Medicine Overview of Diphedan 60mg/5ml Suspension
Diphedan is a prescription medicine used to treat and prevent epilepsy (seizures). It controls seizures by decreasing the abnormal and excessive activity of the nerve cells in the brain.
Diphedan can be used alone or in combination with other medicines. It may be taken with or without food. Your doctor will decide the correct dose for you. This may increase gradually until your condition is stable. This medicine may take several weeks to work but it is important to take it regularly to get the benefit. Do not stop taking it, even if you feel fine, unless your doctor advises you to. You may have more seizures, or your bipolar disorder may get worse.
The most common side effects of this medicine include skin rashes, headache, feeling or being sick, difficulty sleeping, dizziness and feeling sleepy or drowsy. Most side effects wear off, but if they bother you or do not go away, tell your doctor. There may be ways of preventing or reducing these effects.
Before taking this medicine, tell your doctor if you have kidney or liver problems, meningitis or depression or suicidal thoughts. Also let your healthcare team know about all other medications you are using as some may affect, or be affected by, this medicine, including contraceptive pills. If you are pregnant or breastfeeding, Diphedan can be taken if it is clearly needed but the dose may be adjusted. You should avoid driving or riding a bicycle if this medicine makes you drowsy or dizzy. You may need frequent blood tests to check how you are responding to this medicine.
- Epilepsy/Seizures
- Rash
- Headache
- Dizziness
- Vomiting
- Nausea
- Slurred speech
- Vertigo
- Confusion
- Nervousness
- Constipation
- Tremor
- Altered walking
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Take your medication regularly as directed by your doctor as missing doses can trigger seizures.
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Do not change the brand of your medicine and make sure that you have sufficient amount of medicine present with you.
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Some healthy tips to prevent seizures:
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It may cause dizziness and sleepiness. Do not drive or do anything that requires mental focus until you know how it affects you.
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It may increase blood sugar levels. Inform your doctor if you are taking any medicines to treat diabetes.
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It may cause swollen gum (gum hypertrophy), hence take care of oral or dental hygiene.
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Talk to your doctor if you notice sudden mood changes or develop suicidal thoughts.
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Do not stop taking the medication suddenly without talking to your doctor as it may increase the seizure frequency.
Oral
Epilepsy
Adult: Initially, 3-4 mg/kg daily as single dose or in divided doses.
Alternatively, 150-300 mg daily increased gradually to 600 mg daily if necessary. Maintenance: 200-500 mg daily.
Oral
Control of Tonic-Clonic and Complex Partial Seizures
Initial dosage
Neonates: 5 mg/kg/day in 2 divided doses
Child: 6 months to 16 years: 5 mg/kg/day in 2-3 divided doses
Neonates (<28 days)
Initial: 5-8 mg/kg/day PO divided q8-12hr
Age-based maintenance dose
6 months-4 years: Usual range, 8-10 mg/kg/day PO divided two to three times daily
4-7 years: Usual range, 7.5-9 mg/kg/day PO divided two to three times daily
7-10 years: Usual range, 7-8 mg/kg/day IPO divided two to three times daily
10-16 years: Usual range, 6-7 mg/kg/day PO divided two to three times daily
Cardiovascular disease, e.g. sinus bradycardia, heart blocks; DM; hepatic impairment; hypoalbuminemia; porphyria; seizures (may increase frequency of petit mal seizures); debilitated patients; elderly. Caution in IV admin in hypotension, heart failure or MI, monitor BP and ECG during therapy. IV must be given slowly (too rapid admin may cause hypotension, CNS depression, cardiac arrhythmias and impaired heart conduction). Extravasation and intra-arterial admin must be avoided. Do not discontinue abruptly (may increase seizure frequency), unless safety concerns require a more rapid withdrawal. May impair ability to drive or operate machinery.
Lactation: Excreted in breast milk; not recommended
Hypersensitivity, lack of appetite, headache, dizziness, tremor, transient nervousness, insomnia, GI disturbances (e.g. nausea, vomiting, constipation), tenderness and hyperplasia of the gums, acne, hirsutism, coarsening of the facial features, rashes, osteomalacia. Phenytoin toxicity as manifested as a syndrome of cerebellar, vestibular, ocular effects, notably nystagmus, diplopia, slurred speech, and ataxia; also with mental confusion, dyskinesias, exacerbations of seizure frequency, hyperglycaemia. Solutions for inj may cause local irritation or phlebitis. Prolonged use may produce subtle effects on mental function and cognition, especially in children.
Potentially Fatal: Toxic epidermal necrolysis, Stevens-Johnson syndrome.
Effects with other sedative drugs or ethanol may be potentiated. Enhances toxic effects of paracetamol, lithium. Increased risk of osteomalacia with acetazolamide. Decreased serum levels/effects with acyclovir, antineoplastics, benzodiazeines, ciprofloxacin, CYP2C9 inducers (e.g. carbamazepine), CYP2C19 inducers (e.g. rifampin), folic acid, vigabatrin.
Increased serum concentrations with allopurinol, capecitabine, cimetidine, CYP2C9 inhibitors (e.g. fluconazole), CYP2C19 inhibitors (e.g. delavirdine), disulfiram, methylphenidate, metronidazole, omeprazole, SSRI, trazodone, trimethoprim. Increases metabolism of antiarrhythmics, anticonvulsants, antipsychotics, beta-blockers, calcium channel blockers, chloramphenicol, corticosteroids, doxycycline, oestrogens, HMG-CoA reductase inhibitors, methadone, theophylline, TCAs. Decreases levels/effects of clozapine, ciclosporin, tacrolimus, CYP2B6 substrates (e.g. bupropion, selegiline), CYP2C8 substrates (e.g. amiodarone), CYP2C9 substrates (e.g. celecoxib), CYP2C19 substrates (e.g. citalopram), CYP3A4 substrates (e.g. benzodiazepines), digoxin, itraconazole, levodopa, neuromuscular-blocking agents, thyroid hormones, topiramate.
Increases levels/effect of dopamine, ticlopidine. Valproic acid may displace phenytoin from binding sites; and affect phenytoin serum concentrations. Transiently increases the hypothrombinaemia response to warfarin initially, followed by an inhibition of the response.
Potentially Fatal: Enhances the hypotensive properties of dopamine and the cardiac depressant properties of lidocaine.
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