Epanutin Capsules

• The amount of Epanutin needed varies from one person to another. Most adults need between 200mg and 500mg a day either as a single or divided dose. Occasionally higher doses are needed.

Children:

• Infants and children usually start on a dose that depends on their weight (5mg per day for every kg they weigh) and is given as a divided dose, twice a day. The dose is then adjusted up to a maximum of 300mg a day.

Elderly:

• The dose of Epanutin for elderly patients who may be taking other medicines may also need careful consideration and adjustment by their doctor.

Could it interact with other tablets?

Tell your prescriber the names of all the medicines that you are taking so that they can consider all possible interactions. This includes all the medicines which have been prescribed by your GP, hospital doctor, dentist, nurse, health visitor, midwife or pharmacist. You must also tell your prescriber about medicines which you have bought over the counter without prescriptions.

The following medicines may interact with Epanutin capsules:

• vitamin D
• amiodarone
• amphotericin B
• carbamazepine
• chloramphenicol
• chlordiazepoxide
• ciclosporin
• ciprofloxacin
• clozapine
• diazepam
• dicoumarol
• digitoxin
• diltiazem
• disulfiram
• doxycycline
• fluconazole
• fluoxetine
• folic acid
• furosemide
• halothane
• isoniazid
• itraconazole
• ketoconazole
• lamotrigine
• methadone
• methylphenidate
• miconazole
• nifedipine
• omeprazole
• paroxetine
• phenobarbital
• phenylbutazone
• quinidine
• reserpine
• rifampicin
• sodium valproate
• sucralfate
• theophylline
• tolbutamide
• trazodone
• valproic acid
• vigabatrin
• viloxazine
• warfarin

The following types of medicine may interact with Epanutin capsules:

• antacids
• antifungal agents
• antineoplastic agents
• calcium channel blockers
• corticosteroids
• H2 antagonists
• neuromuscular blockers
• oestrogens
• oral contraceptives
• phenothiazines
• salicylates
• succinimides
• sulphonamides
• tricyclic antidepressants

If you are taking Epanutin capsules and one of the above medicines or types of medicines, make sure your prescriber knows about it.

Herbal products should also only be taken after talking with your doctor.

What are the possible risks or side-effects?

Everyone's reaction to a medicine is different. It is difficult to predict which side-effects you will have from taking a particular medicine, or whether you will have any side-effects at all. The important thing is to tell your prescriber or pharmacist if you are having problems with your medicine.

The frequency of these side-effects is unknown:

• coordination problems
• speech problems
• paraesthesiae
• drowsiness
• vertigo
• dizziness
• difficulty sleeping
• feeling nervous
• twitching
• headaches
• neuropathies
• nausea
• vomiting
• constipation
• liver problems
• coarsening of facial features
• overgrowth of gums
• hair overgrowth
• Peyronie's disease
• Dupuytren's contracture
• blood and bone marrow problems - these may be fatal
• lymphadenopathy
• lupus or lupus-like problem
• polyarteritis nodosa
• polyarthropathy
• kidney problems
• status epilepticus can occur when this medicine is stopped abruptly
• high blood sugar
• worsening of porphyria
• may affect the results for certain tests
• abnormal laboratory test results
• folic acid deficiency
• allergic or hypersensitivity reactions - these may be fatal. These reactions may occur with joint pain
• increase in the size of the lips
• brain and central nervous system problems this may occur when there are very high levels of this medicine in the blood. Some of these brain and central nervous system problems may lead to permanent brain injury. You or your carer must seek immediate medical advice if you have confusion, delirium or psychosis
• skin problems including skin rashes, dermatitis, Stevens-Johnson syndrome or toxic epidermal necrolysis. Some of these skin problems may occur with a fever. You must seek medical advice if you get a rash
• problems controlling movement
• abnormal muscle movement
• tremors
• abnormal eye movements
• vitamin D - low level in the body. This may lead to rickets, bone pain, other bone problems or low levels of calcium
• inflammation of the lung and breathing problems
• uncovering symptoms of depression or suicidal tendencies - seek medical advice if you get thoughts of committing suicide or attempt suicide

Can I drink alcohol while taking it?

• Drinking a lot of alcohol can affect the concentration of Phenytoin in your blood and thereby affect how well it works.

What if I’m pregnant/breastfeeding?

If you think you might be pregnant, or are planning to get pregnant, tell your doctor before you take Epanutin.
You should not take Epanutin if you are breast-feeding.

If you have any more questions please ask your Pharmacist.

Remember to keep all medicines out of reach of children
Please Note: We have made every effort to ensure that the content of this information sheet is correct at time of publish, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.

References:

http://www.hpra.ie/img/uploaded/swedocuments/PIL-2132502-17102013113520-635176065220685000.pdf

http://www.drugs.com/uk/epanutin-100mg-capsules-leaflet.html

http://www.netdoctor.co.uk/medicines/brain-and-nervous-system/a6663/epanutin-phenytoin/

https://www.medicines.org.uk/emc/medicine/14232

http://patient.info/medicine/phenytoin-for-epilepsy-epanutin