💊 Phenytoin Oral Liquid 125 mg/5 mL (p)
📌 1. Prescription / Indications:
Phenytoin 125 mg/5 mL oral liquid is commonly prescribed for:
- Generalized tonic-clonic seizures
- Complex partial seizures
- Prevention of seizures post brain injury or surgery
- Used when:
- Rapid titration or high-dose therapy is required
- Tablets are not suitable (e.g., children, elderly, tube-fed patients)
📄 2. Description:
- Form: Oral suspension
- Strength: 125 mg phenytoin sodium per 5 mL
- Label: “(p)” = Pediatric or Palatable
- Appearance: Off-white to light pink thick suspension
- Route: Oral
🔬 3. Nature / Drug Class:
- Category: Antiepileptic / Anticonvulsant
- Class: Hydantoin derivative
- Mechanism: Delays sodium channel recovery in hyperactive neurons → limits repetitive firing, preventing seizures
🌟 4. Advantages:
- High concentration = lower volume per dose (easier in children)
- Ideal for patients needing fine dose adjustments
- Suitable for NG tube or PEG administration
- Pleasant taste (flavored for better compliance)
📦 5. Common Packaging:
| Container | Volume |
|---|
| Amber PET/HDPE bottle | 100 mL / 200 mL / 250 mL |
| Comes with dosing cup/syringe | ✅ Usually included |
🧊 6. Storage Conditions:
- Store at <25°C (room temperature)
- Do not refrigerate (may thicken or settle)
- Protect from light and moisture
- Shake very well before each dose
- Use within 30–60 days after opening (per label)
👩⚕️ 7. Patient Advice:
- Shake vigorously before use
- Administer at the same time each day
- Use oral syringe or marked measuring cup
- Maintain regular blood level checks
- Avoid abrupt discontinuation
- May interact with:
- Alcohol
- Warfarin
- Contraceptives
- Carbamazepine
🎯 8. Purpose / Clinical Use:
| Use Case | Purpose |
|---|
| Pediatric epilepsy | First-line or maintenance therapy |
| High-dose phenytoin titration | More potent formulation |
| Patients with feeding tubes | Liquid route essential |
| Surgery/post-trauma seizures | Prevent recurrence |
⚠️ 9. Precautions / Warnings:
- Therapeutic range: 10–20 mcg/mL
- Toxicity signs:
- Nystagmus
- Ataxia
- Slurred speech
- Chronic use effects:
- Gum hypertrophy
- Hirsutism
- Bone weakening (osteomalacia)
- Pregnancy: Teratogenic (consider folic acid supplementation)
- Liver disease: Dose adjustment required
