Dilantin - Drug Monograph

Comprehensive information about Dilantin including mechanism, indications, dosing, and safety information.

Introduction

Dilantin (phenytoin) is an anticonvulsant medication that has been a cornerstone of epilepsy treatment since its FDA approval in 1953. As a hydantoin derivative, it remains one of the most widely prescribed antiepileptic drugs worldwide for controlling tonic-clonic and partial seizures.

Mechanism of Action

Phenytoin exerts its antiepileptic effects primarily by blocking voltage-gated sodium channels in neuronal membranes. It binds to the inactivated state of these channels, stabilizing them and preventing repetitive firing of action potentials. This use-dependent blockade reduces the spread of seizure activity from epileptogenic foci without significantly affecting normal neuronal conduction. Additionally, phenytoin may modulate calcium channels and inhibit glutamate release.

Indications

  • Treatment of generalized tonic-clonic seizures
  • Treatment of complex partial seizures (psychomotor, temporal lobe)
  • Prevention and treatment of seizures occurring during or following neurosurgery
  • Status epilepticus (IV formulation)
  • Off-label: Certain cardiac arrhythmias (particularly those digitalis-induced) and neuropathic pain

Dosage and Administration

Oral Administration:
  • Adults: Initial dose 100 mg TID; maintenance dose 300-400 mg/day (may range 200-600 mg/day)
  • Pediatrics: Initial dose 5 mg/kg/day in 2-3 divided doses; maintenance 4-8 mg/kg/day
IV Administration:
  • Status epilepticus: Loading dose 15-20 mg/kg at max rate 50 mg/min
  • Maintenance: 100 mg every 6-8 hours
Special Populations:
  • Hepatic impairment: Reduce dose and monitor closely
  • Renal impairment: Use with caution; consider free phenytoin levels
  • Elderly: May require lower doses due to altered pharmacokinetics

Pharmacokinetics

Absorption: Variable and formulation-dependent; extended-release capsules have 90% bioavailability with slow absorption Distribution: Vd 0.6 L/kg; highly protein bound (90-95%); crosses placenta and blood-brain barrier Metabolism: Hepatic via cytochrome P450 enzymes (CYP2C9 and CYP2C19); saturable kinetics (zero-order at therapeutic levels) Elimination: Half-life 7-42 hours (dose-dependent); primarily renal excretion of metabolites

Contraindications

  • Hypersensitivity to phenytoin, other hydantoins, or components
  • Sinus bradycardia, sinoatrial block, second- or third-degree AV block
  • Adams-Stokes syndrome
  • Concurrent delavirdine therapy

Warnings and Precautions

Boxed Warning: Risk of serious dermatologic reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis
  • Cardiac effects: IV administration may cause hypotension, arrhythmias
  • Hepatic injury: Monitor liver function periodically
  • Hematologic effects: May cause megaloblastic anemia, leukopenia, thrombocytopenia
  • Osteomalacia: Long-term use associated with decreased bone mineral density
  • Suicidal ideation: Antiepileptic drugs may increase suicidal thoughts/behavior
  • Withdrawal seizures: Abrupt discontinuation may precipitate status epilepticus

Drug Interactions

Metabolic Interactions:
  • CYP2C9/C19 inhibitors: Amiodarone, fluconazole, isoniazid (increase phenytoin levels)
  • CYP2C9/C19 inducers: Rifampin, carbamazepine (decrease phenytoin levels)
Protein Binding Displacement:
  • Valproic acid, aspirin, warfarin (increase free phenytoin fraction)
Phenytoin as Inducer:
  • Decreases levels of: oral contraceptives, warfarin, cyclosporine, theophylline, many antipsychotics
Other Significant Interactions:
  • Antacids: Reduce phenytoin absorption
  • Dopamine: IV phenytoin may cause hypotension
  • Fluoroquinolones: May alter phenytoin levels

Adverse Effects

Common (≥10%):
  • Nystagmus
  • Ataxia
  • Slurred speech
  • Dizziness
  • Gingival hyperplasia
  • Coarse facial features
Serious (<1%):
  • Stevens-Johnson syndrome
  • Toxic epidermal necrolysis
  • Drug reaction with eosinophilia and systemic symptoms (DRESS)
  • Hepatic necrosis
  • Agranulocytosis
  • Aplastic anemia
  • Cerebellar atrophy (with chronic use)
  • Peripheral neuropathy

Monitoring Parameters

  • Serum phenytoin levels: Therapeutic range 10-20 mcg/mL (total), 1-2 mcg/mL (free)
  • CBC with platelets at baseline and periodically
  • Liver function tests regularly
  • Vitamin D and bone density monitoring with long-term use
  • Signs of dermatologic reactions
  • Neurologic examination for cerebellar signs
  • Oral hygiene assessment for gingival hyperplasia

Patient Education

  • Take consistently with regard to meals and formulation type
  • Do not crush or chew extended-release capsules
  • Maintain good oral hygiene to minimize gingival hyperplasia
  • Avoid alcohol consumption
  • Use effective contraception (phenytoin reduces efficacy of hormonal contraceptives)
  • Report any skin rash, unusual bleeding, bruising, or infection immediately
  • Do not stop abruptly; taper under medical supervision
  • Be aware of potential cognitive effects (drowsiness, impaired coordination)
  • Wear medical alert identification indicating epilepsy diagnosis and medication use

References

1. FDA Prescribing Information: Dilantin (phenytoin) 2. Glauser T, et al. Updated ILAE evidence review of antiepileptic drug efficacy and effectiveness. Epilepsia 2013;54(3):551-63 3. Patsalos PN, et al. Antiepileptic drugs—best practice guidelines for therapeutic drug monitoring. Therapeutic Drug Monitoring 2008;30(1):1-13 4. Brodie MJ, et al. Epilepsy in adults. The Lancet 2019;393(10172):689-701 5. Anderson GD. Pharmacokinetics of antiepileptic drugs. In: Wyllie E, ed. The Treatment of Epilepsy. 6th ed. Lippincott Williams & Wilkins; 2015 6. Zaccara G, et al. Adverse effects of antiepileptic drugs. Acta Neurol Scand 2011;124(s191):30-5

This information is intended for educational purposes only and should not replace professional medical advice. Always consult with a healthcare provider for personalized medical guidance.

Medical Disclaimer

The information provided in this article is for educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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How to Cite This Article

admin. Dilantin - Drug Monograph. MedQuizzify [Internet]. 2025 Sep 07 [cited 2025 Sep 08]. Available from: http://medquizzify.pharmacologymentor.com/blog/drug-monograph-dilantin

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