Dilantin vs Phenytoin What in the world???

I am overly concerned and would like answers.  Why are there so many posts of people having to switch from name brand Dilantin to Phenytoin and having seizure.  I have been seizure free on Dilantin and when my insurance company United Health Care decided they wanted to save money and change me to Phenytoin, I had a seizure.  This to me is playing with someones like and it makes me concerned.  If I Google Dilantin vs Phenytoin, people are having seizures because insurance companies want to save money. 

Who approves the medication to be the same thing as the name brand?  Who in the HELL are they?  I talked to a pharmacist about the differences in medications and she told me that Phenytoin and Dilantin are made with different binders....THEY WORD IS DIFFERENT SHE TOLD ME HERSELF.  So, the body absorbs the medication differently.   This is all about money and not really saving peoples lives and keeping them seizure free.  I see the FDA approves medications.  What gives them the right to approve a medication that does not do that same job as a brand name.  Is Phenytoin not a Neurological medication. Should the government or the FDA approve such a medication to replace Dilantin, as I said before the Pharmacist said its different and thousands upon thousands of people are having seizures from Phenytoin.


Anyone want to elaborate on the for me and give me a good enough reason to not be concerned.  Give me a good enough FDA story on how these meds are the same........They are NOT and it pisses me off and its playing with my life, and if one day I switch because my insurance wont cover Dilantin...and I have a seizure while driving my baby to the Doctor. 

Someone will answer real fast...........................


Re: Dilantin vs Phenytoin What in the world???

What in the world indeed!  Your insurance company would seem to be incredibly mean.  Phenytoin/Dilantin was first used for epi in the 1940s and the patent has long since expired.  In the UK the drug is marketed as ''Epanutin'' rather than ''Dilantin'' and, according to the (2008) National Health Service's annual Prescription Cost Analysis (the official breakdown of NHS expenditure on drugs), a 100mg capsule cost about 3.3p, or less than 2 US cents each.  Generics are certainly cheaper but how cheap can you get?  By contrast, the 100mg tablets of Lamictal (Lamotrigine), the drug I take, cost the NHS c. £1.30 - each.

Your pharmacist is correct about the physical diffferences (binders) between generic versions of patented drugs and the different effects these have on anyone taking them but latter are hardly worth risking if the cost savings are so insignificant.

Might you consider using the services of another insurance company?


Re: Dilantin vs Phenytoin What in the world???

I'm glad i read this, i never knew that....i take both of them to get the exact dose that i need because i was told they don't make a 50mg of phenytoin.

Re: Dilantin vs Phenytoin What in the world???

My husband had the same problem. He was doing fine on Dilantin, switched to generic and started having breakthrough seizures left and right.    After a trip to the ER and a huge medical bill he decided to switch back to the name brand and has been doing much better.  What was so frustrating was that everyone one we asked, ER doc, pharmacists, paramedic, etc said the drugs  were exactly the same thing.  It was only when we spoke to his neurologist did he say that they weren't. 


Re: Dilantin vs Phenytoin What in the world???

I was prescribed Dilatin in 2001 after having a seizure, within the year I was switched to Phenytoin for the rest of that year & with no seizure activity I was taken off ALL medications. NO SEIZURES FOR 3 YEARS. 2004 my stress levels reached there peak & I started having seizures again. Knowing what was up I went back to the doctors & was put back on PHENYTOIN, no seizures for a couple of years. In 2007 I had a GRAND MAUL in JANUARY went to the doctors found my levels were low. Well fixed & 4 months go by no seizures. April, May, June I started having a series of seizures, where in April it showed my levels low, in May it showed my levels were low so they upped my Phenytoin dose from 300 mg a day to 400 mg a day. In June pissed off Knowing it had something to do with the medication I argued with my Doctor/s that I was being overdosed/under dosed with me taking my medication correctly & as prescribed, & now with a series of new side effects.

Now here is my point AFTER I WENT OUT OF MY WAY, NOT DOCTORS or PHARMACIST I kept asking questions to, I found out that during these times off seizure activity it wasn't what type of medication I was taking it was the Pharmacy switching MANUFACTURES of the PHENYTOIN I was taking.

In other words you can be prescribed Dilatin from Manufacturer A / then a newer MANUFACTURER B/ comes out with the same product "BUT BECAUSE IT IS REGULATED BY THE "FDA" in is put in use."
I took PHENTOIN FROM THE MANUFACTURE "MYLAN" during 2001, 2004, till 2006, I HAD NO PROBLEMS.
In 2007 I read my prescription labels for the year & found that I was given MYLANS PHENYTOIN this month, TORA brands PHENYTOIN the next, BACK TO MYLANS PHENYTOIN the following month, 3 months later given SUN PHARMACEUTIS PHENYTOIN wondering what's with the new side effects "I NEVER HAD THIS BEFORE" & a lot of seizures during this time.
I talked to my pharmacist at CVS about this & he ordered me the MYLANS BRAND AGAIN.
NOW Lets see if I have any seizures this year.

I know by facts & proof that any seizure medication can help with control , or bring forth, or give you seizures YET AFTER RUNNING EVERY TEST POSSIBLE ( cat scans, m r i ' s, blood, EEG's,EKG's nothing was found!) & I will not have seizures when taking MYLAN's BRANDED PHENYTOIN. I REFUSE TO TRY OTHER MEDICATIONS BECAUSE THEY WILL TRIGGER MORE SEIZURES JUST TRYING THEM.

There is a lot more of info SO here I HOPE IT HELPS ANY EPILEPTIC OUT THERE!



Re: Dilantin vs Phenytoin What in the world???

There's actually not a problem with the generic versions of any drug- the problems arise when having to switch from one brand to the other, because, as has already been said here, the binding agents are different therefore affect individuals metabolising. So if you're stable on brand dilantin and change to a generic then breakthrough szs are quite common- this applies to all AEDs.


Re: Dilantin vs Phenytoin What in the world???

It is surprising the extent to which generics are substituted for brand versions of AEDs given the comparative personal and public costs of so doing.  Costs might involve loss of driviing license, injury, loss or modification of employment, hospitalisation, insurance, effects on self-confidence, personal relationships and others.

A number of surveys in the past ten years or so have found problems of breakthrough seizures and/or increased side-effects with patients switching from branded to generic AEDs.  One cause seems to lie in the narrow therapeutic range of some drugs, the difference in dosage between that which is less than effective and that which is 'toxic' or where side-effects become intolerable.  The replacement of a brand AED by a generic version can shift this one way or other, for a particular individual, due to the differing rates at which the drug is absorbed and often requires a change in dosage to take account of this.  AEDs with a relatively narrow therapeutic range include Phenytoin(Dilantin), mentioned here, Carbamazipine (Tegretol) and Valproate, all drugs that have long since seen their patents expire and are therefore relatively cheap.  These costs are clearly outweighed by the other costs mentioned above.  The conclusions are inescapable.