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Phenytoin sodium solubility in three intravenous solutions

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Dilantin (phenytoin, phenytoin) 100 mg, film-coated.

Dilantin film-coated. Is supplied as blue.

4.86 stars from 5, 86 votes 6 reviews
Phenytoin
Clinical data
Pronunciation/ f ノ ヒ n ノェ t oハ ノェ n, ヒ f ノ n ノェ t ノ繁ェ n /
Trade namesOriginally Dilantin, many names worldwide [1]
AHFS/Drugs.comMonograph
MedlinePlusa682022
Pregnancy categoryAU: D US: D (Evidence of risk)
Routes of administrationOral, parenteral
ATC codeN03AB02 ( WHO )
Legal status
Legal statusAU: S4 (Prescription only) CA : 邃-only UK: POM (Prescription only) US: 邃-only
Pharmacokinetic data
Bioavailability70窶100% oral, 24.4% for rectal administration
Protein binding95% [2]
Metabolismliver
Onset of action10 to 30 min (IV) [3]
Elimination half-life10窶22 hours [2]
Duration of action24 hr [3]
ExcretionPrimarily through the bile, urinary

Phenytoin IV compatibility and stability

Children tend to metabolize phenytoin more rapidly than adults. Drug rash with eosinophilia and systemic symptoms DRESS reflects a serious hypersensitivity reaction to drugs, characterized by skin rash, fever, lymph node enlargement, and internal organ involvement.

Soft tissue irritation may vary from slight tenderness to extensive necrosis, sloughing and in rare instances has led to amputation. Neurotoxicity has been reported during concomitant use of phenytoin and lithium.

There are many drugs which may increase or decrease serum phenytoin levels or which phenytoin may affect.

Early withdrawal is associated with a better prognosis. Inhibition of metabolism may produce significant increases in circulating phenytoin concentrations and enhance the risk of drug toxicity. The pH of each solution was determined before and after the addition of phenytoin.

Unbound concentration of phenytoin may be elevated in patients with hyperbilirubinemia. Suicide Suicidal ideation and behaviour have been reported in patients treated with antiepileptic agents in several indications.

Crystals were observed in all dextrose solutions; nephelometric measurements indicated crystals were present in all solutions. There are many drugs which may increase or decrease serum phenytoin levels or which phenytoin may affect.

Dilantin information
Drugs name dilantin
Active substance phenytoin, phenytoin
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However, in the event of an allergic or hypersensitivity reaction, rapid substitution of alternative therapy may be necessary. Crystals were observed in all dextrose solutions; nephelometric measurements indicated crystals were present in all solutions.

In these patients with acute hepatotoxicity, phenytoin should be immediately discontinued and not re-administered. The pH of all solutions increased sharply upon addition of phenytoin sodium injection. Administration should commence immediately after the mixture has been prepared and must be completed within one hour the infusion mixture should not be refrigerated.

If a patient is diagnosed with AHS, discontinue the phenytoin and provide appropriate supportive measures.

Clinical particulars 4. Improper administration including subcutaneous or perivascular injection should be avoided.

The intravenous route of administration is preferred. Method of administration: Phenytoin should neither be mixed with other drugs nor be added to dextrose or dextrose-containing solutions due to the potential for precipitation of phenytoin acid.

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Phenytoin Sodium 50mg/ml Solution for Injection

It should be noted that complications may occur more readily in elderly patients. Determination of phenytoin serum levels is advised during use in the management of status epilepticus and subsequently whilst establishing maintenance dosage.

Lower or less frequent dosing may be required see section 5. The syndrome is more severe in previously sensitized individuals. The loading dose should be followed by maintenance doses of mg orally or intravenously every 6 to 8 hours. Intravenous phenytoin should be used with caution in patients with hypotension and severe myocardial insufficiency.

The mechanism is unknown. Improper administration including subcutaneous or perivascular injection should be avoided. Phenytoin clearance may be decreased in elderly patients. Table 1.

Clinical particulars 4. If a patient is diagnosed with AHS, discontinue the phenytoin and provide appropriate supportive measures - phenytoin sodium solubility in three intravenous solutions. Solutions for parenteral administration should be inspected visually for particulate matter and discoloration prior to use. Patients with dilantin iv push hepatic function, the elderly, or those who are gravely ill may show early signs of toxicity.

Children tend to metabolize phenytoin more rapidly than adults. Neurotoxicity has been reported during concomitant use of phenytoin and lithium.

Phenytoin Sodium 50mg/ml Solution for Injection

Soft tissue irritation may vary from slight tenderness to extensive necrosis, and sloughing of skin. Sucralfate may decrease phenytoin serum levels. Where protein binding is reduced, as in uraemia, total serum phenytoin levels will be reduced accordingly. A meta-analysis of randomised placebo controlled trials of anti-epileptic drugs has also shown a small increased risk of suicidal ideation and behaviour.

Due to an increased fraction of unbound phenytoin in patients with renal or hepatic disease, or in those with hypoalbuminemia, the interpretation of total plasma phenytoin concentrations should be made with caution. Serious skin reactions:

This product contains a number of excipients known to have a recognized action or effect. Patients and caregivers of patients should be advised to seek medical advice should signs of suicidal ideation or behaviour emerge. The intravenous route of administration is preferred.

Early withdrawal is associated with a better prognosis. Phenytoin should neither be mixed with other drugs nor be added to dextrose or dextrose-containing solutions due to the potential for precipitation of phenytoin acid.

Clinical particulars 4. Patients should be advised of the signs and symptoms and monitored closely for skin reactions. Therefore, phenytoin concentration should be monitored during co-administration with nelfinavir, as nelfinavir may reduce phenytoin plasma concentration.

If such signs and symptoms occur, the patient should be evaluated immediately. Soft tissue irritation may vary from dilantin iv push tenderness to extensive necrosis, sloughing and in rare instances has led to amputation. Dose reduction of phenytoin therapy is indicated if serum levels are excessive; if symptoms persist, termination of therapy with phenytoin is recommended.

Excipient s with known effect Each 5ml of solution also contains Serum levels of phenytoin in the therapeutic range cannot be rapidly achieved by this method.

The mechanism is unknown. The two brands of phenytoin sodium injection did not differ consistently with respect to solubility. It is not possible to provide a universally applicable dosage schedule.

Due to an increased fraction of unbound phenytoin in patients with renal or hepatic disease, or in those with hypoalbuminemia, the interpretation of total plasma phenytoin concentrations should be made with caution.

Sucralfate may decrease phenytoin http://e-advice.net/hydrea-4151399/synthroid-225-mcg levels. click over here.

The intravenous route of administration is preferred. The concentration of phenytoin declined rapidly in all dextrose solutions but at different rates for each brand.

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Dilantin, 6 reviews:

Comment 邃1 about product

Several individual case reports have suggested that there may be an increased, although still rare, incidence of hypersensitivity reactions, including skin rash and hepatotoxicity, in black patients. The syndrome may not develop for several days after injection. Where protein binding is reduced, as in uraemia, total serum phenytoin levels will be reduced accordingly.


1 / 5 stars
Comment 邃2 about product

A faint yellow discoloration may develop, but this does not affect the potency of the solution. Factors other than pH and cosolvent concentration may affect phenytoin stability in dextrose solutions. Soft tissue irritation may vary from slight tenderness to extensive necrosis, and sloughing of skin.


4 / 5 stars
Comment 邃3 about product

The syndrome may not develop for several days after injection. Phenytoin increases the clearance of quetiapine and thus impairing the effect of it.


5 / 5 stars
Comment 邃4 about product

Excipient s with known effect Each 5ml of solution also contains If a patient is diagnosed with AHS, discontinue the phenytoin and provide appropriate supportive measures. It may be necessary to measure serum phenytoin levels to achieve optimal dosage adjustments.


1 / 5 stars
Comment 邃5 about product

For time periods less than one week, the patient switched from intramuscular administration should receive half the original oral dose for the same period of time the patient received phenytoin intramuscularly. The dosage should then be reduced to a maintenance dose of mg and adjusted according to serum level estimations. Because of the risk of local toxicity, intravenous phenytoin should be injected slowly directly into a large vein through a large-gauge needle or intravenous catheter.


3 / 5 stars
Comment 邃6 about product

Patients with impaired hepatic function, the elderly, or those who are gravely ill may show early signs of toxicity. Factors other than pH and cosolvent concentration may affect phenytoin stability in dextrose solutions. It is concluded that 0.


4 / 5 stars
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