Generic Dilantin

Introduction

Dilantin (phenytoin) is an antiepileptic medication widely used in the United Kingdom for the control of generalized and focal seizures. It belongs to the broader medication group classified as “general health” because its primary therapeutic aim is to maintain neurological stability. The active compound, phenytoin, exerts its effect by stabilising neuronal membranes, thereby reducing the likelihood of abnormal electrical discharge. In addition to epilepsy, Dilantin is occasionally employed for certain cardiac arrhythmias and for the prevention of seizures following neurosurgical procedures.

What is Dilantin?

Dilantin is a synthetic, oral formulation that contains the sodium salt of phenytoin. The drug was first introduced in the 193s and has since become a cornerstone of seizure management. It is marketed in several strengths, most commonly as 30 mg, 100 mg, and 200 mg tablets. The medication is produced by multiple licensed manufacturers, all of which must comply with the United Kingdom’s Medicines and Healthcare products Regulatory Agency (MHRA) standards for quality, safety, and efficacy.

How Dilantin Works

Phenytoin, the active ingredient in Dilantin, blocks voltage‑gated sodium channels during the rapid depolarisation phase of the neuronal action potential. By limiting the influx of sodium ions, the drug prolongs the refractory period of neurons, making them less likely to fire repeatedly. This stabilisation of neuronal excitability reduces the frequency and intensity of epileptic discharges. Pharmacokinetic features relevant to clinical use include:

• Onset of action: Therapeutic concentrations are usually achieved within 3–5 days of regular dosing.
• Half‑life: Approximately 22 hours in adults, but may be prolonged in elderly patients or those with hepatic impairment.
• Clearance: Primarily hepatic metabolism via the cytochrome P450 system (CYP2C9, CYP2C19).

These properties guide dosing intervals and monitoring strategies in routine practice.

Conditions Treated with Dilantin

Who is Dilantin For?

Dilantin is suitable for adult patients (≥ 18 years) who have been diagnosed with epilepsy and require long‑term seizure control. It is especially appropriate when:

• The seizure type is known to respond to sodium‑channel blockers (e.g., focal seizures with secondary generalisation).
• The patient has demonstrated tolerance to first‑line agents such as carbamazepine or levetiracetam but requires an alternative mechanism of action.

Contra‑indications and caution include:

• Severe hepatic impairment, because phenytoin metabolism may be markedly reduced.
• Known hypersensitivity to phenytoin or its excipients.
• Pregnancy (Category D): teratogenic risk warrants specialist obstetric input.

Patients with significant comorbidities (e.g., renal failure, cardiac conduction disorders) should be evaluated by a neurologist before initiating therapy.

Risks, Side Effects, and Interactions

Common

• Gingival hyperplasia: Overgrowth of gum tissue, often reversible with dental hygiene and dose adjustment.
• Hirsutism: Excessive hair growth on the face or body.
• Nystagmus: Involuntary eye movement, usually dose‑related.
• Dermatitis or rash: Mild skin eruptions that may resolve with discontinuation.

Rare

• Peripheral neuropathy: Paresthesia or loss of sensation in distal limbs.
• Cerebellar ataxia: Unsteady gait and coordination deficits.
• Hypersensitivity syndrome: Fever, lymphadenopathy, eosinophilia, and multi‑organ involvement.

Serious

• Stevens‑Johnson syndrome / Toxic epidermal necrolysis: Life‑threatening skin reactions requiring immediate medical attention.
• Severe neutropenia or agranulocytosis: Marked reduction in white blood cells, increasing infection risk.
• Cardiovascular depression: Hypotension and arrhythmias in overdose scenarios.

Clinically Relevant Drug–Drug Interactions

• Warfarin: Phenytoin can increase INR, raising bleeding risk.
• Oral contraceptives: Phenytoin induces hepatic enzymes, potentially reducing contraceptive efficacy.
• Other antiepileptics (e.g., carbamazepine, phenobarbital): Additive sedation and altered serum levels.
• Aspirin and non‑steroidal anti‑inflammatory drugs (NSAIDs): May increase free phenytoin concentrations, enhancing toxicity.

Patients should disclose all concomitant medications, including over‑the‑counter products and herbal supplements, to their prescriber.

Practical Use: Dosing, Missed Dose, Overdose

• Standard dosing: Initial adult dose is typically 100 mg three times daily (300 mg /day). Maintenance doses range from 300 mg to 400 mg per day, adjusted according to serum phenytoin levels (10–20 µg/mL therapeutic window).
• Missed dose: If a dose is forgotten and the next scheduled dose is more than 6 hours away, take the missed dose. Do not double‑dose.
• Overdose management: Symptoms may include nausea, vomiting, ataxia, and cardiac depression. Immediate medical attention is required; treatment involves gastric lavage, activated charcoal, and supportive care.
• Food and alcohol: Phenytoin absorption is not significantly affected by meals, but chronic alcohol intake can alter hepatic metabolism, potentially leading to fluctuating serum levels.
• Comorbidities: In elderly patients, reduced hepatic clearance may necessitate lower doses and more frequent monitoring. Renal impairment does not substantially affect phenytoin elimination but may influence concomitant drug handling.

Buying Dilantin from Our Online Pharmacy

Dilantin can be obtained safely from our online pharmacy in the UK. Our service offers several advantages for patients who may encounter access barriers through conventional channels:

• Affordability: Prices are set close to manufacturer cost, providing a cost‑effective alternative to brand‑name products.
• Verified quality: All batches are sourced from MHRA‑registered overseas suppliers, ensuring consistent potency and purity.
• Reliable delivery: Discreet packaging is dispatched via express courier (typically within 7 days) or standard airmail (approximately 3 weeks).
• International reach: As a pharmacy‑broker service, we collaborate with licensed overseas pharmacies, allowing us to provide medications that might otherwise be unavailable locally.

Our platform respects patient privacy, offering a confidential ordering experience while adhering to UK import regulations for personal use.

FAQ

• What tablet strengths are available for Dilantin in the UK?
  Dilantin is supplied as 30 mg, 100 mg, and 200 mg film‑coated tablets. The strengths enable flexible dosing tailored to individual therapeutic windows.

• Can Dilantin be stored in a bathroom cabinet?
  The medication should be kept at room temperature (15‑30 °C) away from excess humidity. Storing in a bathroom can expose the tablets to moisture, potentially degrading the active ingredient.

• Is Dilantin subject to any special customs restrictions when imported for personal use?
  Under UK law, a patient may import a three‑month supply of a medication for personal use, provided the product is for a legitimate medical purpose and is not classified as a controlled substance. Documentation confirming the prescription is often required at the border.

• Does food affect the absorption of Dilantin?
  Phenytoin’s oral bioavailability is high and is not markedly altered by meals. However, taking the tablet with a full glass of water helps avoid oesophageal irritation.

• What are the visual characteristics of Dilantin tablets?
  The tablets are white to off‑white, oval‑shaped, and scored for easy splitting. Each tablet is imprinted with the strength (e.g., “100” for 100 mg).

• How does Dilantin compare to newer antiepileptic drugs such as levetiracetam?
  Both agents are effective for focal seizures, but levetiracetam has a wider therapeutic window and fewer protein‑binding interactions. Dilantin remains valuable for patients who respond specifically to sodium‑channel blockade or who have contraindications to newer agents.

• Are there any known ethnic differences in Dilantin metabolism?
  Certain CYP2C9 and CYP2C19 polymorphisms, more prevalent in Asian populations, can slow phenytoin metabolism, leading to higher plasma concentrations at standard doses. Genotype‑guided dosing may be considered in these groups.

• Is Dilantin detectable in standard workplace drug testing?
  Phenytoin is not typically included in routine drug‑screen panels for substances of abuse. Specialized forensic tests would be required to detect therapeutic levels.

• Can Dilantin be used for seizure prophylaxis after a traumatic brain injury?
  Clinical guidelines recommend short‑term antiepileptic therapy (including phenytoin) following severe head injury to reduce early post‑traumatic seizures. Long‑term use is usually discontinued after the acute phase unless seizures persist.

• What packaging does Dilantin arrive in when ordered online?
  The medication is shipped in a sealed, tamper‑evident blister pack, with each tablet individually protected. The outer box bears discreet labeling and includes a statement of contents for customs compliance.

Glossary

Sodium‑channel blocker

A class of drugs that inhibit the flow of sodium ions through neuronal voltage‑gated channels, reducing neuronal excitability.

Therapeutic window

The plasma concentration range in which a drug provides optimal efficacy with minimal toxicity; for phenytoin this is typically 10–20 µg/mL.

Hirsutism

Excessive, male‑pattern hair growth in women, commonly induced by androgenic effects of certain medications, including phenytoin.

Stevens‑Johnson syndrome

A severe, immune‑mediated skin reaction characterized by widespread epidermal necrosis and mucosal involvement, requiring immediate medical care.

⚠️ Disclaimer

The information provided about Dilantin is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Dilantin for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.