Community Forum

600mg of dilantin .....anybody on this much??

when I left the hopspital I was on 300mg of dilantin..... 3 weeks later they upped it to 400mg after my follow up appt..... now they just upped me to 600mg per day..... i was on 300mg per day when I was younger..... to make matters worse I have about 5-7 days of insomnia and headaches after they up the doseage.... I know that 300-500mg per day is common for most people.... a dose this big is starting to worry me  about how bad my seizure disorder is and about possible damage to my liver... i was wondering if anybody on here is taking a larger than normal dose of dilantin and what side effect they may be having


Dilantin is monitored by routine bloodwork to determine the therapeutic level.  The increase was most likely done because you may have had low levels. 

 The insomnia could be a result of the increase and if it does not subside in a few weeks, it might be time to inform your doctor.  Since you have doubled your dose of Dilantin, make sure a new level is done. Levels often stabilize by 10 to 14 days.

If you have grown more since your younger days of taking Dilantin, that could very well be the reason why your physician wants to increase it.  Periodic bloodwork should be taken while on Dilantin.

If you are taking the generic form of Dilantin, try and stick with the same manufacturer since generic vs name brand are often metabolized differently.


When were you started on Dilantin?  How old were you then?  What was the timeframe between being upped from 400mg to 600mg?

What Nerak95 said below is exactly right - it's not about how much you're ingesting, it's about the level of it in your system. This is affected by your body mass, metabolism, and other factors. As well, your body gets accustomed to everything you put in it - desensitized in a way. Over longer periods of time, the efficacy of any medication will decrease, which is why I asked the questions above. For example, on day 1 out of the hospital, let's say 300mg had an efficacy of 290mg (10mg lost in digestion/etc). On day 1001 out of the hospital, 300mg may have an efficacy of 200mg. If this is detected in your bloodwork, your dosage will almost certainly be upped.

Personally, I take 400mg/day. I started at 300mg but had a breakout seizure 6-7 weeks later. I've been pretty stable on 400mg for about 3.5 years.

I'm not sure about the insomnia and headaches, I've never experienced those since starting on Dilantin. How is your health otherwise? I found that eating healthy and lots of exercise helps me in a lot of ways, and they could help with these problems. Do you take a multivitamin? Are you on any other medications?

Best thing you can do for your liver is abstain from alcohol. You can take your concerns to a doctor, but a lot of medications are hard on the liver - it's the nature of the beast unfortunately, the liver is a major part of metabolisys. 

a little bit of history  on my seizures.....

had my first 1 at age 17 (1989).. i had 2 seizures at that time and was on 300mg  till I was 22 and was slowly taken off of it.....was seizure free till 2010, when I had a seizure in my sleep.... at that time they figured out it was sleep apnea ( the seizure happened between my 1st and 2nd sleep studies) found out I neeed a cpap machine and seizure free (no meds) till oct 8th 2012.....all my seizures were tonic clonic seizures,  my last one I aspirated vomit into my lungs and and was in a coma for 4 days and stayed in the hospital for another 3 days after coming out of the coma.... I was on 300mg when i left the hospital, they upped it to 400mg at my follow up appt 3 weeks later... they retested after another week then upped me to 600mg... supposed to go in tuesday for a retest... I weighed 160-180lbs  when I was 17.... before the seizure I had been up to 265, and was down to 254 right before my seizure with diet and exercise ( cycling).... lost another 8 lbs in my coma and another 4 before leaving the hospital... now I am around 240 and still trying to lose weight the same as I was before my seizure ... I am also taking a mutivitamin( was before my seizure) vitamin D,B12 and folic acid ( post seizure on these) otherwise my health is ok, most of my issues are side effects which I mentioned in my orginal post....... I was having some issues with insomnia before  my seizure....... seems like stress and insomnia were the triggers on my last 2 seizures

now I am on 800mg.... hopefully  they wont have to increase it anymore as I am unable to sleep for about a week after they increase my dose

Our Mission

The mission of the Epilepsy Foundation is to lead the fight to overcome the challenges of living with epilepsy and to accelerate therapies to stop seizures, find cures, and save lives.

24/7 helpline