Comparative Pharmacology
Head-to-head clinical analysis: DILANTIN versus TRIDIONE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DILANTIN versus TRIDIONE.
DILANTIN vs TRIDIONE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Phenytoin stabilizes neuronal membranes and decreases seizure activity by increasing efflux or decreasing influx of sodium ions across cell membranes in the motor cortex during generation of nerve impulses. It acts by blocking voltage-dependent sodium channels, thereby inhibiting the spread of seizure activity.
Increases seizure threshold by modulating voltage-gated sodium channels and enhancing GABA-ergic inhibition.
300–400 mg/day orally in 2–3 divided doses; IV loading dose 15–20 mg/kg at max 50 mg/min, then 300 mg/day IV divided 2–3 times daily.
300-600 mg orally three times daily; titrate to seizure control.
None Documented
None Documented
Average 22 hours (range 7-42 hours) in adults. Dose-dependent; increases with higher concentrations due to saturable metabolism. In neonates: 10-15 hours. In chronic use, half-life may increase.
16-24 hours (trimethadione); dimethadione (active metabolite) has a half-life of ~6-12 days, leading to drug accumulation.
Primarily hepatic metabolism to inactive metabolites (p-hydroxyphenyltoin and glucuronide conjugate). Less than 5% excreted unchanged in urine. Fecal excretion minimal (<2%).
Renal: ~70% as unchanged drug and metabolites (including dimethadione); biliary/fecal: minimal (<10%).
Category C
Category C
Anticonvulsant
Anticonvulsant