Description of the medicine: Diphenin (Dipheninum)
A mixture of 5, 5-diphenylhydantoin and sodium bicarbonate (in a ratio of 85:15).
Synonyms of diphenylhydantoin and its sodium salt: Alepsin, Dihydantoin, Dilantin sodium, Diphedan, Diphentoin, Epanutin, Eptoin, Hydantal, Hydantoinal, Phenhydon, Phenytoinum, Sodanton, Solantoin, Solantyl, Zentropil, etc.
White crystalline powder. Practically insoluble in water; soluble in 1% caustic alkali solutions.
Available in the form of tablets containing 0.117 g of diphenin and 0.032 g of sodium bicarbonate. The action of these tablets corresponds to the action of diphenylhydantoin sodium.
Diphenin is a derivative of hydantoin, which is close in chemical structure to barbituric acid. It has an anticonvulsant effect without a pronounced hypnotic effect.
When taken orally, it is absorbed at different speeds. The peak concentration in blood plasma is observed after 3 to 12 hours. After absorption, it is rapidly distributed in various organs and tissues, including brain tissue. It is strongly bound by plasma proteins. Less than 5% is excreted unchanged in the urine, the rest is metabolized by liver enzymes. The main metabolite (paraoxyphenyl derivative) is inactive, excreted in the bile, as well as in the urine in the form of glucuronide.
Diphenin is used to treat epilepsy, mainly with large seizures.
Assign inside. In order to avoid irritation of the gastric mucosa (due to an alkaline reaction), take during or after a meal.
Adults are usually prescribed 1/2 to 1 tablet 2-3 times a day. If necessary, increase the daily dose to 3-4 tablets.
Highest doses for adults: single 3 tablets, daily 8 tablets.
Children under 5 years old are given 1/4 tablets of diphenin 2 times a day, 5 - 8 years old - 1/4 tablets 3-4 times a day, older than 8 - 1/2 - 1 tablet 2 times a day.
With insufficient effectiveness of diphenin, phenobarbital or another antiepileptic drug is simultaneously prescribed.
Diphenin is effective in some forms of cardiac arrhythmias, especially with arrhythmias caused by an overdose of cardiac glucose (see Antiarrhythmic drugs)
Due to the inhibitory effect on vestibular reflexes, diphenin can have a beneficial effect in some forms of Meniere's syndrome.
Side effects are possible during treatment with diphenin: dizziness, agitation, fever, difficulty breathing, nausea, vomiting, tremor, ataxia, nystagmus, allergic reactions (skin rash, itching, etc.), lymphadenopathy, hirsutism, etc. Relatively often develops gingival hyperplasia.
With severe side effects, it is necessary to gradually reduce the dose or stop using the drug.
Isoniazid and its derivatives, chloramphenicol, coumarins, acetylsalicylic acid, teturams inhibit the biotransformation of diphenin and may enhance its side effects. On the contrary, phenobarbital, carbamazepine accelerate its metabolism.
Diphenin is contraindicated in diseases of the liver, kidneys, heart failure, cachexia.