Flu: Best Home Remedies and Natural Treatments to Relieve Symptoms
Dilantin Side Effects: What You Should Know
Dilantin (phenytoin) is a brand-name drug that's prescribed for certain types of seizures in adults and children. Dilantin can cause side effects that range from mild to serious, such as drowsiness or confusion.
Dilantin injection has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the "Side effect specifics" section below.
Dilantin can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
These are just a few of the more common side effects reported by people who took Dilantin in clinical trials of Dilantin capsules, Dilantin chewable tablets, or Dilantin injection:
* For more information about this side effect, see "Side effect specifics" below.
Mild side effects can occur with Dilantin use. This list doesn't include all possible mild side effects of the drug. For more information, you can refer to the prescribing information for Dilantin capsules, Dilantin chewable tablets, or Dilantin injection.
Mild side effects that have been reported with Dilantin include:
These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Note: After the FDA approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking Dilantin and want to tell the FDA about it, visit MedWatch.
* For more information about this side effect, see "Side effect specifics" below.
Dilantin may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to the prescribing information for Dilantin capsules, Dilantin chewable tablets, or Dilantin injection.
If you develop serious side effects while taking Dilantin, call your doctor right away. If the side effects seem life threatening or you think you're having a medical emergency, immediately call 911 or your local emergency number.
Serious side effects that have been reported and their symptoms include:
* For more information about this side effect, see "Side effect specifics" below.
ALLERGIC REACTION
For some people, Dilantin can cause an allergic reaction.
In general, symptoms of allergic reaction can be mild or serious. You can learn more about possible symptoms in this article.
Ways to manage
For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They'll also let you know whether you should keep taking the medication.
For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you've had a serious allergic reaction to Dilantin, your doctor may recommend taking a different medication instead.
Dilantin may cause several side effects. Here are some frequently asked questions about the drug's side effects and their answers.
Does Dilantin cause long-term side effects?Yes, Dilantin can cause long-term side effects. Long-term side effects include those that start at any time during therapy or those that don't go away, even after stopping the drug. Some of the long-term side effects Dilantin can cause are:
Talk with your doctor if you have questions or concerns about long-term side effects with Dilantin.
Is Dilantin safe for older adults?Yes, it is safe for older adults to take Dilantin. As you age, it takes longer for your body to clear medication from your system. This can increase your risk for side effects. Because of this, your doctor may prescribe a lower dosage or a different treatment schedule for you.
Older adults may also be more sensitive to some of the side effects of Dilantin, such as osteoporosis or problems with thinking or memory.
If you have any concerns about side effects you may experience during treatment with Dilantin, talk with your doctor.
Can Dilantin cause a change in urine color?It's possible. While changes in urine color haven't been reported in clinical studies of the drug, there are reports that Dilantin can cause urine to turn pink or brown.
In rare cases, Dilantin can cause liver damage. One symptom of liver problems is dark-colored urine. If you have dark-colored urine along with other symptoms such as stomach pain, fever, or nausea, talk with your doctor right away.
Learn more about some of the side effects that Dilantin may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Dilantin capsules, Dilantin chewable tablets, or Dilantin injection.
Risk of cardiovascular problems with rapid infusion of DilantinDilantin injection has a boxed warning about the risk of cardiovascular problems with rapid infusion. Boxed warnings are the most serious warnings from the FDA.
Dilantin can be given by intravenous (IV) infusion (into a vein over time) in cases where it can't be taken by mouth. If given too quickly, Dilantin can cause serious side effects, including an irregular heartbeat, a slow heart rate, or severe low blood pressure. Serious side effects are more likely to occur in people with certain serious conditions and in adults ages 65 years or older.
What you can doDilantin infusions are typically given in a hospital. Your doctor will closely monitor you for serious side effects during and after the infusion. If you have side effects during your infusion, your doctor may decrease your dose or give your infusion more slowly.
Problems with coordinationAtaxia (problems with coordination) is a common side effect reported in clinical studies with Dilantin. You might notice that you are unsteady on your feet, feel off-balance, or have difficulty with fine motor skills.
What you can doYou can reduce your chances of falling by taking safety precautions. Remove any tripping hazards in your home, such as throw rugs or shower mats with a slippery surface. You can also try exercises, such as yoga, to improve your coordination and balance.
You shouldn't drive, use machinery, or do other tasks that require alertness until you know how this drug affects you.
Talk with your doctor if you're experiencing new or worsening problems with coordination. Worsening symptoms may be caused by high blood levels of Dilantin. Your doctor will likely check your Dilantin blood levels and may need to adjust your dose.
Below is important information you should consider before taking Dilantin.
Dilantin injection has a boxed warning. A boxed warning is the most serious warning from the FDA. For details, see the "Side effect specifics" section above.
Other precautionsBefore taking Dilantin, discuss your health history with your doctor. Dilantin may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
The Pharma Price-gouging Scandal
Martin Shkreli: international hate figure
(Image credit: © 2016 Bloomberg Finance LP)
Pharmaceutical companies have hit the headlines for hiking prices for life-saving drugs by shocking amounts. What's going on? Simon Wilson reports.
What's happened?A year of bad publicity over alleged price-gouging tactics by big pharmaceutical companies, especially in the US, was capped earlier this month with the news that Britain's competition regulator, the Competition and Markets Authority (CMA), has slapped its biggest fine ever, some £84.2m, on Pfizer. The penalty, which the US-based multinational is appealing against, comes after the price charged to the NHS for a widely prescribed anti-epilepsy drug rocketed 24-fold (from £2.83 for 100mg to £67.50) between 2012 and 2013.
The CMA has also fined the drug's UK distributor, Flynn Pharma, £5.2m for charging unfair and excessive prices. And this month the regulator accused another multinational, Actavis, of ramping up prices of life-saving hydrocortisone tablets from 70p a pack in 2008 to £88 in March 2016 a 126-fold jump.
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What's going on?Counter-intuitively, both these cases involve drugs on which the originator's patent had recently expired, meaning that other companies if they wished were free to develop "generic" versions. Typically, the pharmaceutical industry operates within a legal-moral framework that amounts to a kind of "social contract" with governments and consumers. The industry can charge premium prices for innovative drugs (it takes billions to develop them, after all), but only for a limited period.
Once a drug maker loses exclusive rights to sell a medicine typically between five and ten years after launch much cheaper "generic" copycat versions are supposed to flood the market, reducing the price of a pill to just a few pence. But in the cases found to be anti-competitive by the CMA, that didn't happen.
Why not?A quirk of the regulatory system in the UK, designed to protect the NHS from excessive drugs costs, means that branded drugs still under patent are subject to price regulation. But once they go "off-brand" they are not. Normally the price falls as other players enter the market and become the default prescribed medicine. Indeed, in the UK, exclusive use of cheaper copycat drugs (where available) is the norm and doctors are required to write the generic name of the drug, rather than a brand name, on prescriptions. But sometimes, where no "me-too" generic product emerges, it means the original producer acquires huge pricing power.
Why would that happen?For a range of commercial, scientific, regulatory and clinical reasons it sometimes makes no sense for a generic producer to enter the market. For example, if a particular drug is complicated to make and/or only a relatively small number of patients take it, generic producers will steer clear. In the case of the epilepsy drug Epanutin (which are capsules of phenytoin sodium, taken by about 48,000 people in the UK), the new price charged by Flynn was far more than Pfizer was charging in other European countries, but for clinical reasons the NHS had no choice but to pay: epilepsy patients who already take phenytoin sodium capsules should not usually be switched to another medicine due to the risk of loss of seizure control.
What about other countries?The soaring cost of prescription drugs has become a massive political issue in the US, which has just 4.6% of the world's population but accounts for a third of spending on drugs, and is easily the largest and most profitable healthcare market in the world. In October 2015 Martin Shkreli, a 32-year-old pharma entrepreneur, became an international hate figure for licensing and then ramping up the price of a drug (Daraprim) given to Aids and cancer patients from $13.50 to $750 a pill.
Then, this year, the drug manufacturer Mylan was engulfed by a firestorm over the price of its EpiPen allergy medicine, which has jumped about 600% since 2007. Then, earlier this month, the firm that sold Daraprim to Shkreli, Impax Laboratories, again made headlines over price-gouging: it put a price tag of $884 on a mebendazole treatment for pinworm which is available over the counter in the UK for £3.50.
So drugs firms are raking it in?Not as much as they used to. An annual report published earlier this month by Deloitte found that the returns on investments in research and development (R&D) by the world's biggest pharmaceutical firms have fallen to their lowest level in six years and are set to fall further. Projected returns for the world's 12 biggest spenders on R&D have fallen from a high of 10.1% in 2010 (the first year the survey was conducted) to just 3.7% in 2016.
Meanwhile, the average cost of developing a drug has jumped from just under $1.2bn to more than $1.5bn over the same period, according to Deloitte. And they found that downward pressure on pricing meant that peak sales ie, the point at which annual drug sales are highest, following patent approval had more than halved from $816m per drug in 2010 to $394m now. Price-gouging scandals are only likely to intensify this trend: around the globe drug makers face political pressure to control prices and deliver value for money (see below).
Can Big Pharma bounce back?Big pharma share prices got a lift in the US after the election of Donald Trump. That's because Hillary Clinton had made drugs prices a major campaigning issue and had promised to crack down hard on unfair pricing. In recent weeks though, Trump too has promised to "bring down drug prices" and slash the national bill by hundreds of billions. Investors look sanguine: biotech stocks dipped 3% but then recovered.
However, according to GlaxoSmithKline CEO Andrew Witty, "it doesn't matter too much who won the election", because the "direction is already set" for big pharma: more controls and less pricing power. "The marketplace will still pay for innovation, but it is not going to pay blindly for innovation," he says.
Common Chemicals Combine To Make Metallic Sodium
There's no debating that metallic sodium is exciting stuff, but getting your hands on some can be problematic, what with the need to ship it in a mineral oil bath to keep it from exploding. So why not make your own? No problem, just pass a few thousand amps of current through an 800° pot of molten table salt. Easy as pie.
Thankfully, there's now a more approachable method courtesy of this clever chemical hack that makes metallic sodium in quantity without using electrolysis. [NurdRage], aka [Dr. N. Butyl Lithium], has developed a process to extract metallic sodium from sodium hydroxide. In fact, everything [NurdRage] used to make the large slugs of sodium is easily and cheaply available – NaOH from drain cleaner, magnesium from fire starters, and mineral oil to keep things calm. The reaction requires an unusual catalyst – menthol – which is easily obtained online. He also gave the reaction a jump-start with a small amount of sodium metal, which can be produced by the lower-yielding but far more spectacular thermochemical dioxane method; lithium harvested from old batteries can be substituted in a pinch. The reaction will require a great deal of care to make sure nothing goes wrong, but in the end, sizable chunks of the soft, gray metal are produced at phenomenal yields of 90% and more. The video below walks you through the whole process.
It looks as though [NurdRage]'s method can be scaled up substantially or done in repeated small batches to create even more sodium. But what do you do when you make too much sodium metal and need to dispose of it? Not a problem.
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