Phenytoin dosing adjustment
Common Questions and Answers about Phenytoin dosing adjustment
dilantin
The safety and effectiveness of these dosing interval adjustment recommendations have not been clinically evaluated in patients with moderate or severe renal impairment, therefore
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clinical response to treatment and renal function should be closely monitored in these patients [See Warnings and Precautions (5.3)]. There are no data to recommend use of VIREAD tablets 150, 200 or 250 mg or VIREAD oral powder in patients with renal impairment.
Well Keppra is the most commonly used anti-seizure medication in a setting of TBI. Often the right dose and timing adjustment helps. Symptoms in hospital may not have been due to Kreppa, and your mother may now be stronger and adjust to Kreppa.
However, you can discuss with her neurologist and ask for a change. Another drug which is commonly used in this setting is phenytoin or Dilantin. Maybe you can start this with your mother, but this also has side effects and hence may not suit her.
Based on the results of these tests, you would then make a further small adjustment in meds, if necessary. Keep testing every 4 - 6 weeks until your levels are stable and you're feeling good.
After that testing can become less frequent. Every 4 - 6 months would be appropriate, but more frequently if you have symptoms.
Hope this helps.
It is transient for many people meaning it will go away as you get used to the medication. There may be a dosing adjustment needed. Please speak to your doctor about it.
In a small study, phenytoin-induced seizures occurred most often in patients with serum phenytoin concentrations of 50 mcg/ml or higher.[393] Peripheral neuropathy, usually occurring weeks to months after drug initiation, has also been reported in patients receiving phenytoin. A single case report describes the onset of neuropathy within a few hours of drug administration.[9780]
Adverse GI effects of phenytoin therapy include nausea/vomiting, constipation, abdominal pain, and anorexia.
Folic acid supplementation in folate-deficient patients with epilepsy changes the pharmacokinetics of phenytoin, usually leading to lower serum phenytoin concentrations and possible seizure breakthrough..."
It however says that initiation of Folic acid and phenytoin together is beneficial.
Since you can't go back and start all over again, you can take a small dose. It has been observed that as los as 1mg dose can perturb phenytoin’s levels, You may take doses lower than 1mg/day.
The plasma half-life of tramadol following a single and multiple dosing was 6 and 7 hours, respectively. This increase in half-life upon multiple dosing is not considered to be clinically significant or to warrant dosage adjustment for chronic use."
I've also read that 5x the half life takes you to a level that's deemed insignificant.
Moban® brand of molindone hydrochloride contains calcium ions which interfere with the absorption of phenytoin. Ingestion times of phenytoin and antacid preparations containing calcium should be staggered in patients with low serum phenytoin levels to prevent absorption problems”. Taken from http://www.rxlist.com/cgi/generic/phenyt_od.htm
Our population is divided into 4 type of metabolizers ranging from rapid to slow metabolizers depending upon the speed of elimination of drug from body.
I had to change doctors mid way through the dosage adjustment as I moved to Japan and my communication with the doctors here is minimum, thanks to a language barrier!!!
Thank you for your question, you are relatively fine with Phenytoin and the seizure episodes in a form of lack of speech are the residue of a generalized type seizure. I don’t have a full description of your consciousness during the lack of speech episodes to decide whether this start is a partial epilepsy which can continue in a generalized or it is a generalized one from the first moment..
Hello AB, welcome to the medhelp forum. Phenytoin can cause certain side effects like dizziness and mental confusion. Some people may also manifest incoordinate movements. Weight gain is not a documented side effect. It could be related to your alcohol consumption or wrong dietary habits and lack of exercise. An occasional one or two drink may be fine but moderate or large amount can cause significant increases in blood levels of phenytoin due to induction of hepatic enzymes.
I suggest that you ask the hospital or the doctor who requested the test since they may have their own protocol regarding tamoxifen dosage adjustment in accordance with p450 levels.
Regards.
During those times I had not yet been diagnosed and was able to go back to life like normal, however after the diagnosis and being on phenytoin and switching to oxcarbazepine i am feeling awful. Dizzy, nauseated, moody, extremely tired, severe headaches that come and go. All i get from my Neurologist is these are side effects that will eventually go away. Because i never know when these symptoms will come on too strong I have missed a lot of days at work during my probation period.
First 'two' riba? I looked back at a prior post. You said hubby was Geno 3 and weighed 195 lbs. Standard dosing of riba (a flat 800 mg per day) is not as effective as weight-based (in hubby's case about 1200 mg per day). You should talk with the doc one more time. Hubby need to take the best shot at getting rid of this the first time. Good luck.
//pain-topics.org/pdf/Opioids-Renal-Hepatic-Dysfunction.
I totally forgot to tell you that he is on Phenytoin 100mg once daily. Can this be continued and taken for a long period of time?
Thank you doctor once again for your immediate reply.
Call your local pharmacist. We at MedHelp are not allowed to give out dosing instructions. Your pharmacist will be able to tell you exactly how to dose the medications. If your regular pharmacy is closed on Sunday, call any pharmacist availabe at your local grocery store or drug store such as Walgreens, CVS, or RiteAid.
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