In this article, we will consider the instructions for use, price and reviews for the Difenin preparation. "Difenin" is a drug produced in tablets. It is used in the treatment of epilepsy, ventricular arrhythmia, trigeminal neuralgia. The main active ingredient in the drug is phenytoin.
What does the instruction manual for Difenin tell us?
Composition of the drug and release form
The description of "Difenin" in the instructions for use is quite detailed. The manufacturer produces the drug in the form of tablets. Instructions for use the composition of "Difenin" (analogues have a similar effect) describes as follows. The main component in the composition is phenytonin in the amount of 100 mg per 1 tablet. Talc, potato starch, sodium bicarbonate, magnesium stearate are used as additional components.
The detailed composition of "Difenin" is indicated in the instructions. Feedback on the use of the tool will be presented below.
Pharmacological action
The drug has an anticonvulsant, antiarrhythmic, muscle relaxant, analgesic effect.
"Difenin" is a highly effective anticonvulsant drug. However, it does not cause a pronounced hypnotic effect when compared 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 causes excitation of the cerebellum, thereby activating inhibitory pathways that affect the cerebral cortex.
The drug "Difenin" effectively increases the pain threshold in the manifestations of trigeminal neuralgia. When taken, the duration of the pain attack caused by this disease is reduced. In addition, excitation and the frequency of occurrence of repeated discharges are reduced.
The drug has the ability to increase the pain threshold in the manifestation of trigeminal neuralgia. When taking the drug, the duration of the pain attack characteristic of this disease is reduced, the excitation and the frequency of repeated discharges are reduced.
The antiarrhythmic effect is due to the ability of "Difenin" to reduce abnormal ventricular automatism, shorten the refractory period, and reduce membrane excitability.
Pharmacokinetics
The period during which the main active component of "Difenin" is absorbed into the patient's blood is variable, that is, changeable. For example, observe the maximum concentrationphenytoin in the blood can be 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 penetrates into the cerebrospinal fluid. The release of the substance occurs along with saliva, gastric and intestinal juice, breast milk and sperm. An obstacle to phenytoin is also the placental barrier. When taking "Difenin" during pregnancy, its concentration in the blood of the mother will be equal to the concentration in the blood of the fetus.
Metabolization of phenytoin occurs with the participation of liver enzymes. The half-life of the drug occurs within 24 hours. If the course of treatment was prolonged, the complete elimination of the drug will occur no earlier than three days after the end of the intake.
This is described in detail in the instructions for "Difenin". Analogues of the drug have a similar effect.
Indications
According to the instructions for use, Difenin tablets are prescribed for admission if there are the following indications:
- Irregular heart rhythms caused by organic lesions of the central nervous system or resulting from an overdose of drugs from the group of cardiac glycosides.
- Trigeminal neuralgia.
- Epilepsy. In particular, with major epileptic seizures, which are accompanied by cases of loss of consciousness.
- Treatment and prevention of epileptic seizures in neurosurgery.
Contraindications for taking
As the instructions for use indicate, "Difenin" is contraindicated for patients who have:
- Porphyria (one of the varieties of genetic pathologyliver).
- Adams-Stokes syndrome.
- Increased sensitivity to the substances that make up the drug.
- Liver, kidney 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).
"Difenin" can be prescribed with extreme caution and under the close supervision of the attending physician to children with manifestations of rickets, patients with diabetes mellitus, the elderly, patients diagnosed with chronic alcoholism, impaired liver and kidney function.
Methods of application and dosing
In accordance with the instructions for use, "Difenin" should be taken during a meal 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 for adult patients is 3-4 mg per kilogram of the patient's weight. Reception once a day. Over time, to achieve the desired therapeutic effect, the dosage may be increased. Most often, the maintenance dose is at the level of 200-500 mg per day. Reception can be carried out one or more times during the day.
In the treatment of children, the initial dosage should be 5 mg per kilogram of the patient's weight. Reception is carried out twice a day. Subsequently, the dose increases, but cannot be more than 300 mg per day. Levelmaintenance dosage - 4-8 mg / kg per day.
Side effects
In this section we will look at the side effects. At the end of the article, we will talk about the price and analogues of Difenin.
Instructions for use and reviews confirm that the following undesirable effects may develop during therapy with the drug:
- Hematopoietic system disorders: agranulocytosis, megaloblastic anemia, thrombocytopenia, leukopenia, etc.
- Gastrointestinal and digestive system disorders: Nausea, vomiting, loss of appetite, constipation, gingival hyperplasia, toxic hepatitis, liver tissue damage are not excluded.
- Nervous system disorders can manifest as muscle weakness, mood swings, insomnia, ataxia, nystagmus, difficulty breathing, confusion, agitation, incoordination, 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 Difenin.
Overdose
A dose of 2-5 grams is fatal for a person. Overdose symptoms appear as:
- Nystagmus (at a concentration of 20 micrograms of active ingredient per milliliter of blood plasma).
- Ataxia(at a concentration of the active substance 30 mcg/ml).
- Dysarthria (at a concentration of the active substance 40 mcg/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.
Treatment of overdose involves taking activated charcoal at the recommended dosage for poisoning, laxatives, and symptomatic therapy. Currently, specific antidotes to medicine are unknown. In the acute period, the patient needs to ensure the necessary maintenance of the functions of the cardiovascular system, respiration. Dialysis is shown according to the instructions for use for Difenin (Diphenine).
Special instructions for admission
Select the required dosage with great care. It should be remembered that an increased dosage can provoke a disproportionate increase in blood concentrations. 7-10 days after the start of epilepsy therapy with this drug, an analysis should be carried out to determine the concentration of the substance in the patient's blood.
Use "Difenin" for monotherapy of absences, as well as for combination therapy with the parallel development of absences and tonic-clonic seizures should not be.
Specialists do not recommend the use of the drug in patients with diagnosed porphyria, as exacerbation is possiblediseases.
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 Difenin, it is necessary to control the level of phosphorus and calcium in the patient's blood. Recommended parallel intake of drugs with a high content of vitamin D.
When treating 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, liver enzymes are required. It is important to control 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 for the elderly and patients with impaired renal and hepatic function involves dosage adjustments.
The concentration of phenytoin in the blood is significantly increased in acute alcohol intoxication. If intoxication is chronic, it decreases. For the duration of the course of treatment, the patient should refrain from ethyl-containing drinks. Analogues should also be accepted.
Instructions for use for "Difenin" reports that therapy may be accompanied by toxic effects from the central nervous system.
In rarecases when taking Difenin or similar antiepileptic drugs, the patient may have suicidal thoughts. It is necessary to warn the patient about this in advance.
At the background of taking phenytoin in the blood serum, the concentration of T4 may decrease, the concentration of glucose, GGT (gamma-glutamyl transpeptidase) and alkaline phosphatase may increase.
"Difenin" is capable of provoking 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 the background of convulsions 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 Difenin.
The drug can cause jaundice, leukocytosis, hepatomegaly, eosinophilia. An increase in the level of transaminases is not excluded. If symptoms of these diseases appear, it is recommended to stop taking the drug.
The hematopoietic system may react to Difenin therapy with thrombocytopenia, leukopenia, granulocytopenia, agranulocytosis, pancytopenia. In some cases, death occurs. Cases of Hodgkin's disease, pseudolymphomas, benign lymph node hyperplasia, lymphadenopathy have been reported.
Recommended at the time of taking the drugrefrain 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, contraception is required. During breastfeeding, the drug is not recommended. So it says in the instructions for use for the drug "Difenin".
In old age and childhood
Children under the age of 3 years, the drug is strictly contraindicated. Elderly patients should be treated 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 Difenin with Trazodone, Tolbutamide, Sulfonamide, Sulfinpyrazone, Succinimide, salicylates, estrogens, Fluoxetine, Omeprazole ", "Methylphenidate", "Isoniazid", "Halothane", blockers of histamine H1 receptors, "Dicumarol", "Diazepam", "Chlordiazepoxide", "Chloramphenicol", "Metronidazole", "Itraconazole", "Miconazole", "Ketoconazole "," Fluconazole "," Amphotericin B "," Amiodarone ". The therapeutic effect of "Difenin" in this caseincreases, 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.
Parallel intake with "Acetazolamide" provokes rickets, osteomalacia.
Concomitant use with acyclovir drugs reduces the effectiveness of phenytoin.
The concentration of the main substance may decrease when taking Theophylline, Pyridoxine, Vigabatrin, Sucralfate, Reserpine, folic acid, Carbamazepine, Difemin.
The concentration of the main substance may increase when taking Cimetidine, Phenylbutazone, Felbamate, Ritonavir, Clarithromycin, Imipramine, Disulfiram, Nifedipine, Diltiazem.
Concomitant use of phenytoin and paracetamol reduces the effectiveness of the latter.
Instructions for use for "Difenin" confirms this.
Price and terms of sale
The drug is dispensed in pharmacies strictly according to a prescription issued by a doctor.
The cost of the drug may vary depending on the region of sale and the number of tablets in the package. Average price per pack"Difenin", containing 20 tablets, fluctuates at the level of 50 rubles. This is not indicated in the instructions for use for Difenin. According to reviews, the price is acceptable for many.
Analogues
Structural analogues of "Difenin" currently do not exist. Analogues according to the mechanism of action include such medicines as Fengidon, Eptoin, Solantil, Difantoin. The decision to replace the drug with its analogue can be made solely 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 issue.
Reviews about "Difenin"
Patients treated with Difenin leave mostly positive feedback. It is noted that even long-term use of the drug does not affect its therapeutic efficacy. Epileptic seizures are actually reduced during treatment with the drug.
However, some patients report poor he alth 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 for Difenin, price, reviews and analogues.
