Diphenin( internationally known as Phenytoin) is a drug that has been removed from glycolyl urea. The drug is used to relax the skeletal muscle tissue, reduce its tone, eliminate heart rhythm disturbances, reduce the appearance of bouts of pain.
Also, the drug has a pronounced anticonvulsant effect without a hypnotic effect, which distinguishes it from other similar ones. Reduces the duration of convulsive seizures.
Refers to the group of antiepileptic drugs.
Table of contents
- Contents
- Pharmacological action
- Pharmacokinetics of the
- Mechanism of action
- Indications for use
- Instructions for use: Schemes and doses
- Overdose and actions for it
- Special conditions and guidelines
- Interaction with other drugs and substances
- Practical experience of application of
- Pros and cons of preparation
- Purchase and storage of
Components of medicament
The composition of the drug includes:
- phenytoin - 99, 5 mg per tablet;
- baking soda;
- stearic acid and calcium;
- starch;
- talc mineral.
The product is released on the drugstore counters in cardboard plates of 10 tablets. In one blister pack also 10 tablets.
Pharmacological action
The main disease in which use Diphenin - epilepsy. During the attacks of this disease, in the motor cortex of the
, the phenytoin
formula changes, in which the main elements of the drug come into play.
Due to the presence of phenytoin - the main component of the drug, the boundaries of excitability are compensated, as a result, there is a decrease in sodium, which is in the membrane cells. This is also characterized by a decrease in the neural coupling potential( ATP).
This fact leads to the fact that in the adjacent areas of the head cortex the process of inhibition of the foci of epilepsy starts.
In addition, the main element of the drug has a positive effect on the brain stem, which inhibits the activity of its centers.
This effect has an effect on large epileptic seizures, and in particular, on their tonic stage.
Pharmacokinetics of
Depending on the regimen of the drug and its dosage, the time of the maximum concentration of the active substance in the blood is determined. It fluctuates within 3-12 hours.
The distribution of drug elements of the agent occurs through the central nervous system. And also settles in the tissues and enters the seminal ejaculate, cerebrospinal fluid, bile, saliva, breast milk and digestive juice. It binds to the proteinaceous substance in the blood by 70 - 95%.
The drug is broken down by the liver and forms passive products of metabolism. In this case, this is 5-( p-hydroxoxyl) -5-phenylhydantoin.
The dosage used characterizes the elimination time, at a standard dose this occurs around the clock( + -1 hour).If the medicine has been used for a long time, the complete disposal of the substances takes place within 72 hours.
Mechanism of action
Into the swollen cells of Purkinje fibers penetrates the active substance of the tablet and stabilizes their membrane, which in turn leads to antiarrhythmic effects. And also the probability of calcium ions penetration into cells decreases and the transmembrane currents are blocked.
Membrane-stabilizing action prevents seizures, protecting the nerve and muscle cells from prolonged nerve impulses during the activation of the body.
Thanks to the hydantoin base, the product performs the function of enhancing the effect of drugs that are used in parallel.
Indications for use
Use of Phenytoin is recommended during manifestations of diseases with convulsive syndrome:
- large seizures of epilepsy;
- temporal lobe epilepsy;
- epileptic seizures with loss of consciousness or with aura;
- abnormalities of the central nervous system with cardiac dysfunction;
- with cardiotonic overdose;
- trigeminal neuralgia( ancillary drug);
- Ménière syndrome.
When receiving the drug is not allowed
The drug is not recommended for use with hypersensitivity to the component composition, as well as:
- Morgagni syndrome;
- atrioventricular block 2 and 3 degrees;
- blockade of the heart of the sinoatrial form;
- bradycardia with decreased heart rate;
- deficiency of the liver and kidney;
- chronic alcohol intoxication.
Also, due to the possible loss of the effectiveness of NRTIs, it is not recommended to mix Phenytoin with Delavirdine.
Instructions for use: Schemes and doses
Depending on the degree of manifestation of epilepsy symptoms, 0.5-1 Phenytoin tablet is taken 3 times a day. To optimize the patient's condition, the dosage increases with time to 4 tablets per day. The maximum allowed dose is no more than 8 units in 24 hours and no more than 3 at a time.
Children's dosage( 5-9 years) should not exceed 0.5 tablets at a time, no more than 2 times a day. For children older than 9 years, the dosage is determined from the calculation of 5-8 mg per 1 kg of the body.
With arrhythmia, the recommended use of the drug is not more than 4 tablets per day, given that the first result is manifested after 4 days of admission. After achieving the first effect, the dosage is reduced by 3 tablets.
Also to achieve a quick result when the disease is neglected, there is a developed scheme of application:
- 1 day - 2 tablets 4 times a day;
- Day 2 - 1 unit of the drug 5 times a day;
- Day 3 - 1 tablet for 5 doses per day;
- from 4 days to the end of the course of admission - 1 unit of the drug 3 times a day.
Overdose and actions with it
Overdose Diphenin is accompanied by the main symptomatology:
- nausea with vomiting;
- trembling in the hands;
- disorder of vision;
- toxic hepatitis;
- pendulum involuntary eye movements;
- traffic coordination disorder;
- dysarthria;
- loss of consciousness;
- coma, sopor;
- lowering blood pressure;
- respiratory failure;
- sleep apnea;
- appetite suppression;
- constipation;
- lymphadenopathy.
In case of manifestation of such symptoms, it is necessary to give the patient first aid. When a person is in a conscious state, it can be limited to washing the stomach and taking sorbents.
Respiratory failure or inhibition of the cardiovascular system can be eliminated with artificial air carriers.
Treatment is only for symptoms. A universal antidote has not yet been found.
An overdose can occur if the application patterns are violated and the permitted dosage is increased. And also this factor depends on the amount of contained phenytoin in the blood plasma. For example, involuntary eye movements can occur with a dosage of more than 20 mg, and a muscle movement disorder exceeding 30 mg.
Special conditions and indications
During the course of the drug, it is recommended to refrain from drinking alcoholic beverages. But if you apply Diphenin with alcohol once, the concentration of phenytoin in the blood will increase.
If the functionality of the liver and kidneys fails, it is necessary to consult a doctor about dosing.
The drug during pregnancy is prescribed by doctors only when the matter of the mother's health is above the risk for the child to be born. After childbirth, there may be a clotting disorder.
Application during lactation is prohibited, due to the fact that Diphenin enters the breast milk. This can cause an adverse reaction in the child.
Interaction with other drugs and substances
Diphenin in parallel with other medications:
- Prolongs the work of Paracetamol.
- Increases the toxicity of aminazine and other drugs that are based on phenytoazine, sulfonamide, or reserpine.
- Medications for St. John's wort reduce the concentration of phenytoin in the plasma. Such an action can last for 10-14 days after the end of taking medications with this herb. As well as reducing the substance in the blood may affect Sucralfate, vitamin B9, Teofillin, Nelfinavir and Vigabatrin.
- Cardiodepressive effect enhances the drug compound with lidocaine and beta-adrenergic blocker.
- Increase in the amount of phenytoin in the blood increases: dicumarol, omeprazone, viloxazine, succinimides, isoniazid, diazepam, golotam, tolbutamide, nifedipine, amiodarone and any anti-fungal agents.
- The drug reduces the effectiveness of antifungal, antitumor agents. The action is blocked: Methadone, Furosemide, Digitoxin, Clozapine, Paroxetine, estrogens and oral contraceptives.
- In addition, the drug may affect the test results and increase the calcium and vitamin B9 content.
Practical experience of using
Reviews of patients and doctors who use Diphenin in practice.
I suffer from epilepsy not for the first year, and after consulting a doctor, he prescribed me Diphenin. For a long time I was afraid to drink it, because I heard about its effects and side effects.
The doctor personally gave me a dosage and a chart of use with other tablets. Positively surprised by the effect. Attacks began to show less often. Tell me, what else can this composition be combined to achieve complete elimination of epilepsy?
Polina Selezneva
I have seizures of epilepsy. To the doctor did not address, but when on hearing has got Фенитоин has decided to try to spend on drink. He came to the pharmacy, and he is released only on prescription. After another attack( 2 times a month), I decided to go to the hospital. The doctor also offered to drink Diphenin with Finlepsin( 400 mg).After a month of use, weakened seizures. But they did not disappear.
Nikita Sergeev
I prescribe the drug to epileptics, as the main one. But honestly, do not risk appointing it to children. Once he prescribed it to the boy 9 years in the minimum dose( half a tablet a day), after two days of use, he had side effects( suppression of breathing and vomiting).Although the adult organism always takes it to cheer. Here you can safely bet 4 +.
It is also not recommended to take the drug for people with periodontitis and stomatitis. Diphenin can exacerbate these diseases.
I do not advise him to get behind the wheel after his admission, side effects pop up suddenly.
Teplov Alexander Sergeevich, neurologist
I consider Diphenin a good remedy, which corresponds to price and quality trends. Basically, these funds are very expensive. The same drug costs between 200-250 rubles, which makes it affordable for people. Of course, there are drugs and stronger. I always assign them in pairs.
Nevbiraka Sergey Ilyich
Pros and cons of
According to feedback, it is possible to determine the obvious pluses and minuses of the drug.
Pros:
- price;
- improves sleep and mood;
- effect.
Cons:
- exacerbation of disease( periodontal disease);
- often shows side effects;
- is not recommended for children under 6 years of age.
Purchase and storage of
Buy Diphenin in Russia( 10 pcs.) Can be for 180 rubles. While the blister with 60 pcs.will cost about 950 rubles.
Store the preparation in a dry, sun-protected place. Shelf life - 4 years. It is released on prescription.
Analogues, as such, are absent, but for similar active substances, Diphenine can be replaced by Diphedan, Gidantal, Sodanton, Dipentoin, Ferghydon.
