phenytoin hepatotoxicity

Hi everyone, I'm new to this community. My neurologist just informed me that Osteoporosis and shrinkage of the Cerebellum are very serious side effects for long term users of Dilantin. Does anyone know more about this? I've been taking 500mg of Dilantin for over 30 years since I was a teenager, and now I'm terribly worried. Not one of the neurologists had mentioned anything about this over the years, and now at 46, I've learned that I may have severe osteoporosis.

Therefore, it is essential to read the labels of all over-the-counter medications carefully. Other commonly used medications, such as omeprazole (Prilosec), phenytoin (Dilantin), and isoniazid (INH), may increase the risk of liver injury caused by acetaminophen. It is always in the liver patient’s best interest to consult with a liver specialist prior to taking any medication.

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.

Combining fluoxetine or paroxetine with phenytoin can also lead to increased phenytoin side effects and reduce blood levels of paroxetine. You really need to discuss the potential drug interactions with your own doctor.

Other commonly used medications, such as omeprazole (Prilosec), phenytoin (Dilantin), and isoniazid (INH), may increase the risk of liver injury caused by acetaminophen. It is always in the liver patient’s best interest to consult with a liver specialist prior to taking any medication. Acetylsalicylic acid (aspirin) and other NSAIDs such as Motrin are drugs that are widely used for their anti-inflammatory and analgesic effects. They also have the potential to cause drug-induced liver disease.

Therefore, it is essential to read the labels of all over-the-counter medications carefully. Other commonly used medications, such as omeprazole (Prilosec), phenytoin (Dilantin), and isoniazid (INH), may increase the risk of liver injury caused by acetaminophen. It is always in the liver patient’s best interest to consult with a liver specialist prior to taking any medication.

You should tell your doctor if you experience any of these symptoms while taking phenytoin, so that your blood level of phenytoin can be measured and your dose reduced if necessary. " Also, he has had a major surgery, and will need time to recover. However, any changes need to be reported to the doctor.

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.

Other commonly used medications, such as omeprazole (Prilosec), phenytoin (Dilantin), and isoniazid (INH), may increase the risk of liver injury caused by acetaminophen. It is always in the liver patient’s best interest to consult with a liver specialist prior to taking any medication. Acetylsalicylic acid (aspirin) and other NSAIDs are drugs that are widely used for their anti-inflammatory and analgesic effects. They also have the potential to cause drug-induced liver disease.

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.

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.

Tuberculosis was more common in alcoholic and Child class C cirrhosis (Table 1). Antituberculosis therapy (ATT) is associated with hepatotoxicity in 10%. Hepatotoxicity requires withdrawal, modification, and sequential reintroduction to achieve cure of tuberculosis. Using such hepatotoxic drugs in presence of cirrhosis or advanced liver disease is a challenge.

Although clinically significant liver injury is extremely rare from statins, mild increases in liver enzymes can occur in 1%–3% of patients. Because of the concern of possible hepatotoxicity, statins are labeled as contraindicated in patients with liver disease. Given the prevalence of liver diseases in the population, such as nonalcoholic fatty liver disease (NAFLD), hepatitis C (HCV), and others, many patients have not benefitted from the cardiovascular protective effects of statins.

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.

Addition of other antiepileptic drugs like phenytoin,lamotrigene and sedatives will be helpful for controll of his night symptoms.

ve heard of that might help with the itch are trying the over the counter antihistamines or antihistamine hydroxyzine (Atarax), anticonvulsants (e.g. gabapentin, carbamazepine, phenytoin), antidepressants (e.g. amitriptyline, paroxetine, mirtazapine), and even Pregabelin (Lyrica)....

Phenytoin hepatotoxicity

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