Phenytoin

When ATH:
N03AB02

Characteristic.

The white crystalline powder. Practically insoluble in water, insoluble in 1% caustic alkali.

Pharmacological action.
Antiepileptic, anticonvulsant, antiarrhythmic, miorelaksiruyuschee.

Application.

Epilepsy (large seizures), prevention of post-traumatic epilepsy and postneyrohirurgicheskoy, ventricular arrhythmias, incl. intoxication cardiac glycosides, some forms of Meniere's syndrome, neuralgia nerve troynichnogo.

Contraindications.

Hypersensitivity, the liver and kidneys, heart failure, kaxeksija, porphyria.

Restrictions apply.

In the period of pregnancy is appointed only for health.

Side effects.

Dizziness, excitation, tremor, ataxia, nistagmo, fever, nausea, vomiting, changes in connective tissue (coarsening of facial features, Dupuytren's contracture), allergic skin reactions (rash, itch); prolonged use (especially in children) -neuralgia, giperplaziya right, Osteopathy, hypocalcemia, megaloblastnaya anemia, less common is Lymphadenopathy, girsutizm.

Cooperation.

Uskoryayut biotransformatsiyu phenobarbital and carbamazepine, slow down (may increase the side effects) — isoniazid and its derivatives, chloramphenicol, kumarinы, acetylsalicylic acid, disulьfiram.

Overdose.

Symptoms: If the concentration in the blood of children more 20 mg/l evolution of acute intoxication-nystagmus, ataxia, mental disorders, joint pain; in more severe cases, bradycardia, ventricular fibrillation, auricular flutter, asystole, and coma.

Treatment: symptomatic. No specific antidote.

Dosing and Administration.

Inside, during or after a meal (in order to avoid irritation of the gastric mucosa). Adults — on 1/2-1 table. 23 times per day, if necessary, the daily dose was increased to 3-4 tablets., The maximum daily dose - 8 Table. Children up 5 years - 1/4 Table. 2 once a day, 5-8 years 1/4 Table. 3-4 Times daily, senior 8 years are 1/2-1 table. 2 once a day.

Precautions.

Careful selection of doses (epilepsy determine the blood concentration of 7-10 day treatment), tk. elimination is a process saturated and increase in dose may be accompanied by a disproportionate increase in the level of plasma. When expressed adverse events is necessary to reduce the dose or stop the drug.

Cooperation

Active substanceDescription of interaction
Algeldrat + Magnesium hydroxideFKV. Slows absorption (the interval between doses should be at least 2 no).
HalothaneFMR. Increases (mutually) the risk of toxic effects.
DisulьfiramFKV. Slows biotransformation (inhibits microsomal oxidation), significantly increases the Cmax and the risk of intoxication (the combined use of a correction dose).
RifampicinFKV. Accelerates biotransformation (induces cytochrome P450) and reduces the effect of.
TiclopidineFKV. FMR. Increases concentration in blood (the combined use caution).
TopiramateFKV. Slows biotransformation (ингибирует CYP2C), may increase the blood levels and increase the risk of toxic effects (the combined use caution).
FluoxetineFKV. FMR. It increases concentration in blood and increases the likelihood of toxic effects (the combined use caution).

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