Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Inhibits
  • Induces
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics

Brand Names


Austria: Epanutin, Epilan; Belgium: Diphantoine, Epanutin; Bulgaria: Epilan; Cyprus: Epanutin; Czech Republic: Epanutin, Epilan; Denmark: Fenytoin; Estonia: Phenhydan; Finland: Epanutin, Hydantin; France: Dilantin; Germany: Epanutin, Phenhydan, Phenytoin, Zentropil; Greece: Epanutin; Hungary: Diphedan, Epanutin; Ireland: Epanutin; Italy: Aurantin, Dintoina, Fenito; Luxembourg: Di-Hydan, Diphantoine, Epanutin, Phenhydan; Netherlands: Diphantoine, Epanutin; Poland: Phenytoin, Phenytoinum; Romania: Fenitoina, Phenhydan, Phenytoin; Slovakia: Epilan; Spain: Epanutín, Fenitoína, Sinergina; Sweden: Epanutin, Fenantoin, Lehydan; UK: Epanutin, Phenytoin.

North America

Canada: Dilantin, Phenytoin, Tremytoine; USA: Dilantin, Phenytek, Phenytoin.

Latin America

Argentina: Epamín, Etoína, Fenigramón, Fenitenk, Fenitoína, Lotoquis, Opliphon; Brazil: Epelín, Fenital, Fenitón, Hidantal, Unifenitoín; Mexico: Biodán, Comvufén, Epamín, Fenidantoín, Feniffler, Fenitoína, Fenitrón, Hidantoína.


Japan: Aleviatin, Hydantol, Phenytoin.

Drug combinations

Phenytoin and Phenobarbital


Phenytoin: C~15~H~12~N~2~O~2~. Mw: 252.27. 5,5-Diphenylhydantoin. CAS-57-41-0 (1975).

Phenytoin Sodium: C~15~H~11~N~2~NaO~2~. Mw: 274.25. 2,4-Imidazolidinedione, 5,5-diphenyl-, monosodium salt. CAS-630-93-3.

Pharmacologic Category

Class Ib Antiarrhythmics. Anticonvulsants; Hydantoins. (ATC-Code: N03AB02).

Mechanism of action

Stabilizes neuronal membranes and decreases seizure activity by increasing efflux or decreasing influx of sodium ions across cell membranes in motor cortex during generation of nerve impulses. Prolongs effective refractory period and suppresses ventricular pacemaker automaticity, shortens action potential in heart.

Therapeutic use

Management of generalized tonic-clonic (Grand mal), complex partial seizures. Prevention of seizures following head trauma/neurosurgery.

Pregnancy and lactiation implications

Phenytoin crosses placenta. Congenital malformations and isolated cases of malignancies (including neuroblastoma) and coagulation defects reported in neonate following delivery. Enters breast milk.

Unlabeled use


Hypersensitivity to phenytoin, other hydantoins, or any component of the formulation. Pregnancy.

Warnings and precautions

Hematologic effects reported (e.g. neutropenia, leukopenia, thrombocytopenia, pancytopenia, and anemias). Dermatologic reactions (including toxic epidermal necrolysis and Stevens-Johnson syndromes), although rarely reported, resulted in fatalities (Asian patients with variant HLA-B*1502 may be at increased risk). Acute hepatotoxicity associated with hypersensitivity syndrome characterized by fever, skin eruptions, and lymphadenopathy reported. Osteomalacia reported. Use with caution in sinus bradycardia, SA block, or AV block, in hepatic impairment, and in any condition associated with low serum albumin levels, which will increase free fraction of phenytoin in serum and, therefore, pharmacologic response. Use with caution in porphyria. May increase frequency of petit mal seizures. Effects with other sedative drugs or ethanol may be potentiated. Use with caution in debilitated patients, and in the elderly. Intravenous form may cause hypotension, skin necrosis at intravenous site. Avoid I.V. administration in small veins. Sedation, confusional states, or cerebellar dysfunction (loss of motor coordination) may occur at higher total serum concentrations, or at lower total serum concentrations when free fraction of phenytoin is increased. Anticonvulsants should not be discontinued abruptly.



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