUSPENSION 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 taking EPTOIN ORAL SUSPENSION. You should not breast-feed if you are taking EPTOIN ORAL SUSPENSION.

While taking EPTOIN ORAL SUSPENSION, if you have thoughts of harming or killing self, immediately consult your doctor. EPTOIN ORAL SUSPENSION should be cautiously used in children and elderly patients.

The most common side effects of taking EPTOIN ORAL SUSPENSION are irregular eye movements, slurred speech, drowsiness, problems with movement and balance, decreased coordination, and confusion. Contact your doctor if any of the symptoms deteriorate.

Uses Of EPTOIN ORAL SUSPENSION

Manages

• certain forms of epilepsy
• trigeminal neuralgia

How EPTOIN ORAL SUSPENSION Works

EPTOIN ORAL SUSPENSION controls and manages seizures by managing repetitive discharge of normal brain cells, that occurs during a fit. Its ability to selectively suppress high frequency firing contributes in trigeminal neuralgia as well.

How to use EPTOIN ORAL SUSPENSION

Take EPTOIN ORAL SUSPENSION as advised by your physician. Shake well before use. Your doctor will determine an appropriate dose and duration for you depending upon your age, body weight and disease condition. You can take EPTOIN ORAL SUSPENSION at the same time every day as directed by your doctor. Do not stop taking EPTOIN ORAL SUSPENSION unless your doctor advises you to stop.

Side Effects Of EPTOIN ORAL SUSPENSION

How To Manage Side Effects

Skin rash:

Avoid hot showers because hot water can further irritate your skin. 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.

Dizziness:

Lie down until dizziness is gone, then get up slowly. Don’t hurry and move slowly and carefully. Get adequate rest. Drink plenty of water and other fluids. Avoid coffee, cigarettes, alcohol, and drugs. If dizziness persists, consult your doctor.

Drowsiness:

Try few lifestyle changes to improve your energy levels when you feel drowsy such as taking and maintaining consistent sleep schedule. Exercise regularly (such as daily walk or running) and eat a nutritious diet with plenty of whole grains, legumes, fruits, and vegetables. Consult your doctor if drowsiness worsens.

Warning & Precautions

Pregnancy

EPTOIN ORAL SUSPENSION should be used with caution in pregnant women as it may cause birth abnormalities in unborn baby. Women of childbearing potential should use a suitable non-hormonal contraceptive method to avoid getting pregnant while taking EPTOIN ORAL SUSPENSION. Consult your doctor before taking it.

Breastfeeding

Breastfeeding should be avoided while taking EPTOIN ORAL SUSPENSION. Before taking it, inform your doctor if you are breastfeeding.

Driving and Using Machines

Do not drive or operate any machines if you experience dizziness or drowsiness while taking EPTOIN ORAL SUSPENSION.

Alcohol

Avoid consumption of alcohol while taking EPTOIN ORAL SUSPENSION because it may affect the concentration of the medicine in the blood. EPTOIN ORAL SUSPENSION should be used with caution in patients having alcohol dependence. Consult your doctor before taking it.

Kidney

EPTOIN ORAL SUSPENSION should be taken with caution in patients with kidney disease. Consult your doctor before taking it.

Liver

EPTOIN ORAL SUSPENSION is not recommended for use in patients who ever had liver problems from taking phenytoin. EPTOIN ORAL SUSPENSION should be taken with caution in patients with liver disease. Consult your doctor before taking it.

Allergy

Do not take EPTOIN ORAL SUSPENSION if you are allergic to phenytoin or any of the other ingredients of this medicine, or similar medicines like hydantoins, or if you ever had an allergic reaction to fosphenytoin, ethotoin or mephenytoin. EPTOIN ORAL SUSPENSION should be used with caution in patients who ever had an allergic reaction to a similar type of medicine called carboxamides, barbiturates, succinimides, and oxazolidinediones. Consult your doctor before taking it.

Interactions

A. Drug - Drug interactions:

Before taking EPTOIN ORAL SUSPENSION, inform your doctor if you are taking any of the following medicines:

• medicines used to manage heart and circulation problems (Ex. dicoumarol, digitoxin, digoxin, disopyramide, mexiletine, nisoldipine, amiodarone, furosemide, quinidine, reserpine, diltiazem, nifedipine)
• medicines used to manage blood clots (Ex. apixaban, dabigatran, edoxaban, rivaroxaban, warfarin, ticagrelor)
• medicines used to manage epilepsy (Ex. oxcarbazepine, carbamazepine, topiramate, phenobarbital, lamotrigine, sodium valproate, valproic acid, ethosuximide, vigabatrin, lacosamide)
• medicines used to manage fungal infections (Ex. amphotericin B, posaconazole, voriconazole, fluconazole, itraconazole, ketoconazole, miconazole)
• medicines used to manage tuberculosis and other bacterial infections (Ex. isoniazid, chloramphenicol, sulphonamides, rifampicin, doxycycline, clarithromycin, sulfadiazine, sulfamethoxazole, trimethoprim, ciprofloxacin)
•  medicines used in HIV (Ex. delavirdine, ritonavir, saquinavir, efavirenz, fosamprenavir, indinavir, lopinavir, nelfinavir)
• medicines used to manage stomach ulcers (Ex. omeprazole, sucralfate, cimetidine, ranitidine, famotidine, antacids)
• theophylline (used for asthma and bronchitis)
• medicines used to manage pain (Ex. aspirin, ibuprofen)
• medicines used to manage inflammation (Ex. prednisolone, dexamethasone)
• medicines used for sleeplessness, depression and psychiatric disorders (Ex. chlordiazepoxide, clozapine, diazepam, disulfiram, fluoxetine, methylphenidate, paroxetine, phenothiazines, trazodone, amitriptyline, fluvoxamine, quetiapine, sertraline)
• tolbutamide (used to manage high blood sugar)
• medicines used in cancer (Ex. teniposide, fluorouracil, capecitabine, doxorubicin, methotrexate, bleomycin, carboplatin, cisplatin)
• medicines used to manage pregnancy (Ex. estradiol, dienogestrel)
• hormone replacement therapy (Ex. oestrogens)
• medicines used to suppress immune system (Ex. ciclosporin, tacrolimus)
• medicines used to expel parasitic worms from the body (Ex. praziquantel, albendazole)
• 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 to control blood cholesterol (Ex. atorvastatin, fluvastatin, simvastatin)

Overdosage:

If you or anyone else accidentally took too much of EPTOIN ORAL SUSPENSION, consult your doctor immediately or visit the nearby hospital. Symptoms of EPTOIN ORAL SUSPENSION overdose include rapid eye movements, clumsy movements, trouble speaking, shaking, overactive bodily reflexes like twitching, lethargy, slurred speech, blurred vision, nausea, and vomiting.

Synopsis

More Information

• Keep EPTOIN ORAL SUSPENSION out of reach of children
• Do not store EPTOIN ORAL SUSPENSION above 25°C

FAQs About EPTOIN ORAL SUSPENSION

Is EPTOIN ORAL SUSPENSION safe to take in pregnancy?

EPTOIN ORAL SUSPENSION should be used with caution in pregnant women, as it may cause abnormalities in unborn foetus. Women who are having childbearing capability should use non-hormonal contraceptive methods to avoid getting pregnant. Inform your doctor immediately if you become pregnant during management with EPTOIN ORAL SUSPENSION.

Can EPTOIN ORAL SUSPENSION be taken along with alcohol?

No. You are not advised to consume alcohol while taking EPTOIN ORAL SUSPENSION because it may affect the concentration of the medicine in the blood. Consult your doctor regarding further doubts.

What happens if I suddenly discontinue taking EPTOIN ORAL SUSPENSION?

Suddenly stopping EPTOIN ORAL SUSPENSION may lead to seizures which can be life threatening so, do not discontinue taking it without consulting your doctor. If required, your doctor will reduce the dose of EPTOIN ORAL SUSPENSION slowly before stopping it completely.

Can I take any herbal preparations during management with EPTOIN ORAL SUSPENSION?

Before taking EPTOIN ORAL SUSPENSION, inform your doctor if you are taking, have taken, or might take any other medicine, including any herbal medicine, as these might cause serious side effects by interacting with each other. The herbal preparation St John’s wort (used in depression) should not be taken during management with EPTOIN ORAL SUSPENSION.

Can I take contraceptive pills during management with EPTOIN ORAL SUSPENSION?

If you are a woman of childbearing age and are not planning a pregnancy, you should use effective contraception during management with EPTOIN ORAL SUSPENSION as it may affect how hormonal contraceptives, such as the contraceptive pill, work and make them less effective at managing pregnancy. Discuss with your doctor regarding the most suitable type of contraception to use while you are taking EPTOIN ORAL SUSPENSION.

What if I forget to take a dose of EPTOIN ORAL SUSPENSION?

If you forget to take a dose of EPTOIN ORAL SUSPENSION, 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 ORAL SUSPENSION two times to make up for the missed dose.

Can EPTOIN ORAL SUSPENSION affect any of my medical tests?

EPTOIN ORAL SUSPENSION might affect some of the tests in ways like increased blood sugar levels, or decreased blood calcium, folic acid and vitamin D levels, and abnormal thyroid function test results. Before going for any tests, inform your doctor that you are taking EPTOIN ORAL SUSPENSION.

References

1.KD Tripathi. Anti-epileptic drugs. Essentials of Medical Pharmacology. Eighth Edition, 2019. Page – 439, 440.

2. Barbara G. Wells, Joseph T. DiPiro, Terry L. Shwinghammer, Cecily V. DiPiro. Epilepsy. Pharmacotherapy Handbook. Ninth edition. Page- 518.

3. Reynolds EH, Chadwick D, Galbraith AW. One drug (phenytoin) in the treatment of epilepsy. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. May 1976. [Accessed on 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. March 2022. [Accessed on 22nd June 2022] https://www.ncbi.nlm.nih.gov/books/NBK551520/

4. Delpharm Orleans. Electronic Medicines Compendium (EMC) [Revised in April 2022] [Accessed on 22nd June 2022] https://www.medicines.org.uk/emc/files/pil.2257.pdf

5. Parke-Davis Div of Pfizer Inc. Dilantin-125 (Phenytoin suspension). [Revised in March 2022] [Accessed 22nd June 2022] https://labeling.pfizer.com/showlabeling.aspx?id=560

6. Pfizer Canada Inc. Dilantin-30 Suspension/Dilantin-125 Suspension (Phenytoin Oral Suspension). [Revised in July 2018] [Accessed 22nd June 2022] https://www.rpharms.com/Portals/0/RPS%20document%20library/Dilantin%20PIL.pdf?ver=2019-05-03-100420-957

Useful Diagnostic Tests

• Complete blood count
• Electroencephalogram (EEG)