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This document outlines essential safety information and warnings associated with the use of phenytoin (Dilantin). It is crucial to understand these details and discuss any concerns with your healthcare provider before starting or discontinuing this medication.

• Withdrawal Seizures: Abruptly stopping phenytoin (Dilantin) can result in status epilepticus, a severe condition where seizures persist beyond 5 minutes or occur consecutively without recovery. Always consult your neurologist for a gradual reduction plan if you need to stop taking this medication.

• Suicidal Thoughts or Behavior: Phenytoin (Dilantin), like other antiseizure drugs, may increase the risk of suicidal thoughts or actions, starting as early as one week after treatment begins. Report any mood changes, depression, or self-harm thoughts to a healthcare professional immediately.

• Serious Skin and Allergic Reactions: Rare but severe skin reactions such as toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome (SJS), and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) can occur. Stop use and seek medical assistance if you develop a rash or other severe symptoms. Individuals of Asian descent or those with the HLA-B*1502 gene are at increased risk.

• Heart Problems: Phenytoin (Dilantin) may cause a slow heart rate or cardiac arrest. If you experience dizziness, fainting, or a very slow heartbeat, contact your healthcare provider immediately.

• Liver Problems: This medication can lead to serious liver damage or failure. Report symptoms like jaundice, fever, nausea, or stomach pain to your prescriber right away.

• Lower Blood Cell Count: Phenytoin (Dilantin) can occasionally reduce blood cell counts, potentially causing life-threatening conditions. Notify your healthcare provider if you experience unusual bruising, infections, or fatigue.

• Effects on Vitamin D and Bone Health: Long-term use may weaken bones, increasing the risk of osteopenia, osteoporosis, or fractures. Discuss bone health maintenance with your healthcare provider.

• Harm to Unborn Baby: Phenytoin (Dilantin) can pose risks to an unborn child, including birth defects. If you're pregnant or planning to become pregnant, consult your prescriber. Consider enrolling in the North American Antiepileptic Drug Pregnancy Registry for more information on medication safety during pregnancy.

• High Blood Sugar Levels: This medication may elevate blood sugar levels, complicating diabetes management. Monitor your blood sugar levels and report significant changes to your healthcare provider.

• High Phenytoin Levels: Elevated levels can lead to mental changes or permanent brain damage. Contact your prescriber if you experience confusion or other symptoms. Blood levels may be checked, and dosage adjustments made.

Contraindications:

• Do not use phenytoin (Dilantin) if you are allergic to it or similar medications.
• Avoid use if you have a history of liver damage from this medication or are taking delavirdine.

Always follow your healthcare provider’s instructions and report any side effects or unusual symptoms promptly.

When taking this medication, you might experience some common side effects such as headache, nausea, vomiting, dizziness, constipation, drowsiness, nervousness, or trouble sleeping. These are typically mild, but if they persist or worsen, consult your healthcare provider. Phenytoin might also cause swollen or bleeding gums; maintain good oral hygiene and visit your dentist regularly to mitigate this. Some individuals may notice symptoms like unpredictable eye movements, loss of coordination, slurred speech, or confusion.

Although many people tolerate the medication well, be aware of more serious side effects that need prompt medical attention. These include a slow heartbeat, excessive hair growth, unusual tiredness, increased thirst or urination, double or blurred vision, facial changes, or bone pain. Additionally, there is a risk of mood changes, such as depression or suicidal thoughts, which should be reported immediately to your healthcare provider.

Rarely, this medication can cause severe allergic reactions characterized by symptoms like rash, fever, swollen lymph nodes, severe dizziness, or breathing difficulties. In such cases, seek urgent medical help. Other significant concerns include liver issues, indicated by persistent nausea, vomiting, stomach pain, yellowing skin or eyes, and dark urine. Serious skin reactions or low blood cell counts, which manifest as easy bruising, infections, or swollen lymph nodes, are also critical and require immediate medical attention. Always contact your healthcare provider if you notice any unusual or severe symptoms.

Phenytoin (Dilantin) has the potential to interact with various medications and supplements. It's important to inform your doctor and pharmacist of all the medications you are currently taking, including prescription, over-the-counter medications, vitamins, and herbal supplements.

Some drugs may impact the elimination of phenytoin from your body, influencing its effectiveness. These include Amiodarone, azole antifungals like Itraconazole, macrolide antibiotics such as Erythromycin, estrogens, Isoniazid, and rifamycins like Rifabutin. Additionally, herbal supplements like St. John's wort can also interact with phenytoin.

Phenytoin can also accelerate the removal of other drugs from your system, potentially affecting their efficacy. This includes medications such as Atazanavir, certain cancer treatments like Imatinib and irinotecan, cobicistat, corticosteroids like Prednisone, and several others.

It's crucial to note that phenytoin may reduce the effectiveness of hormonal birth control methods, such as pills, patches, or rings, possibly leading to unintended pregnancy. Discuss with your healthcare provider about using additional reliable birth control methods. If you experience new spotting or breakthrough bleeding, this may indicate that your birth control is not working effectively.

Phenytoin might also interfere with specific laboratory tests, potentially causing inaccurate results. Ensure that your healthcare professionals and laboratory staff are aware of your phenytoin usage. If you have any concerns or questions about these interactions, consult your doctor or pharmacist for personalized advice.