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Dilantin

[Phenytoin]


Indications & Dosage
INDICATIONS AND USAGE

Dilantin (phenytoin) is indicated for the control of tonic-clonic (grand mal) and psychomotor (temporal lobe) seizures.

Phenytoin serum level determinations may be necessary for optimal dosage adjustments (s

Text Continues Below



ee DOSAGE AND ADMINISTRATION and CLINICAL PHARMACOLOGY sections).

DOSAGE AND ADMINISTRATION

Serum concentrations should be monitored and care should be taken when switching a patient from the sodium salt to the free acid form. Dilantin® Kapseals® , Dilantin Parenteral, and Dilantin with Phenobarbital are formulated with the sodium salt of phenytoin. The free acid form of phenytoin is used in Dilantin-125 Suspension and Dilantin Infatabs.

Because there is approximately an 8% increase in drug content with the free acid form over that of the sodium salt, dosage adjustments and serum level monitoring may be necessary when switching from a product formulated with the free acid to a product formulated with the sodium salt and vice versa.

General

Dosage should be individualized to provide maximum benefit. In some cases serum blood level determinations may be necessary for optimal dosage adjustments— the clinically effective serum level is usually 10-20 mcg/ mL. With recommended dosage, a period of seven to ten days may be required to achieve steady-state blood levels with phenytoin and changes in dosage (increase or decrease) should not be carried out at intervals shorter than seven to ten days.

Adult Dose

Patients who have received no previous treatment may be started on one teaspoonful (5 mL) of Dilantin-125 Suspension three times daily, and the dose is then adjusted to suit individual requirements. An increase to five teaspoonfuls daily may be made, if necessary.

Pediatric Dose:

Initially, 5 mg/ kg/ day in two or three equally divided doses, with subsequent dosage individualized to a maximum of 300 mg daily. A recommended daily maintenance dosage is usually 4 to 8 mg/ kg. Children over 6 years and adolescents may require the minimum adult dose (300 mg/ day).

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