Product Description: What Epanutin is and what it is Epanutin is one of a group of medicines called anti - epileptic drugs : This medicine is used to treat epilepsy. Epanutin can be used to control a variety of epileptic conditions control or prevent seizures during head injury. Epanutin can also be used to treat trigeminal neuralgia ( facial nerve pain ). Epanutin Hard Capsules are indicated for control of tonic-clonic seizures (grand mal epilepsy), partial seizures (focal including temporal lobe) or a combination of these. for the prevention and treatment of seizures occurring during or following neurosurgery and/or severe head injury. Epanutin Hard Capsules has also been employed in the treatment of trigeminal neuralgia but it should only be used as second line therapy if carbamazepine is ineffective or patients are intolerant to carbamazepine. How To Use: Adult Dosage for Seizures: Initially 3 to 4mg/kg/day with subsequent dosage adjustment if necessary. For most adults a satisfactory maintenance dose will be 200 to 500mg daily in single or divided doses. Exceptionally, a daily dose outside this range may be indicated. Dosage should normally be adjusted according to serum levels where assay facilities exist. Adult Dosage for Trigeminal Neuralgia: The clinically effective dose has not been established in clinical trials. In adults, 300-500 mg given in divided daily doses have been reported in the literature. Dosing should be adjusted based on clinical response. Determination of serum phenytoin level is advised. Levels of total phenytoin should not exceed 20 mcg/ml. Elderly (over 65 years): Phenytoin clearance is decreased in elderly patients and lower or less frequent dosing may be required (see section 5.2 Pharmacokinetic properties-Age). As with adults the dosage of Phenytoin Sodium Flynn Hard Capsules should be titrated to the patient's individual requirements using the same guidelines. As elderly patients tend to receive multiple drug therapies, the possibility of drug interactions should be borne in mind. Infants and Children: Initially, 5mg/kg/day in two divided doses, with subsequent dosage individualized to a maximum of 300mg daily. A recommended daily maintenance dosage is: Usually 4 mg/kg to 8 mg/kg. Neonates: The absorption of phenytoin following oral administration in neonates is unpredictable. Furthermore, the metabolism of phenytoin may be depressed. It is therefore especially important to monitor serum levels in the neonate. Warnings And Precautions: Phenytoin is not effective for absence (petit mal) seizures. If tonic-colonic (grand mal) and absence seizures are present together, combined drug therapy is needed. Phenytoin may affect glucose metabolism and inhibit insulin release. Hyperglycemia has been reported in association with toxic levels. Phenytoin is not indicated for seizures due to hypoglycemia or other metabolic causes. Abrupt withdrawal of phenytoin in epileptic patients may precipitate status epilepticus. When, in the judgement of the clinician, the need for dosage reduction, discontinuation, or substitution of alternative anti-epileptic medication arises, this should be done gradually. However, in the event of an allergic or hypersensitivity reaction, rapid substitution of alternative therapy may be necessary. In this case, alternative therapy should be an anti-epileptic drug not belonging to the hydantoin chemical class. Phenytoin may precipitate or aggravate absence seizures and myoclonic seizures. Herbal preparations containing St John's wort (Hypericum perforatum) should not be used while taking phenytoin due to the risk of decreased plasma concentrations and reduced clinical effects of phenytoin Ingredients: Epanutin capsule contains phenytoin sodium as an active ingredient