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What is Epanutin and what is it Epanutin is one of a group of medicines called antiepileptic drugs: This medicine is used to treat epilepsy. Epanutin can be used to control a variety of epileptic conditions to control or prevent seizures during a head injury. Epanutin can also be used to treat trigeminal neuralgia (facial nerve pain). Epanutin hard capsules are indicated for the control of tonic-clonic seizures (grand mal epilepsy), partial seizures (focal including temporal lobe) or a combination of these seizures. For the prevention and treatment of seizures that occur during or after neurosurgery and/or severe head injury. Epanutin hard capsules have also been used in the treatment of trigeminal neuralgia, but should only be used as a second-line treatment if carbamazepine is ineffective or patients are intolerant to carbamazepine. How to use Adult dosage for seizures: Initially 3 to 4 mg/kg/day with subsequent dose adjustment if necessary. For most adults, the usual maintenance dose is 200 to 500 mg daily in single or divided doses. Exceptionally, a daily dose outside this range may be indicated. The dose should usually be adjusted according to serum levels where testing facilities are available. Adult dosage for trigeminal neuralgia: The clinically effective dose has not been determined in clinical trials. In adults, 300-500 mg in divided daily doses has been reported in the literature. Doses should be adjusted based on clinical response. It is recommended to determine the level of phenytoin in the blood. Total phenytoin levels should not exceed 20 mcg/ml. Seniors (over 65 years): Phenytoin clearance is decreased in elderly patients and lower or less frequent doses may be required (see section 5.2 Pharmacokinetics - Age). As with adults, the dosage of phenytoin sodium flannel hard capsules should be titrated according to the individual patient's requirements using the same guidelines. Because elderly patients tend to receive multiple drug therapies, the potential for drug interactions should be taken into account. Infants and children: Initially, 5 mg/kg/day in two divided doses, with a subsequent dose of a maximum of 300 mg daily. The recommended daily maintenance dose is: Usually 4 mg/kg to 8 mg/kg. Newborn: The absorption of phenytoin after oral administration in neonates is unpredictable. Furthermore, the metabolism of phenytoin may be decreased. Therefore, it is especially important to monitor serum levels in the newborn. Warnings and precautions Phenytoin is ineffective for absence seizures (petit mal). In the presence of tonic-clonic (grand mal) and absence seizures, combination drug therapy is required. Phenytoin may affect glucose metabolism and inhibit insulin secretion. Hyperglycemia has been reported in association with toxic levels. Phenytoin is not indicated for seizures due to hypoglycemia or other metabolic causes. Abrupt withdrawal of phenytoin in patients with epilepsy may result in status epilepticus. When the doctor sees the need to reduce the dose or stop taking or replace alternative antiepileptic drugs, this should be done gradually. However, if an allergic reaction or hypersensitivity occurs, rapid replacement of an alternative therapy may be necessary. In this case, the alternative treatment should be an antiepileptic drug that does not belong to the hydantoin chemical class. Phenytoin may cause or worsen absence or myoclonic seizures. Herbal preparations containing St. John's wort (Hypericum perforatum) should not be used while taking phenytoin due to the risk of decreased plasma concentrations and reduced clinical effects of phenytoin. Side Effects Decreased coordination, nervousness, unsteadiness, shaking hands or feet, unusual facial expressions, difficulty sleeping, uncontrolled eye movements, yellow eyes or skin. Storage Information Store Epanutin capsule in a dry place. Epanutin capsules should be stored at 25°C. Store Epanutin capsules in their original packaging. Keep Epanutin Capsule out of reach of children. Do not use Epanutin capsules after the expiry date stated on the package. Ingredients Phenytoin Specifications Product Form: Capsules
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