Epanutin Parenteral

What is it?

An anticonvulsant and class I antiarrhythmic preparation available in ampoules for injection containing 50mg phenytoin sodium per ml.

Medical Uses

Status epilepticus (an emergency situation in which a patient suffers continuous epileptic seizures without regaining consciousness in between. If the convulsions are not halted, the person suffers irreversible brain damage and may die). Also, used for prevention of seizures during/following neurosurgical operations and serious head injury and for heart arrhythmias, particularly those caused by digitalis.

Dosage

Adults, status epilepticus, 10 to 15mg per kg of body weight by slow intravenous injection or infusion, after diazepam has been given intravenously. Heart arrhythmias, 3.5 to 5mg/ kg body weight in first instance, by intravenous injection, or infusion with dose repeated once, if necessary. The delivery rate should not be greater than 50mg per minute. Children, for status epilepticus only, new-born infants, initial dose of 15 to 20mg per kg of body weight by slow intravenous injection or infusion, delivered at rate no greater than 1 to 3mg per kg per minute. Other children, 10 to 15mg per kg of body weight administered in same way

Special Care

Pregnancy, breastfeeding, ECG and close monitoring needed; resuscitation equipment should be on hand.

Avoid Use

Patients with heart block.

Possible Drug and Food Interactions

Theophylline, analgesics, anticonvulsants, amiodarone, coticosteroids, antineoplastics, folic acid, anticoagulants of the coumarin group, antibacterials, vitamin D, chloramphenicol, antifungal drugs, anntipsychotics, oral contraceptives, benzodiazepines, quinidine, disulfram, tolbutarnide, antacids, ulcer drugs.

Known Side Effects

Upset stomach, lack of sleep, drowsiness, allergic effects, blood changes, slurring of speech, confusion, unsteadiness, swelling of gums and lymph glands; there may be unusual growth of hair (hirsutism) and motor activity. Rapid abnormal eye movements (nystagmus) may occur and drug should be withdrawn in the event of skin rash.