Analogs
Clonazepam, Benzobital, Vimpat, Droplet, Convalis, Lamotrigine, Levetirecam‑Teva, Levetirezam lupin, Algerica, Ogrania, Pregabalin richter, Newropentin.
Pharmacological action
It has anticonvulsant, antiarrhythmic, analgesic, and muscle relaxant effects. The drug has a pronounced hypnotic effect.
Indications for use
Epilepsy, mainly large epileptic seizures accompanied by loss of consciousness. Epileptic status with tonic-clonic seizures. Treatment and prevention of epileptic seizures in neurosurgery. Sometimes prescribed for the treatment of cardiac arrhythmias caused by organic lesions of the central nervous system, an overdose of cardiac glycosides. As a second-line drug or in combination with Carbamazepine, it is indicated for trigeminal neuralgia.
Dosage and administration method
Inside, during or after a meal.
For epilepsy (partial and generalized tonic-clonic seizures) single dose for adults – 0.5-1 tablet. Take 2-3 times a day.
To achieve an optimal therapeutic effect, the daily dose can be adjusted to 3-4 tablets. Maximum doses for adults: single-3 tablets, daily-8 tablets.
Children aged 5-8 years assign 0.5 tablets 2 times a day, over the age of 8 years – 0.5-1 tablet 2 times a day (at the rate of 4-8 mg/kg of body weight per day).
Arrhythmias: adults – 1 tablet 4 times a day, then the daily dose should be reduced to 3 tablets. To quickly achieve therapeutic concentration – 2 tablets 4 times on the 1st day, 1 tablet 5 times on the 2nd-3rd day and 1 tablet 2-3 times a day-from the 4th day of treatment.
Trigeminal neuralgia: 1-3 tablets per day.
Side effects
Dizziness, agitation, difficulty breathing, tremor, ataxia, nystagmus, impaired coordination of movements, confusion, diplopia, insomnia, mood changes, drowsiness, headache, muscle weakness, dysarthria; in isolated cases-peripheral neuropathy, dyskinesia (including chorea, dystonia). Allergic reactions.
Contraindications
Hypersensitivity to hydantoin anticonvulsants. Heart failure, Adams-Stokes syndrome, grade II‑III AV block, sinoatrial block, sinus bradycardia; hepatic or renal failure, cachexia, porphyria. With caution: children with rickets, elderly patients, diabetes mellitus, chronic liver and kidney diseases, and chronic alcoholism.
Overdose
Symptoms. There is an increase in the severity of side effects: nausea, vomiting, abdominal pain, shaking hands, visual impairment, nystagmus, ataxia, dysarthria, confusion or loss of consciousness, coma, lack of pupil response to light, hypotension, respiratory depression, apnea.
Treatment. If the patient is conscious, it is necessary to wash the stomach, give activated charcoal or other sorbents. Mechanical ventilation may be necessary if the central nervous system, respiratory and cardiovascular systems are depressed. Hemodialysis may be prescribed because phenytoin does not fully bind to plasma proteins. Treatment is symptomatic. The antidote is unknown.