Health Centres - Pro-epanutin
How does it work?
This medicine contains the active ingredient fosphenytoin, which is an anticonvulsant medicine. It is broken down in the body to an anticonvulsant medicine called phenytoin and its effects are due to the action of phenytoin. Phenytoin works by stabilising electrical activity in the brain.
The brain and nerves are made up of many nerve cells that communicate with each other through electrical signals. These signals must be carefully regulated for the brain and nerves to function properly. When abnormally rapid and repetitive electrical signals are released in the brain, the brain becomes over-stimulated and normal function is disturbed. This results in fits or seizures.
Phenytoin prevents seizures by preventing the excessive electrical activity in the brain. It is thought to achieve this by preventing sodium from entering nerve cells when they begin to fire rapid and repetitive electrical signals. A build up of sodium in the nerve cells is necessary for the electrical signal to build up and be passed on to other nerve cells. As phenytoin prevents this, it helps stabilise the electrical activity in the brain.
What is it used for?
-
Repeated fitting with no recovery of conciousness between seizures
-
Seizures associated with brain surgery or head injury
- As a temporary substitute for oral phenytoin
Warning!
- Symptoms such as confusion, rapid involuntary eye movements, blurred vision, slurred speech or clumsy movements may be signs that the blood level of this medicine is too high. The blood level of the medicine should be measured in people experiencing these symptoms so that the dose can be reduced if necessary.
- This medicine should be stopped in people who experience a skin rash or other signs of allergic reaction or syndrome during treatment. An allergic syndrome can often include problems with the liver and if this is discovered this medicine should not be restarted.
- Abrupt withdrawal of anticonvulsive treatment can result in increased numbers of seizures. If this medicine needs to be stopped suddenly it is normally necessary for it to be replaced with a different anticonvulsive medicine.
- This medicine may cause dizziness and drowsiness and may therefore effect the ability of patients to perform skilled tasks such as driving or operating machinary.
Use with caution in
- Elderly people
- Decreased heart function (myocardial insufficiency)
- Low blood pressure (hypotension)
- Low level of the protein albumin in the blood (hypoalbuminaemia)
- Kidney disease
- Liver disease
-
Diabetes
Not to be used in
- Slow heart rate of less than 50 beats per minute (sinus bradycardia)
- Defect of the heart's electrical message pathways that results in decreased function of the heart (heart block)
- A syndrome characterised by attacks of temporary loss of conciousness that happen when the blood flow stops due to problems with the heart beat (Adams-Stokes syndrome)
- Life long inherited blood disease characterised by sudden attacks of high blood pressure, mental disturbances and abdominal pain (acute intermittent porphyria)
- Allergy to phenytoin or other medicines of this type (hydantoins)
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
Pregnancy and Breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- It is very important for women with epilepsy to talk to the doctor responsible for their epilepsy treatment before becoming pregnant. Antiepileptic medicines are associated with an increased risk of developmental disorders and malformations in the baby. However, stopping antiepileptic treatment during pregnancy runs the risk of the mother having seizures, which can harm both the mother and the foetus. This risk may be higher than that from continuing the medication. It is important that all the risks and benefits of treatment are weighed up. Seek medical advice from your doctor.
- It is not known if this medicine passes into breast milk, however, when phenytoin is taken by mouth by breastfeeding mothers small amounts of the medicine do enter breast milk. It is recommended that mothers being treated with this medicine do not breastfeed. Seek medical advice from your doctor.
Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Rapid involuntary movements of the eyes (nystagmus)
- Dizziness
- Pins and needles (paraesthesia)
- Shaky movements and unsteady walk (ataxia)
- Shaking, usually of the hands (tremor)
- Drowsiness
- Nervousness
- Confusion
- Slurred speech
- Difficulty in sleeping (insomnia)
- Low blood pressure (hypotension)
- Heart problems such as irregular heart beats and heart block
- Lung problems such as inflammation (pneumonitis) or difficulty breathing
- Disturbance in the components of the blood
- Liver or kidney problems
- Constipation
- Dry mouth
- Nausea and vomiting
- Alteration in taste
- Rash or itching
- Visual disturbances
- Sensation of ringing, or other noise in the ears (tinnitus)
- Pain at the injection site
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
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