Side Effects of Dilatin
- Though the compound was discovered in the early 1900's, its usefulness as an anticonvulsant was not seen until the late 1930's. For many years, Dilantin was considered first-line therapy for the treatment of seizures. Newer, more effective agents with fewer side effects have since decreased its use.
- Dilantin acts to stabilize nerve membranes by controlling the flow of sodium ions during brain activity.
- The effects of Dilantin are dependent upon its levels in the body. Desirable levels for seizure control without toxic effects are generally found between 10 and 20 micrograms per milliliter (mcg/ml.) Levels less than 10 mcg/ml may not provide adequate seizure control and levels greater than 20mcg/ml may produce unwanted effects.
- Dilantin may cause a number of side effects, many of which are dependent on drug level within the bloodstream. At concentrations greater than 20 mcg/ml, patients may experience an involuntary, rapid movement of the eye called nystagmus. At concentrations greater than 30 and 40 mcg/ml, patients may experience movement difficulties and decreased mental function, respectively. Concentrations greater than 100mcg/ml can be fatal.
Side effects unrelated to blood level include gingival hyperplasia, an overgrowth of gum tissue seen in nearly 20 percent of patients on long-term therapy. Other cosmetic effects include softening of the bones, unwanted hair growth, coarsened facial features and rash. Dilantin may also slow heart rate, decrease blood pressure and cause abnormal heart rhythms. Endocrine system effects include decrease in insulin sensitivity and liver changes. Central nervous system side effects include drowsiness, dizziness, slurred speech, vision changes and headache. Nausea and vomiting may also occur. - For maximum benefit with minimal toxic effects, patients should periodically have their Dilantin blood level evaluated. Taking Dilantin doses at the same time each day helps maintain consistent blood levels. Before taking other medications, seek medical advice as this may affect Dilantin levels. Vitamin D supplementation may be required to reduce negative effects on bone. Avoid or limit alcohol consumption while taking Dilantin.