Pronunciation:

FEN-i-toin

Dosage Forms:

• Solution

Classifications:

Therapeutic—

Anticonvulsant

Chemical—

Hydantoin (class)

Uses of This Medicine:

Phenytoin injection is used to control certain types of seizures (convulsions) in the treatment of epilepsy. It is also used to prevent and treat seizures that occur during brain surgery. This medicine is an anticonvulsant that works in the brain tissue to stop seizures.

This medicine is to be given only or under the direct supervision of a doctor.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of phenytoin injection in children.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of phenytoin injection in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require an adjustment in the dose for patients receiving phenytoin injection.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Artemether
• Atazanavir
• Boceprevir
• Cabotegravir
• Cobicistat
• Daclatasvir
• Darunavir
• Dasabuvir
• Delamanid
• Delavirdine
• Doravirine
• Elbasvir
• Elvitegravir
• Fostemsavir
• Grazoprevir
• Isavuconazonium
• Lenacapavir
• Lorlatinib
• Lurasidone
• Maraviroc
• Mavacamten
• Nirmatrelvir
• Ombitasvir
• Pacritinib
• Paritaprevir
• Piperaquine
• Praziquantel
• Ranolazine
• Rilpivirine
• Ritonavir
• Telaprevir
• Tenofovir Alafenamide

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Abemaciclib
• Abiraterone Acetate
• Acalabrutinib
• Adagrasib
• Afatinib
• Alfentanil
• Alpelisib
• Amiodarone
• Apazone
• Apixaban
• Apremilast
• Aprepitant
• Aripiprazole
• Asciminib
• Aspirin
• Atogepant
• Avacopan
• Avapritinib
• Axitinib
• Beclamide
• Bedaquiline
• Belumosudil
• Bendamustine
• Benzhydrocodone
• Berotralstat
• Betrixaban
• Bictegravir
• Bortezomib
• Bosutinib
• Brexpiprazole
• Brigatinib
• Buprenorphine
• Bupropion
• Cabozantinib
• Calcifediol
• Cannabidiol
• Capecitabine
• Capmatinib
• Carbamazepine
• Cariprazine
• Cenobamate
• Ceritinib
• Chlorpheniramine
• Cisatracurium
• Clarithromycin
• Clofazimine
• Clozapine
• Cobimetinib
• Codeine
• Copanlisib
• Crizotinib
• Cyclophosphamide
• Dabigatran Etexilate
• Dabrafenib
• Daridorexant
• Darolutamide
• Dasatinib
• Deferasirox
• Deflazacort
• Desogestrel
• Dexamethasone
• Diazepam
• Diazoxide
• Dienogest
• Digoxin
• Dihydrocodeine
• Dolutegravir
• Dopamine
• Doxifluridine
• Doxorubicin
• Doxorubicin Hydrochloride Liposome
• Dronedarone
• Drospirenone
• Duvelisib
• Edoxaban
• Elacestrant
• Elexacaftor
• Eliglustat
• Encorafenib
• Entrectinib
• Enzalutamide
• Eravacycline
• Erdafitinib
• Erlotinib
• Eslicarbazepine Acetate
• Estetrol
• Estradiol
• Ethinyl Estradiol
• Ethosuximide
• Ethynodiol
• Etonogestrel
• Etravirine
• Everolimus
• Exemestane
• Ezogabine
• Fedratinib
• Fenfluramine
• Fentanyl
• Fexinidazole
• Finerenone
• Fluconazole
• Fluorouracil
• Fluoxetine
• Fluvastatin
• Fosaprepitant
• Fosnetupitant
• Fostamatinib
• Futibatinib
• Gefitinib
• Gepirone
• Gestodene
• Gilteritinib
• Glasdegib
• Glecaprevir
• Halothane
• Hemin
• Hydrocodone
• Ibrexafungerp
• Ibrutinib
• Idelalisib
• Ifosfamide
• Imatinib
• Infigratinib
• Infliximab
• Irinotecan
• Irinotecan Liposome
• Istradefylline
• Itraconazole
• Ivabradine
• Ivacaftor
• Ivosidenib
• Ixabepilone
• Ixazomib
• Ketoconazole
• Lamotrigine
• Lapatinib
• Larotrectinib
• Ledipasvir
• Lefamulin
• Lemborexant
• Leniolisib
• Letermovir
• Levoketoconazole
• Levoleucovorin
• Levonorgestrel
• Lidocaine
• Linagliptin
• Lopinavir
• Lumateperone
• Lurbinectedin
• Macimorelin
• Macitentan
• Manidipine
• Maribavir
• Medroxyprogesterone
• Meperidine
• Mestranol
• Methadone
• Methotrexate
• Miconazole
• Midostaurin
• Mifepristone
• Mirtazapine
• Mitapivat
• Mobocertinib
• Naloxegol
• Neratinib
• Netupitant
• Nifedipine
• Nilotinib
• Nimodipine
• Nintedanib
• Nitisinone
• Nomegestrol
• Norelgestromin
• Norethindrone
• Norgestimate
• Norgestrel
• Olanzapine
• Olaparib
• Olutasidenib
• Omaveloxolone
• Omeprazole
• Orlistat
• Osimertinib
• Oxcarbazepine
• Oxycodone
• Paclitaxel
• Palbociclib
• Paliperidone
• Palovarotene
• Panobinostat
• Pazopanib
• Pemigatinib
• Pentazocine
• Perampanel
• Pexidartinib
• Phenobarbital
• Pibrentasvir
• Pimavanserin
• Pirtobrutinib
• Pitolisant
• Ponatinib
• Ponesimod
• Posaconazole
• Pralsetinib
• Pretomanid
• Primidone
• Quetiapine
• Quizartinib
• Regorafenib
• Relugolix
• Reserpine
• Ribociclib
• Rifampin
• Rimegepant
• Ripretinib
• Risperidone
• Ritlecitinib
• Rivaroxaban
• Rocuronium
• Roflumilast
• Rolapitant
• Romidepsin
• Ruxolitinib
• Samidorphan
• Saquinavir
• Segesterone
• Selpercatinib
• Selumetinib
• Sertraline
• Sildenafil
• Simeprevir
• Sirolimus Protein-Bound
• Sofosbuvir
• Sonidegib
• Sorafenib
• Sotorasib
• Sparsentan
• Stiripentol
• St John's Wort
• Sufentanil
• Sunitinib
• Tacrolimus
• Tamoxifen
• Tasimelteon
• Tazemetostat
• Tegafur
• Temsirolimus
• Tezacaftor
• Theophylline
• Thiotepa
• Ticagrelor
• Tivozanib
• Tocilizumab
• Tofacitinib
• Tolvaptan
• Topiramate
• Trabectedin
• Tramadol
• Triclabendazole
• Tucatinib
• Ubrogepant
• Ulipristal
• Upadacitinib
• Valbenazine
• Valproic Acid
• Vandetanib
• Velpatasvir
• Vemurafenib
• Venetoclax
• Vilazodone
• Vincristine
• Vincristine Sulfate Liposome
• Vinflunine
• Voclosporin
• Vonoprazan
• Vorapaxar
• Voriconazole
• Vortioxetine
• Voxelotor
• Voxilaprevir
• Zanubrutinib
• Zolpidem
• Zuranolone

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acetaminophen
• Acetazolamide
• Acyclovir
• Amitriptyline
• Amprenavir
• Aripiprazole Lauroxil
• Atorvastatin
• Betamethasone
• Bexarotene
• Bleomycin
• Busulfan
• Carboplatin
• Caspofungin
• Chloramphenicol
• Cimetidine
• Ciprofloxacin
• Cisplatin
• Clobazam
• Clopidogrel
• Cortisone
• Cyclosporine
• Dicumarol
• Digitoxin
• Diltiazem
• Disopyramide
• Disulfiram
• Doxepin
• Felbamate
• Fludrocortisone
• Fluvoxamine
• Folic Acid
• Fosamprenavir
• Ginkgo
• Imipramine
• Isoniazid
• Levodopa
• Levofloxacin
• Levomethadyl
• Levothyroxine
• Lithium
• Methoxsalen
• Methsuximide
• Midazolam
• Nafimidone
• Nelfinavir
• Nilutamide
• Nisoldipine
• Ospemifene
• Pancuronium
• Paroxetine
• Phenprocoumon
• Piperine
• Prednisolone
• Prednisone
• Progabide
• Quinidine
• Quinine
• Remacemide
• Rifapentine
• Rufinamide
• Sabeluzole
• Shankhapulshpi
• Simvastatin
• Sirolimus
• Sulfamethizole
• Sulfamethoxazole
• Sulfaphenazole
• Sulthiame
• Telithromycin
• Tenidap
• Tiagabine
• Ticlopidine
• Ticrynafen
• Tirilazad
• Tizanidine
• Tolbutamide
• Trazodone
• Triamcinolone
• Trimethoprim
• Tubocurarine
• Valacyclovir
• Vecuronium
• Verapamil
• Vigabatrin
• Viloxazine

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Ethanol

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Blood or bone marrow problems (eg, agranulocytosis, leukopenia, thrombocytopenia) or
• Diabetes or
• Heart failure or
• Heart rhythm problems or
• Hypotension (low blood pressure) or
• Lymphadenopathy (lymph node problems) or
• Porphyria (an enzyme problem)—Use with caution. May make these conditions worse.

• Heart block (eg, Adams-Stokes syndrome, AV block, or sinoatrial block) or
• Sinus bradycardia (slow heartbeat)—Should not be used in patients with these conditions.

• Hypoalbuminemia (low albumin in the blood) or
• Kidney disease or
• Liver disease—Use with caution. The effects may be increased because of slower removal from the body.

Proper Use of This Medicine:

A nurse or other trained health professional will give you or your child this medicine in a hospital. This medicine is given as a shot into a muscle or into a vein.

Your doctor will only give you or your child a few doses of this medicine until your condition improves. You will be switched to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

Precautions While Using This Medicine:

It is very important that your doctor check your progress closely while you or your child are receiving this medicine. This is to see if it is working properly and to allow for a change in the dose. Blood tests may be needed to check for any unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

Do not receive this medicine while you or your child are also taking delavirdine (Rescriptor®). Using these medicines together may cause unwanted effects.

This medicine may cause some people to become dizzy, lightheaded, faint, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert and able to see well.

Do not stop using this medicine without first checking with your doctor. Stopping the medicine suddenly may cause your seizures to return or to occur more often.

If you or your child develop a skin rash, hives, or any allergic reaction to this medicine, tell your doctor or nurse as soon as possible.

Tell your doctor right away if you or your child develop a fever, rash, swollen, painful, or tender lymph glands in the neck, armpit, or groin, unusual bleeding or bruising, or yellow eyes or skin after receiving this medicine. These may be symptoms of a serious and life-threatening condition called Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS).

This medicine may cause liver damage. Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin.

This medicine may cause purple glove syndrome. Tell your doctor right away if you or your child have skin discoloration, pain, or swelling at the injection site after receiving this medicine.

This medicine may affect blood sugar levels. If you or your child notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.

If you or your child develop any unusual or strange thoughts and behavior while receiving phenytoin injection, be sure to discuss it with your doctor. Some changes that have occurred in people receiving this medicine are like those seen in people who drink too much alcohol. Other changes might be confusion, worsening of depression, hallucinations (seeing, hearing, or feeling things that are not there), suicidal thoughts, and unusual excitement, nervousness, or irritability.

Birth control pills may not work while you are using this medicine. To keep from getting pregnant, use another form of birth control along with your birth control pills. Other forms include a condom, a diaphragm, or a contraceptive foam or jelly.

Avoid drinking alcohol while you are receiving this medicine.

Before you have any medical tests, tell the medical doctor in charge that you or your child are taking this medicine. The results of some tests may be affected by this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Chest pain or discomfort

cold, clammy, or pale skin

decreased coordination

difficulty with sleeping

disorientation

dizziness

drowsiness to profound coma

fainting

fast, slow, or irregular heartbeat

hallucination

headache

lightheadedness

measles-like skin rash

mood or other mental changes

nausea

nervousness

pain in the shoulders, back, neck, or jaw

shakiness and unsteady walk

slow heart rate

slurred speech

sweating

swelling of the feet and lower legs

troubled breathing

uncontrolled eye movements

unsteadiness, trembling, or other problems with muscle control or coordination

unusual tiredness or weakness

Rare

Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site

blistering, crusting, irritation, itching, peeling, or reddening of the skin

cracked, dry, or scaly skin

inability to move the eyes

increased blinking or spasms of the eyelid

shakiness in the legs, arms, hands, or feet

sticking out of the tongue

trouble with breathing, speaking, or swallowing

twitching, uncontrolled movements of the tongue, lips, face, neck, trunk, arms, or legs

unusual facial expressions

Incidence not known

Abdominal or stomach pain

bleeding gums

blisters, hives, or itching

bloating of the abdomen or stomach

blood in the urine or stools

bloody, black, or tarry stools

blurred vision

break in the skin, especially associated with blue-black discoloration, swelling, or drainage of fluid

burning, numbness, tingling, or painful sensations

chills

cough or hoarseness

dark urine

diarrhea

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

fainting spells

fever with or without chills

general feeling of discomfort or illness

general feeling of tiredness or weakness

hair loss

high fever

irritation in the mouth

joint or muscle pain

light-colored stools

loss of appetite

loss of heat from the body

lower back or side pain

muscle or joint pain

painful or difficult urination

pale skin

pinpoint red spots on the skin

red skin lesions, often with a purple center

red, irritated eyes

red, swollen skin

redness and swelling of the gums

skin rash

sore throat

soreness of the muscles

sores, ulcers, or white spots on the lips or in the mouth

stomach pain, continuing

sweating

swollen glands

swollen, painful, or tender lymph glands in the neck, armpit, or groin

unexplained bleeding or bruising

unsteadiness or awkwardness

unusual bleeding or bruising

vomiting

weakness in the arms, hands, legs, or feet

weight loss

yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Change in consciousness

changes in patterns and rhythms of speech

loss of consciousness

pounding in the ears

unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

Difficulty having a bowel movement (stool)

enlarged lips

feeling of constant movement of self or surroundings

increased hair growth on the forehead, back, arms, and legs

pain of the penis on erection

sensation of spinning

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.