In this article, we consider the instructions for use, price and reviews for the drug "Diphenin". "Diphenin" is a tablet drug. It is used in the treatment of epilepsy, ventricular arrhythmias, trigeminal neuralgia. The main active substance in the composition of the medication is phenytoin.
What does the instruction for use with Diphenin tell us?
The composition of the drug and the form of release
The description of "Diphenin" in the instructions for use is quite detailed. The manufacturer produces the drug in the form of tablets. Instructions for use, the composition of "Diphenin" (analogues have a similar effect) is described as follows. The main component in the composition is phenytonin in an amount of 100 mg per 1 tablet. Talc, potato starch, sodium bicarbonate, magnesium stearate are used as additional components.
The detailed composition of "Diphenin" is indicated in the instructions. Feedback on the use of the tool will be presented below.
pharmachologic effect
The drug has an anticonvulsant, antiarrhythmic, muscle relaxant, analgesic effect.
"Diphenin" is a highly effective anticonvulsant drug. However, it does not cause pronounced sleeping pills, if we compare it with other drugs used in the treatment of epilepsy. The decrease in convulsive activity is due to the action of the main component - phenytoin. The substance stimulates the cerebellum, thereby inhibiting the inhibitory pathways that affect the cerebral cortex.
The drug "Diphenin" effectively increases the pain threshold for manifestations of trigeminal neuralgia. When taken, the duration of an attack of pain caused by this disease is reduced. In addition, the excitation and the frequency of occurrence of repeated discharges are reduced.
The medication has the ability to increase the pain threshold with the manifestation of trigeminal neuralgia. When taking the drug, the duration of the onset of pain characteristic of this disease is reduced, the arousal, the frequency of occurrence of repeated discharges are reduced.
The antiarrhythmic effect is due to the ability of "Diphenin" to reduce abnormal ventricular automatism, shorten the refractory period, and reduce the excitability of membranes.
Pharmacokinetics
The period during which the main active component of Diphenin is absorbed into the patient’s blood is variable, that is, variable. For example, you can observe the maximum concentration of phenytoin in the blood 3-12 hours after oral administration of the drug. The distribution of phenytoin occurs in all organs and tissues. It affects the central nervous system and enters the cerebrospinal fluid. The excretion of the substance occurs along with saliva, gastric and intestinal juice, breast milk and sperm. The barrier to phenytoin is also not the placental barrier. When taking "Diphenin" during pregnancy, its concentration in the mother’s blood will be equal to the concentration in the fetal blood.
Phenytoin metabolism occurs with the participation of liver enzymes. The elimination half-life of the drug occurs within 24 hours. If the course of treatment was long, complete elimination of the drug will occur no earlier than three days after the end of the dose.
This is described in detail in the instructions for "Diphenin." Analogues of the drug have a similar effect.
Indications
According to the instructions for use, the diphenin tablets are prescribed for use if the following indications are available:
- Heart rhythm disturbances caused by organic lesions of the central nervous system or resulting from an overdose of drugs of the cardiac glycoside group.
- Trigeminal neuralgia.
- Epilepsy. In particular, with large epileptic seizures, which are accompanied by cases of loss of consciousness.
- Treatment and prevention of epilepsy seizures in neurosurgery.
Contraindications
As indicated by the instructions for use, "Diphenin" is contraindicated in patients who have:
- Porphyria (one of the varieties of the genetic pathology of the liver).
- Adams-Stokes Syndrome.
- Hypersensitivity to the substances that make up the drug.
- Hepatic, renal failure.
- Cachexia. It is an extremely dangerous depletion of the body. It develops against the background of diseases of a tumor nature.
- Atrioventricular block (II and III degrees).
“Diphenin” can be prescribed with special care and under the close supervision of the attending physician to children with rickets, patients with diabetes mellitus, elderly people, patients with diagnosed chronic alcoholism, impaired liver and kidney function.
Methods of use and dosage
In accordance with the instructions for use, "Diphenin" should be taken during meals or immediately after it. Compliance with this recommendation will avoid possible irritation of the mucous membranes of the stomach.
The dosage at the initial stage of treatment of adult patients is 3-4 mg per kilogram of patient weight. Reception once a day. Over time, the dosage may be increased to achieve the desired therapeutic effect. Most often, the maintenance dose is at the level of 200-500 mg per day. Reception can be carried out one or several times during the day.
When treating children, the initial dosage should be 5 mg per kilogram of patient weight. Reception is carried out twice a day. Subsequently, the dose increases, but cannot be more than 300 mg per day. The maintenance dosage level is 4-8 mg / kg per day.
Side effects
This section discusses side effects. At the end of the article we will talk about the price and analogues of "Diphenin".
Instructions for use and reviews confirm that the following undesirable effects may develop during therapy using the drug:
- Violations of the hematopoietic system: agranulocytosis, megaloblastic anemia, thrombocytopenia, leukopenia, etc.
- Disorders from the gastrointestinal tract and digestive system: the occurrence of nausea, vomiting, loss of appetite, constipation, gingival hyperplasia, toxic hepatitis, damage to the liver tissue is not ruled out.
- Violations of the nervous system can manifest themselves in the form of muscle weakness, mood swings, insomnia, ataxia, nystagmus, shortness of breath, confusion, agitation, impaired coordination of movements, headache, dizziness.
- Various allergic manifestations in the form of fever, skin rash, in rare cases, purple or bullous dermatitis accompanied by hepatitis. It is worth noting that sometimes reactions from the dermis are accompanied by rashes similar to those that appear with scarlet fever and measles.
This is confirmed by the instructions for use and reviews of "Diphenin."
Overdose
A dose of 2-5 grams is fatal for humans. Symptoms of an overdose manifest as:
- Nystagmus (at a concentration of 20 μg of active substance per milliliter of blood plasma).
- Ataxia (at a concentration of the active substance of 30 μg / ml).
- Dysarthria (at a concentration of the active substance of 40 μg / ml).
In case of an overdose, the phenomena of tremor, hyperreflexia, drowsiness, slurred speech, nausea, vomiting, hypotension, coma are not excluded. Death occurs as a result of the development of cardiovascular failure and acute respiratory failure.
Overdose treatment involves the use of activated charcoal in the dosage recommended for poisoning, laxatives, and symptomatic therapy. Currently, specific antidotes to medicine are unknown. In the acute period, the patient needs to provide the necessary maintenance of the functions of the cardiovascular system, respiration. Dialysis is indicated according to the instructions for use with Diphenine.
Special instructions for admission
The necessary dosage should be selected with particular care. It should be remembered that an increased dosage can provoke a disproportionate increase in blood concentration. 7-10 days after the start of epilepsy therapy using this drug, it is necessary to conduct an analysis to determine the concentration of the substance in the patient's blood.
Use of "Diphenin" for monotherapy of absences, as well as for combination therapy with the simultaneous development of absences and tonic-clonic seizures should not be.
Experts do not recommend the use of the drug in patients with diagnosed porphyria, since an exacerbation of the disease is possible.
Long courses of treatment can provoke a decrease in bone density, the development of osteoporosis, osteopenia, osteomalacia. In this regard, throughout the course of treatment with "Diphenin" it is necessary to control the level of phosphorus and calcium in the blood of the patient. Parallel intake of drugs with a high content of vitamin D is recommended.
In the treatment of pediatric patients during a period of intensive growth, the risk of developing negative effects from the connective tissue increases.
During the course of treatment, first monthly, and then every 6 months, clinical blood tests, alkaline phosphatase, and liver enzymes are required. It is important to monitor the state of the thyroid gland. With the sudden cancellation of “Difemin”, an epileptic seizure may occur.
If there are signs indicating hypersensitivity to the components of the drug, or signs of the development of Stevens-Johnson or Lyell syndromes, the drug should be discontinued.
Therapy of the elderly and patients with impaired renal and hepatic function involves dosage adjustment.
The concentration of phenytoin in the blood increases significantly with acute alcohol intoxication. If chronic intoxication is reduced. During the course of treatment, the patient should refrain from ethyl-containing drinks. You should also take analogues.
Instructions for use with "Diphenin" reports that therapy may be accompanied by toxic effects from the central nervous system.
In rare cases, when taking "Diphenin" or similar antiepileptic drugs, suicidal thoughts may occur. It is necessary to warn the patient about this in advance.
While taking phenytoin in blood serum, the concentration of T4 may decrease, the concentration of glucose, GGT (gamma-glutamyl transpeptidase) and alkaline phosphatase may increase.
"Diphenin" is able to provoke the development of hyperglycemia if a toxic concentration of the main component is observed in the blood. In this regard, it is forbidden to take it against a background of seizures or hypoglycemia caused by metabolic disorders. The use of antiepileptic drugs increases the risk of developing a disease such as severe exfoliative dermatitis. The disease is accompanied by eosinophilia, fever, systemic manifestations. It is not excluded the development of life-threatening conditions, death. The manifestation of such signs involves a complete examination of the patient and the complete abolition of "Diphenin."
The drug is able to provoke the occurrence of jaundice, leukocytosis, hepatomegaly, eosinophilia. An increase in the level of transaminases is not excluded. When symptoms of these diseases appear, it is recommended to stop taking the drug.
The hematopoietic system for Diphenin therapy can respond to thrombocytopenia, leukopenia, granulocytopenia, agranulocytosis, pancytopenia. In some cases, death occurs. There have been cases of Hodgkin's disease, pseudolymph, benign lymph node hyperplasia, lymphadenopathy.
At the time of taking the drug, it is recommended to refrain from driving a car and complex mechanisms, as well as from potentially dangerous activities.
Use during pregnancy and breastfeeding
Throughout the course of treatment with the drug, compliance with contraception is required. During breastfeeding, taking the drug is not recommended. So it is said in the instructions for use with the medicine "Diphenin."
In old and childhood
For children under 3 years of age, the drug is strictly contraindicated. Therapy of patients in old age should be carried out with extreme caution. Dose adjustment required.
Interaction with other medicines
Phenytoin significantly enhances the inhibitory effect of other drugs on the central nervous system.
An increase in the concentration of the main component in the blood can be observed while taking Diphenin with Trazodone, Tolbutamide, Sulfonamide, Sulfinpyrazone, Succinimide, salicylates, estrogens, Fluoxetine, Omeprazole, Methylphenidate , Isoniazid, Halotan, histamine H1 receptor blockers, Dicumarol, Diazepam, Chlordiazepoxide, Chloramphenicol, Metronidazole, Itraconazole, Miconazole, Ketoconazole, , Amphotericin B, Amiodarone. The therapeutic effect of "Diphenin" is enhanced, the risk of side effects increases.
Phenytoin is able to change the therapeutic effect of antifungal drugs, vitamin D, Rifampicin, Quinidine, oral contraceptives, estrogens, Furosemide, Doxycycline, Digitoxin, Dicumarol, glucocorticosteroids, Clozapine.
Concurrent administration with "Acetazolamide" provokes rickets, osteomalacia.
Concurrent administration with acyclovir preparations reduces the effectiveness of phenytoin.
The concentration of the main substance may decrease when taking "Theophylline", "Pyridoxine", "Vigabatrin", "Sucralfate", "Reserpine", folic acid, "Carbamazepine", "Difemina".
The concentration of the main substance can increase with the intake of Cimetidine, Phenylbutazone, Felbamate, Ritonavir, Clarithromycin, Imipramine, Disulfiram, Nifedipine, Diltiazem.
The simultaneous administration of phenytoin and paracetamol reduces the effectiveness of the latter.
Instructions for use with "Diphenin" confirms this.
Cost and terms of sale
The drug is dispensed in pharmacies strictly according to the prescription prescribed by the doctor.
The cost of the drug may vary depending on the region of sale and the number of tablets in the package. The average price of a package of “Diphenin” containing 20 tablets varies at the level of 50 rubles. This is not indicated in the instructions for use with Diphenin. According to reviews, the price is acceptable for many.
Analogs
Structural analogues of "Diphenin" currently does not exist. By analogs by the mechanism of action can be attributed such medications as “Fengidon”, “Eptoin”, “Solantil”, “Difantoin”. The decision to replace the drug with its analogue can only be made by the attending physician.
Storage
Keep the drug in a dry, dark place out of the reach of children. Storage temperature - from 5 to 30 degrees Celsius. Subject to the recommended storage conditions, the drug retains its properties for 4 years from the date of release.
Reviews about "Diphenin"
Patients undergoing treatment with "Diphenin", leave mostly positive reviews. It is noted that even prolonged use of the drug does not affect its therapeutic effectiveness. Epileptic seizures during treatment with the drug are really shrinking.
However, some patients feel unwell when changing the drug and switching from phenytoin to similar antiepileptic drugs. The best effect is achieved with combined treatment using different medications.
We reviewed the instructions for use with Diphenin, price, reviews and analogues.