Medication Description: Difenin (Dipheninum)
A mixture of 5, 5-diphenylhydantoin and sodium bicarbonate (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; let's dissolve in 1% solutions of caustic alkalis.
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 sodium diphenylhydantoin.
Difenin 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 ingestion is absorbed at different speeds. The peak concentration in the blood plasma is observed in 3 to 12 hours. After absorption, it is quickly distributed in various organs and tissues, including in the brain tissues. Strongly bound by plasma proteins. Less than 5% is excreted in the urine unchanged, the rest is metabolized by liver enzymes. The main metabolite (paraoxiphenyl derivative) is inactive, excreted in bile, as well as in urine as a glucuronide.
Difenin is used to treat epilepsy, mainly for large convulsive seizures.
Assign inside. In order to avoid irritation of the mucous membrane of the stomach (due to alkaline reaction) taken during or after meals.
Adults are usually prescribed 1/2 - 1 tablet 2-3 times a day. If necessary, increase the daily dose to 3-4 tablets.
Higher doses for adults: single 3 tablets, daily 8 tablets.
Children under 5 years old give 1/4 tablets of diphenin 2 times a day, 5 to 8 years old - 1/4 tablets 3-4 times a day, over 8 - 1/2 - 1 tablet 2 times a day.
With insufficient effectiveness of difenina, phenobarbital or another antiepileptic drug is also prescribed at the same time.
Difenin is effective in some forms of cardiac arrhythmias, especially in cases of arrhythmias caused by an overdose of cardiac glucositis (see Antiarrhythmic drugs)
Due to the overwhelming effect on the vestibular reflexes, difenin may have a beneficial effect in some forms of Meniere's syndrome.
When treating difenin possible side effects: dizziness, agitation, fever, difficulty breathing, nausea, vomiting, tremor, ataxia, nystagmus, allergic reactions (skin rash, itching, etc.), lymphadenopathy, hirsutism, etc. Relatively often develops gingival hyperplasia.
In case of severe side effects, it is necessary to gradually reduce the dose or stop using the drug.
Isoniazid and its derivatives, chloramphenicol, coumarins, acetylsalicylic acid, teturam inhibit the biotransformation of diphenin and may increase its side effects. On the contrary, phenobarbital, carbamazepine accelerates its metabolism.
Difenin contraindicated in diseases of the liver, kidneys, heart failure, cachexia.