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Introduction About EPSOLIN INJECTION
EPSOLIN INJECTION contains phenytoin which belongs to the group of medicines called Anti-epileptic drugs. It is used to manage certain forms of epilepsy (fits or seizures) like grand mal fits, status epilepticus (seizures continue for hours or days) and to manage fits during or after neurosurgery.
Epilepsy can be defined as a chronic brain disorder which occurs when signals and chemicals of the brain cells are not working properly. EPSOLIN INJECTION can also be used to rectify some heart rhythm abnormalities.
During EPSOLIN INJECTION management, your doctor might ask you to take certain blood tests to monitor side effects. You will also be advised to maintain good oral hygiene and massage the gums to manage bleeding, tender or enlarged gums.
Before receiving EPSOLIN INJECTION, inform your doctor if you have liver, kidney or heart problems, porphyria or diabetes. Avoid consumption of alcohol while receiving EPSOLIN INJECTION as it may affect its blood concentration.
Ask your doctor before receiving EPSOLIN INJECTION during pregnancy. EPSOLIN INJECTION should be used in breastfeeding women only if the potential benefit justifies the potential risk to the foetus. EPSOLIN INJECTION should be cautiously used in children and elderly patients.
The most common side effects of receiving EPSOLIN INJECTION are rapid involuntary eye movements, slurred speech, impaired or decreased coordination, sleepiness and mental confusion. Contact your doctor if any of the symptoms deteriorate.
Uses Of EPSOLIN INJECTION
EPSOLIN INJECTION is used to:
- manage grand mal fits and status epilepticus
- prevent fits during or after neurosurgery
- rectify some heart rhythm abnormalities
How EPSOLIN INJECTION Works
EPSOLIN INJECTION reduces or manages fits by controlling the hyperactivity in the brain that can cause epilepsy or fits.
How to use EPSOLIN INJECTION
EPSOLIN INJECTION will be given to you only by a doctor or a nurse into a vein as an intravenous infusion. Your doctor will decide the right dose and duration for you according to your age, body weight and disease condition. Do not stop receiving EPSOLIN INJECTION unless your doctor advises you to stop.
Side Effects Of EPSOLIN INJECTION
Common
- nystagmus (rapid involuntary eye movements)
- slurred speech
- impaired or decreased coordination
- sleepiness
- mental confusion
Rare
- serious forms of allergic reactions
- Drug Reaction with Eosinophilia and Systemic Symptoms (an extensive skin rash)
- angioedema (swelling beneath the skin)
- dyskinesias (impaired voluntary movement), including chorea (jerky involuntary movements of the shoulders, hips and face), dystonia (muscular spasm and abnormal posture), shaking and asterixis (inability to maintain sustained posture with subsequent brief jerky involuntary movements)
- certain types of dermatitis
Stop receiving EPSOLIN INJECTION and contact your doctor immediately if you experience any of the following side effects:
- severe allergic reactions (swelling of the eyelids, face, lips, rash or itching especially affecting the whole body, breathing problems, sudden wheeziness)
- purple glove syndrome (discolouration of the skin, swelling and pain in the area of injection which then radiates down to the arms, hands and fingers)
- serious skin reactions (Ex. Stevens-Johnson syndrome, toxic epidermal necrolysis accompanied by blistering of mouth and tongue)
- blood abnormalities (bruising, fever, severe sore throat, paleness, decreased red blood cells, white cells and platelets)
- hypersensitivity reactions (skin rash, fever, swollen glands, increased white blood cells, swollen organs such as liver, lungs, heart, kidneys and large intestine)
- inflammatory disease called systemic lupus erythematosus (painful and swollen joints)
- have confusion or mental illness which could be a sign of a high amount of medicine in the blood
- chest pains and palpitations
- swollen lymph nodes
- thoughts of harming or killing self
How To Manage Side Effects
Skin rash:
Avoid hot bathing because hot water can irritate your skin further. Do not scratch the affected area. Use protective clothing when going outdoors. Regularly moisturize your skin. Consult your doctor if your skin rash gets worse.
Warning & Precautions
Pregnancy
EPSOLIN INJECTION should be used with caution in pregnant women as it may cause harm to the unborn baby. Women of childbearing capability should use a suitable non-hormonal contraceptive method to avoid getting pregnant while receiving EPSOLIN INJECTION. Consult your doctor before receiving it. Inform your doctor if you become pregnant during management with EPSOLIN INJECTION.
Breastfeeding
EPSOLIN INJECTION should be used in breastfeeding women only if the potential benefit justifies the potential risk to the foetus. Consult your doctor before receiving it.
Driving and Using Machines
Do not drive or operate any machines if you feel dizzy or drowsy after receiving EPSOLIN INJECTION.
Alcohol
Avoid consumption of alcohol while receiving EPSOLIN INJECTION because it may reduce the effectiveness of management or increase the side effects. EPSOLIN INJECTION should be used with caution if the patient has consumed a large amount of alcohol recently or if they drink large amounts of alcohol regularly or if they have alcohol dependence. Consult your doctor before receiving it.
Kidney
EPSOLIN INJECTION should be used with caution in patients having kidney disease. Consult your doctor before receiving it.
Liver
EPSOLIN INJECTION is not recommended for use in patients who experienced prior acute liver toxicity due to phenytoin. EPSOLIN INJECTION should be used with caution in patients with liver disease. Consult your doctor before receiving it.
Allergy
Do not receive EPSOLIN INJECTION if you are allergic to Phenytoin or any of the other ingredients of this medicine or similar hydantoins such as ethotoin or methoin.
Heart Disease
EPSOLIN INJECTION is not recommended in patients having abnormal heart rhythm and heart block, a slow heartbeat, heart problems that affect your heart rate or Adams-Stokes syndrome (suddenly passing out due to change in your heart rate). EPSOLIN INJECTION should be used with caution in patients having low blood pressure, heart failure or heart rhythm problems. Consult your doctor before receiving it.
Others
Before receiving EPSOLIN INJECTION, inform your doctor if you have:
- porphyria (an inherited disease affecting the nervous system and skin, characterised by abdominal pain, vomiting or muscle weakness)
- diabetes (high blood sugar levels)
Use in paediatrics:
EPSOLIN INJECTION can be used for newborns, infants and children but consult your child’s doctor for advice.
Use in geriatrics:
EPSOLIN INJECTION should be used with caution in elderly patients. Consult your doctor before receiving it.
Interactions
A. Drug - Drug interactions:
Before receiving EPSOLIN INJECTION, inform your doctor if you are taking any of the following medicines:
- medicines used for epilepsy or fits (Ex. carbamazepine, lamotrigine, phenobarbital, sodium valproate and valproic acid, topiramate, oxcarbazepine, ethosuximide,vigabatrin)
- medicines used to manage fungal infections (Ex. amphotericin B, voriconazole, miconazole, fluconazole, itraconazole, ketoconazole, posaconazole)
- medicines used to manage skin diseases (Ex. methoxsalen)
- medicines used for tuberculosis and other infections (Ex. chloramphenicol, isoniazid, rifampicin, sulfadiazine, sulfamethizole, sulfamethoxazole-trimethoprim, sulfaphenazole, sulfisoxazole, doxycycline, ciprofloxacin)
- medicines used for asthma and bronchitis (Ex. theophylline)
- medicines used for diabetes (Ex. tolbutamide, insulin)
- medicines used for pain and inflammation (Ex. phenylbutazone, aspirin, prednisolone)
- medicines used for stomach ulcers and heartburn (Ex. omeprazole, sucralfate, cimetidine, ranitidine, famotidine, antacids)
- medicines used for sleeplessness, depression and psychiatric disorders (Ex. chlordiazepoxide, clozapine, diazepam, disulfiram, lithium, methadone, fluoxetine, fluvoxamine, sertraline, haloperidol, levodopa, paroxetine, methylphenidate, phenothiazines, quetiapine, trazodone, reserpine, amitriptyline, viloxazine)
- medicines used to manage cancer (Ex. teniposide, fluorouracil, doxorubicin, methotrexate, capecitabine, bleomycin, carboplatin, cisplatin)
- medicines used for organ and tissue transplants, to manage rejection (Ex. ciclosporin, tacrolimus)
- medicines used for heart and circulation problems (Ex. dicoumarol, amiodarone, digitoxin, digoxin, nisoldipine, disopyramide, mexiletine, furosemide, quinidine, reserpine, diltiazem, nifedipine)
- hormone replacement therapies (Ex. oestrogens)
- medicines used to manage pregnancy (Ex. estradiol, dienogestrel)
- medicines used to lower high blood cholesterol and triglycerides (Ex. atorvastatin, fluvastatin, simvastatin)
- medicines used in the management of HIV infection (Ex delavirdine, efavirenz, fosamprenavir, indinavir, lopinavir, nelfinavir, ritonavir, saquinavir)
- medicines used to expel parasitic worms from the body (Ex. albendazole, praziquantel)
- medicines used to manage thyroid disorders (Ex. thyroxine)
- medicines used to relax the muscles (Ex. pancuronium, rocuronium, vecuronium)
- medicine used to manage severe pain (Ex. methadone, halothane)
- non-prescription medicines (Ex. folic acid, St John’s Wort, vitamin D)
- medicines used for blood thinning (Ex. warfarin, dicoumarol)
Overdosage:
EPSOLIN INJECTION will be administered to you only by a doctor or a nurse in a hospital, so it is unlikely to receive an overdose. However, consult your doctor or nurse if you experience any unusual symptoms like nystagmus (involuntary eye movement), double vision, loss of control of the whole body, dysarthria (speech disorder), muscle spasms, lethargy, nausea and vomiting.
Synopsis
| Drug | : | Phenytoin |
| Pharmacological Category | : | Anti-epileptic drugs |
| Therapeutic Indication | : | Seizures (fits) |
| Dosage Forms | : | Injection, Tablet, Capsule, Syrup, Suspension |
More Information
- Keep EPSOLIN INJECTION out of reach of children
- Store EPSOLIN INJECTION below 30°C
FAQs About EPSOLIN INJECTION
Q: What is Epsolin Injection used for?
A: Epsolin Injection is a prescription medicine used in the management of epilepsy (fits/seizures).
Q: What does Epsolin Injection contain?
A: Epsolin Injection contains the active ingredient called phenytoin sodium, which is an anticonvulsant medication.
Q: How is Epsolin Injection administered?
A: Epsolin Injection is administered by injection into a vein (intravenous) or muscle (intramuscular) by a healthcare professional.
Q: How does Epsolin Injection work?
A: Epsolin Injection works by stabilizing the electrical activity in the brain and reducing the occurrence of abnormal electrical impulses that can lead to seizures.
Q: Does Epsolin Injection cause weight gain?
A: Weight gain is not commonly reported as a side effect of Epsolin Injection. However, individual responses may vary.
Q: Can Epsolin Injection be used in children?
A: Epsolin Injection may be used in children under the supervision of a healthcare professional. Dosage adjustments may be necessary based on the child's age and weight.
Q: Does Epsolin Injection affect the action of birth control pills?
A: Phenytoin, the active ingredient in Epsolin Injection, may reduce the effectiveness of birth control pills. It is essential to use additional contraceptive methods while taking Epsolin Injection.
Q: Does Epsolin Injection make you feel sleepy?
A: Drowsiness is a common side effect of Epsolin Injection. It is important to avoid activities that require mental alertness, such as driving or operating machinery, until you know how the medication affects you.
Q: How long does it take for Epsolin Injection to show results?
A: The onset of action of Epsolin Injection varies depending on individual factors such as the severity of seizures and response to management. It may start working within a few hours to days of starting management, but optimal control of seizures may take several weeks.
Q: What are the side effects of taking Epsolin Injection?
A: The most common side effects of taking Epsolin Injection are dizziness, drowsiness, headache, nausea, vomiting, constipation, and rash. Less common side effects may include confusion, blurred vision, difficulty speaking, and allergic reactions.
Q: Who should not take Epsolin Injection?
A: Epsolin Injection should not be used in patients with a history of hypersensitivity to phenytoin or other ingredients in the formulation, severe liver disease, or certain blood disorders. Additionally, patients with a history of drug abuse or dependence should use Epsolin Injection with caution due to its potential for abuse and dependence.
Q: Can Epsolin Injection be used during pregnancy?
A: EPSOLIN INJECTION should be used with caution in pregnant women as it may cause harm to the unborn baby. Women of childbearing capability should use a suitable non-hormonal contraceptive method to avoid getting pregnant while receiving EPSOLIN INJECTION. Consult your doctor before receiving it. Inform your doctor if you become pregnant during management with EPSOLIN INJECTION.
References
1. KD Tripathi. Anti-epileptic drugs. Essentials of Medical Pharmacology. Eighth Edition, 2019. Page – 439.
2. E H Reynolds, D Chadwick, A W Galbraith, one drug (phenytoin) in the treatment of epilepsy. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. May 1976. [Accessed 22nd June 2022] https://pubmed.ncbi.nlm.nih.gov/57334/
3. Gupta M, Tripp J. Phenytoin. NIH National Library of Medicine, National center for biotechnology information. [Revised on 16th March 2022] [Accessed on 22nd June 2022] https://www.ncbi.nlm.nih.gov/books/NBK551520/
4. Delpharm Tours. Electronic Medicines Compendium (EMC). [Revised in December 2018 [Accessed 22nd June 2022] https://www.medicines.org.uk/emc/files/pil.4326.pdf
5. Hospira UK Limited. Electronic Medicines Compendium (EMC). [Revised in July 2019] [Accessed 22nd June 2022] https://www.medicines.org.uk/emc/files/pil.3794.pdf
6. Dailymed. Phenytoin sodium (phenytoin sodium injection). [Revised in December 2021] [Accessed 22nd June 2022] https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=31d00e75-4fe0-4aec-9cba-c86cb78762c5&type=display
Useful Diagnostic Tests
- Complete blood count
- Electroencephalogram (EEG)
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