Phenobarbital+phenytoin
About
Phenobarbital+phenytoin belongs to the group of neurological medication called 'anticonvulsants or antiepileptic drugs', primarily used to control seizures (fits) in epilepsy. Phenobarbital+phenytoin is also used to control or prevent seizures during/after brain surgery and also treats trigeminal neuralgia (facial nerve pain). Epilepsy is the central nervous system's disorder characterized by a sudden rush of electrical activity in the brain leading to seizures or fits, unusual behaviour and loss of awareness.
Phenobarbital+phenytoin contains two antiepileptic medicines: 'Phenobarbital' and 'Phenytoin'. Phenobarbital (also known as phenobarbitone or phenobarb) belongs to the class of drugs called barbiturate anticonvulsants/hypnotics. It works by increasing the activity of GABA (gamma-aminobutyric acid), a neurotransmitter or chemical messenger in the central nervous system. This GABA reduces the abnormal brain activity that occurs during a seizure episode. Phenytoin belongs to the class of drugs called hydantoins. Brain cells or neurons normally work at a certain rate. During a seizure episode, these brain cells are forced to work rapidly in an uncontrolled way. Phenytoin helps prevent the brain cells from such rapid uncontrolled working, thus preventing the brain's abnormal electrical activity during seizures.
Take Phenobarbital+phenytoin with or without food. You are advised to take Phenobarbital+phenytoin for as long as your doctor has prescribed it for you, depending on your medical condition. Like all medicines, Phenobarbital+phenytoin also causes side effects, although not everybody gets them. Common side effects of Phenobarbital+phenytoin include dizziness, drowsiness, excitation, headache, tiredness, loss of appetite, nausea, vomiting, constipation, spinning sensation and trouble sleeping. Most of these side-effects do not require medical attention and will resolve gradually over treatment. However, if these side-effects persist for a longer time, please seek medical advice.
Please do not skip or stop taking Phenobarbital+phenytoin midway without consulting your doctor since it may increase seizures. Let your doctor know if you are a pregnant or breastfeeding woman before taking Phenobarbital+phenytoin. Phenobarbital+phenytoin should not be given to children unless prescribed by a doctor. Avoid alcohol consumption while taking Phenobarbital+phenytoin as it might increase the occurrence of side effects. Please inform your doctor about all the prescription and over-the-counter medicines you take before starting Phenobarbital+phenytoin.
Uses of Phenobarbital+phenytoin
Medicinal Benefits
Phenobarbital+phenytoin contains two antiepileptic/anticonvulsant medicines, namely: 'Phenobarbital' and 'Phenytoin.' It is used to control seizures (fits) in epilepsy. Phenobarbital+phenytoin also controls or prevents seizures during/after brain surgery and treats trigeminal neuralgia (facial nerve pain). Phenobarbital (also known as phenobarbitone or phenobarb) is a barbiturate anticonvulsant/hypnotic. It increases GABA activity (gamma-aminobutyric acid), a chemical messenger in the central nervous system. This GABA reduces the abnormal brain activity that occurs during a seizure episode. Phenobarbital does not work for absence seizures. Phenytoin is a hydantoin anticonvulsant medication. It helps prevent the brain cells from rapid uncontrolled working, thus preventing the brain's abnormal electrical activity during seizures. Phenytoin effectively controls jerking movements and muscle spasms during seizure episodes known as grand mal fits. However, Phenytoin does not work for absence (petit mal) seizures.
Directions for Use
Storage
Side Effects of Phenobarbital+phenytoin
- Dizziness
- Drowsiness
- Excitation
- Headache
- Nystagmus (involuntary eye movement)
- Tiredness
- Loss of appetite
- Nausea
- Vomiting
- Constipation
- Spinning sensation
- Trouble sleeping
In-Depth Precautions and Warning
Drug Warnings
Inform your doctor if you have a medical history of liver/kidney/heart diseases, hormonal imbalance (Addison's disease), vitamin deficiencies (folic acid, vitamin K, and Vitamin B12), lung disorders (sleep apnoea, chronic obstructive pulmonary disease-COPD), mood disorders (depression, suicidal thoughts), alcohol or drug use and blood disorders like porphyria before starting Phenobarbital+phenytoin. If you have diabetes, Phenobarbital+phenytoin should be used with caution since it may affect the blood sugar levels. You may also opt for sugar-free liquid formulations. Please do not stop taking Phenobarbital+phenytoin midway without consulting your doctor since it may lead to increased seizures. Let your doctor know if you are a pregnant or breastfeeding woman before taking Phenobarbital+phenytoin. Phenobarbital+phenytoin should not be given to children unless prescribed by a doctor. Avoid alcohol consumption while taking Phenobarbital+phenytoin as it might increase the occurrence of side-effects. Phenobarbital+phenytoin can cause dizziness and affect your ability to drive; hence drive with caution.
Drug Interactions
Drug-Drug Interaction: Phenobarbital+phenytoin may interact with anti-inflammatory drugs (azapropazone), HIV/AIDS drugs (darunavir, delavirdine, etravirine, rilpivirine), heart-related drugs (dofetilide), blood pressure-lowering drugs (nisoldipine), cholesterol-lowering agents (colesevelam), anti-psychotics (molindone, quetiapine), weight loss drugs (orlistat), Vitamins (pyridoxine (vitamin B6)), other anti-seizure medicines (valproic acid), azole antifungals (itraconazole), anti-ulcer drugs (sucralfate) and antibiotics (telithromycin).
Drug-Food Interaction: Avoid alcohol and St. John's wort (antidepressant and herbal supplement) while using Phenobarbital+phenytoin.
Drug-Disease Interaction: Phenobarbital+phenytoin may have interactions with heart problems, hormonal imbalance, lung problems, diabetes, anaemia, alcoholism, blood disorders and kidney or liver diseases.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeAvoid taking alcohol while using Phenobarbital+phenytoin since it may worsen the side effects.
Pregnancy
cautionPhenobarbital+phenytoin is a pregnancy category D drug and has harmful effects on the baby. However, seizure control is mandatory during pregnancy. Phenobarbital+phenytoin should be used only if the benefits outweigh the risk in a pregnant woman. Please consult your doctor before taking Phenobarbital+phenytoin if you are pregnant or planning to conceive.
Breast Feeding
cautionPhenobarbital+phenytoin is excreted into the breast milk and is not recommended if you are a breastfeeding woman. Please consult your doctor before taking Phenobarbital+phenytoin if you are breastfeeding.
Driving
cautionYou may experience dizziness and drowsiness while using Phenobarbital+phenytoin. In such cases, do not drive or operate machinery until you are mentally alert and focused.
Liver
cautionDose adjustment may be needed. Phenobarbital+phenytoin should be used with caution in patients with liver impairment/liver disease. Please consult your doctor if you have a liver impairment or any concerns regarding this.
Kidney
cautionDose adjustment may be needed. Phenobarbital+phenytoin should be used with caution in patients with kidney impairment/kidney disease. Please consult your doctor if you have kidney impairment or any concerns regarding this.
Children
safe if prescribedPhenobarbital+phenytoin can be given to children only if prescribed by the doctor. The dosage depends on the child's age and weight.
Habit Forming
Diet & Lifestyle Advise
- Following a ketogenic diet (low in carbohydrates and high in fat) is recommended.
- Meditation, walking, involving in a task and smelling a strong odour are few self-control methods to prevent seizures.
- Acupuncture therapy may also be helpful.
- Rest properly, avoid stress by doing meditation or yoga.
- Manage stress, eat healthily, drink plenty of water, exercise regularly and get plenty of sleep.
- Include Vitamin D rich foods like fatty fish, mackerel, tuna, dairy products, orange juice, soy milk, cereals, beef liver, cheese and egg yolks in your diet.
- Also, it is advised to take folic acid and vitamin K rich foods and supplements during pregnancy.
Special Advise
- Your doctor may advise you to get regular blood tests to test the amount of Phenobarbital+phenytoin in your blood.
- Monitor your blood pressure and sugar levels regularly while using Phenobarbital+phenytoin.
- It is advised to get a Vitamin D profile done once in a while using Phenobarbital+phenytoin.
- Phenobarbital in Phenobarbital+phenytoin may lower your folic acid and Vitamin K levels, increasing the risk of spinal cord defects. Please undergo examinations folic acid and Vitamin K to keep a check and use folate and Vitamin K supplements if necessary.
Patients Concern
Disease/Condition Glossary
Epilepsy is a central nervous system disorder in which brain activity becomes abnormal, leading to rapid fits/seizure episodes with unusual behaviour and loss of awareness.
Fits/Seizure is a sudden rush of electrical activity in the brain. The main symptom of epilepsy is fits. Epilepsy is of two main types: Generalized seizures (affect the entire brain) and Partial seizures (affect one part of the brain). A mild seizure might be difficult to recognize as it lasts for only a few seconds, during which one lacks awareness. Stronger seizures cause uncontrollable muscle twitches and spasms, lasting for a few seconds to several minutes. Lack of sleep, high fever, stress, bright lights, caffeine, certain medicines, alcohol and skipping meals/overeating are a few of the most common triggers for seizures. The possible causes of epilepsy include traumatic brain injury, scarring on the brain after a brain injury, high fever, stroke, vascular diseases, lack of oxygen to the brain, brain tumour and genetic disorders.
FAQs
Phenobarbital+phenytoin works by controlling the abnormal electrical activity of the brain that causes seizures (fits). Thereby, Phenobarbital+phenytoin helps in controlling epileptic fits involving spasm of the muscles and jerking.
Phenytoin in Phenobarbital+phenytoin can make birth control pills less effective. Talk to your doctor about using non-hormonal contraceptives like condoms and diaphragm with spermicide to prevent pregnancy.
Please do not stop taking Phenobarbital+phenytoin without consulting your doctor on your own as it may lead to increased seizures. Continue taking Phenobarbital+phenytoin for as long as your doctor has prescribed it to you. Do not be reluctant to speak with your doctor if you experience any difficulty while taking Phenobarbital+phenytoin.
Phenytoin in Phenobarbital+phenytoin may cause swelling in the gums. Massage your gums, brush and floss your teeth daily, visit your dentist if you experience this problem regularly.
Phenytoin in Phenobarbital+phenytoin may affect the blood sugar levels. Also, liquid formulations of Phenobarbital+phenytoin may contain sucrose or sugar. Hence it is advised to consult a doctor before starting Phenobarbital+phenytoin. Your doctor may also advise sugar-free formulations.
Phenytoin in Phenobarbital+phenytoin may rarely cause depression/suicidal thoughts. If you experience any of these symptoms, consult your doctor immediately.