REACTION TO SODIUM DIPHENYL HYDANTOINATE (DILANTIN SODIUM)

Abstract

Sodium diphenyl hydantoinate (dilantin sodium) is a drug which has been in increasing use since 1937 for the control of chronic convulsive disorders. Its chemical structure is related to that of phenylethylhydantoin, better known as nirvanol. The latter drug is a hypnotic which at one time was used extensively in the treatment of chorea and in all cases produced a characteristic toxic erythema about the tenth or twelfth day. Dilantin sodium is an anticonvulsant but not a hypnotic drug and produces cutaneous reactions in an estimated 5 per cent of cases.¹The therapeutic dose for the average adult is 0.1 Gm. given orally three times daily. Merritt and Putnam¹placed the maximum daily dose at 0.6 Gm. and warned of the continued administration of the drug in the face of cutaneous reactions, even of the mildest character. Reactions attributable to dilantin sodium may be classified as follows: Gastrointestinal System.—Nausea and vomiting are the most common reactions and are believed to be due to high alkalinity of the drug. Giving the drug at meal time avoids these reactions to some extent.