Comparative Pharmacology
Head-to-head clinical analysis: DILANTIN versus VIGADRONE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DILANTIN versus VIGADRONE.
DILANTIN vs VIGADRONE
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.
Irreversible inhibitor of GABA transaminase (GABA-T), leading to increased brain concentrations of gamma-aminobutyric acid (GABA).
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.
Adults: 500 mg orally twice daily, may increase by 500 mg/day every week; maximum 1500 mg twice daily.
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.
Terminal elimination half-life: 5-7 hours in young adults; 12-15 hours in elderly; therapeutic steady-state achieved within 2-3 days.
Primarily hepatic metabolism to inactive metabolites (p-hydroxyphenyltoin and glucuronide conjugate). Less than 5% excreted unchanged in urine. Fecal excretion minimal (<2%).
Renal: 70% unchanged; hepatic metabolism: 20% (primarily via CYP4A7, not CYP450); fecal: <5%.
Category C
Category C
Anticonvulsant
Anticonvulsant