Are you going to be given Phenytoin Injection? Then know this for sure!

If you have a sudden seizure, or perhaps you have epilepsy, or you have had brain surgery, your doctor may have given you this medicine to stop your seizures. It's called a phenytoin injection. Simply put, it works by calming and controlling the parts of your body's nervous system that sometimes become overactive. So let's talk about this in more detail, shall we?

What is Phenytoin? Let's understand exactly!

Phenytoin is a key medication used to control and prevent seizures . It is often used in people with epilepsy . It is also given to reduce the risk of seizures during and after brain surgery.

Think of the nerves in our brain as little wires that carry electrical messages. Sometimes these "wires" can have little "short circuits." That's when seizures occur. So, what Phenytoin does is calm down those overactive nerves and reduce those "short circuits." That is, it controls overactive nerves.

Doctors may sometimes use this medicine for other things, so if you have any questions, it's best to ask your doctor or pharmacist.

What are the things you need to tell the doctor before giving you this medicine?

This is very important. Before you are given the Phenytoin injection, it is essential that your care team is aware of the following:

• Are you addicted to alcohol? Alcohol can affect the effectiveness of this medicine.
• Are you of Asian descent? Some people with Asian genes may have a different way of processing this medicine in their bodies, so it's important to be aware of this.
• Do you have diabetes (Diabetes Mellitus)? This medicine may affect blood sugar levels.
• Do you have heart problems?
• Do you have liver disease? This medicine is cleared from the body by the liver. So if you have a liver problem, it may affect it.
• Do you have low blood pressure?
• Have you ever had suicidal thoughts, plans, or attempts? Or has anyone in your family ever had one? This is important to mention because this medicine can affect the mood of some people.
• Are you allergic to phenytoin, hydantoin, other medications, foods, dyes, or preservatives?Say something, even if it's just a little thing.
• Are you pregnant or trying to get pregnant?
• Are you a breastfeeding mother?

It is very important for your own safety to tell the doctor these things without hiding them.

How do you use this medicine?

This is an injection into a vein . This means it is not something you can use at home. It is given to you by medical professionals in a hospital or clinic setting .

This medicine is for you only. Never give the medicine the doctor has prescribed to you to anyone else, even if they have the same symptoms as you.

If this medicine is given to children: In some selected cases, this medicine can also be given to children. However, there are special considerations to be taken into account. Talk to your medical team about this.

Overdose: This is unlikely to happen because it is given in a hospital. However, if you think you have taken too much of this medicine, call a poison control center or emergency room immediately.

What if I miss a dose?: Since this is given in a hospital, it doesn't matter if you miss a dose. The medical staff will take care of it.

What should you be especially careful about when taking this medicine?

When you receive this vaccine, the medical staff will monitor your condition very carefully. But it's good for you to be aware of these things:

• Serious skin reactions: This is very important. These can happen weeks or months after you start taking this medicine. Tell your doctor right away if you get a skin rash with symptoms such as fever and body aches. These rashes may turn red or purple and then blister and peel. Or, if you have red rashes along with swelling of the face, lips, or swollen lymph nodes in the neck or armpits, tell your doctor right away. This may be an emergency.
• Drowsiness, dizziness: You may feel drowsy and dizzy. Therefore, avoid driving, operating machinery, or doing anything that requires concentration until you know how this medicine affects you. Avoid getting up or sitting down too quickly, especially if you are elderly. This can make you more likely to get dizzy and fall.
• Alcohol: Alcohol can alter the effects of this medication, so avoid drinking alcohol altogether.
• Suicidal thoughts:This medicine may slightly increase your risk of suicidal thoughts or actions. So pay special attention to your mental state and how you feel. If your mood gets worse, you feel like you're going to die, or you feel more sad or anxious than usual , tell your healthcare team right away. Don't hide it.
• Vitamin D and folic acid deficiency: This medication may cause a decrease in vitamin D and folic acid levels in the body. Therefore, talk to your healthcare team about the foods you eat, the vitamins you take, and take supplements if necessary.

What are the possible side effects?

Like any medicine, Phenytoin can cause some side effects. Not everyone gets them, but it's good to be aware of them.

Side effects that you should report to your doctor immediately:

If you have any of these symptoms, tell your doctor without delay:

• Allergic reactions: Skin rash, itching, hives, swelling of the face, lips, tongue, or throat.
• High blood sugar (Hyperglycemia): Feeling extremely thirsty, needing to urinate frequently, feeling unusually tired, blurred vision.
• Symptoms of infection: fever, chills, cough, sore throat.
• Liver injury: Pain in the upper right side of the abdomen, loss of appetite, nausea, light-colored stools, dark yellow or brown urine, yellowing of the eyes or skin, unusual tiredness.
• Pain, swelling, blue/purple discoloration, and spreading at the injection site.
• Phenytoin toxicity: Uncontrollable eye movements, loss of balance or difficulty walking, difficulty speaking, unusual tiredness, nausea, vomiting.
• Rash, fever, and swollen lymph nodes.
• Redness, blistering, peeling, and sometimes even inside the mouth can occur.
• Slow heartbeat: Feeling dizzy, fainting, confusion, shortness of breath, unusual tiredness.
• Swollen lymph nodes in the neck, groin, chest, or armpits.
• Feelings such as suicidal thoughts, worsening mental state, and depression.
• Unusual bruising or bleeding.

Side effects that are usually not dangerous, but should be reported to your doctor if they persist:

These usually go away in a few days. But if they persist, tell your doctor if they bother you:

• Difficulty concentrating, remembering, or speaking.
• Dizziness.
• Drowsiness.
• Headache .

This list does not include all possible side effects. If you notice anything else that is not listed, talk to your doctor about it.

Can this interact with other medications? (Drug Interactions)

This is also very important. Phenytoin can interact with many other medications, herbs, and vitamins. So tell your doctor about all the medications you take (prescribed, over-the-counter, herbs, vitamins, and dietary supplements). Also, tell your doctor if you smoke, drink alcohol, or use illegal drugs.

Never take Phenytoin with these medications:

If you are using these medications, it is not advisable to take Phenytoin. Therefore, you should talk to your doctor about this.

• Artemether
• Some antiviral medications for HIV or hepatitis
• Idelalisib
• Isavuconazonium
• Lonafarnib
• Lorlatinib
• Lumefantrine
• Lurasidone
• Pacritinib
• Praziquantel
• Ranolazine

Phenytoin may also interact with the following medications:

This list is a bit long, but if you are using any of these, don't forget to tell your doctor.

• Albendazole
• Alcohol
• Aspirin and aspirin-like medications
• Bleomycin
• Capecitabine
• Carboplatin
• Some medications for blood pressure, heart disease, and irregular heartbeat
• Some medications for depression, anxiety, or other mental illnesses
• Cholesterol-lowering medications such as Atorvastatin, Fluvastatin, and Simvastatin
• Medicines for fungal infections such as Fluconazole, Itraconazole, Ketoconazole, Miconazole, Posaconazole, Voriconazole
• Other medications used for seizures: Carbamazepine, Ethosuximide, Felbamate, Lacosamide, Lamotrigine, Methsuximide, Oxcarbazepine, Phenobarbital, Topiramate, Valproic acid, Vigabatrin
• Medicines for stomach problems such as antacids, cimetidine , omeprazole, and sucralfate
• Medicines that prevent or treat blood clots, such as Warfarin, Apixaban, Dabigatran, Edoxaban, and Rivaroxaban
• Chloramphenicol
• Chlorpropamide
• Cisplatin
• Cyclosporine
• Disulfiram
• Doxorubicin
• Doxycycline ( Doxycycline )
• Female hormones, for example estrogen and birth control pills
• Fluorouracil
• Folic acid
• Irinotecan
• Isoniazid
• Muscle relaxants during surgery
• Methadone
• Methotrexate
• Methylphenidate
• Paclitaxel
• Phenothiazines (e.g. chlorpromazine, mesoridazine, prochlorperazine, thioridazine)
• Rifampin
• St. John's Wort (this is a herb)
• Steroid medications (e.g. prednisone, cortisone)
• Sulfadiazine
• Sulfamethoxazole
• Teniposide
• Theophylline
• Ticagrelor
• Ticlopidine
• Tolbutamide
• Vitamin D

This list is not exhaustive, so it's best to tell your doctor about all the medications you take.

How to store? (This may not be relevant to you)

Since this vaccine is given in a hospital or clinic, you usually don't have to worry about storing it. But just to be aware:

• This medicine should be kept out of the reach of children.
• It should be stored at room temperature (between 15 and 30 degrees Celsius).
• Do not use expired medicine.

This information is relevant to hospital staff.

Finally, the most important thing (Take-Home Message)

Okay, so that's all you need to know about the Phenytoin injection. Remember, this is an important medication for controlling seizures.

The most important thing is that if you have any questions, concerns, or new symptoms, talk to your doctor, nurse, or pharmacist. Don't keep anything to yourself. They are there to help you.

Wishing you a speedy recovery!

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