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Ethotoin |
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indicationFor the control of tonic-clonic (grand mal) and complex partial (psychomotor) seizures.pharmacologyEthotoin is a hydantoin derivative and anticonvulsant. Ethotoin exerts an antiepileptic effect without causing general central nervous system depression. The mechanism of action is probably very similar to that of phenytoin. The latter drug appears to stabilize rather than to raise the normal seizure threshold, and to prevent the spread of seizure activity rather than to abolish the primary focus of seizure discharges.mechanism of actionThe mechanism of action is probably very similar to that of phenytoin. The latter drug appears to stabilize rather than to raise the normal seizure threshold, and to prevent the spread of seizure activity rather than to abolish the primary focus of seizure discharges. Ethotoin inhibits nerve impulses in the motor cortex by lowering sodium ion influx, limiting tetanic stimulation.toxicitySymptoms of overdose include drowsiness, loss of or impaired muscle coordination, nausea, visual disturbance, and, at very high doses, coma.biotransformationHepatic. The drug exhibits saturable metabolism with respect to the formation of N-deethyl and p-hydroxyl-ethotoin, the major metabolites.absorptionFairly rapidly absorbed, however, the extent of oral absorption is not known.half life3 to 9 hoursdrug interactionsAlprazolam: Ethotoin may increase the metabolism of alprazolam via CYP3A4.Aminophylline: Decreased effect of both products Amiodarone: Increases the effect of hydantoin Aprepitant: The CYP3A4 inducer, ethotoin, may decrease the effect of aprepitant. Betamethasone: The enzyme inducer, ethotoin, may decrease the effect of the corticosteroid, betamethasone. Capecitabine: Capecitabine increases the effect of hydantoin Chloramphenicol: Increases phenytoin, modifies chloramphenicol Chlordiazepoxide: Ethotoin may increase the metabolism of chlordiazepoxide via CYP3A4. Chlorpheniramine: The antihistamine increases the effect of hydantoin Cimetidine: Increases the effect of hydantoin Ciprofloxacin: Decreases the hydantoin effect Clomifene: The enzyme inducer, ethotoin, decreases the effect of the hormone agent, clomifene. Clorazepate: Ethotoin may increase the metabolism of clorazepate via CYP3A4. Clozapine: Hydantoin decreases the effect of clozapine Conjugated Estrogens: The enzyme inducer, ethotoin, decreases the effect of the hormone agent, conjugated estrogens. Cyclosporine: The hydantoin decreases the effect of cyclosporine Dexamethasone: The enzyme inducer, ethotoin, may decrease the effect of the corticosteroid, dexamethasone. Diazepam: Ethotoin may increase the metabolism of diazepam via CYP3A4. Diethylstilbestrol: The enzyme inducer, ethotoin, decreases the effect of the hormone agent, diethylstilbestrol. Disopyramide: The hydantoin decreases the effect of disopyramide Disulfiram: Increases the effect of phenytoin Doxycycline: The anticonvulsant, ethotoin, decreases the effect of doxycycline. Estradiol: The enzyme inducer, ethotoin, decreases the effect of the hormone agent, estradiol. Ethinyl Estradiol: This product may cause a slight decrease of contraceptive effect Felbamate: Increased phenytoin levels and decreased felbamate levels Felodipine: The hydantoin decreases the effect of felodipine Fluconazole: Increases the effect of hydantoin Fludrocortisone: The enzyme inducer, ethotoin, may decrease the effect of the corticosteroid, fludrocortisone. Fluorouracil: Fluorouracil increases the effect of hydantoin Fluoxetine: Fluoxetine increases the effect of phenytoin Flurazepam: Ethotoin may increase the metabolism of flurazepam via CYP3A4. Fluvoxamine: Increases the effect of hydantoin Folic Acid: Folic acid decreases the levels of hydantoin Furosemide: The hydantoin decreases the effect of furosemide Gabapentin: Increases the effect of hydantoin Gefitinib: The CYP3A4 inducer, ethotoin, may decrease the serum concentration and therapeutic effects of gefitinib. Hydrocortisone: The enzyme inducer, ethotoin, may decrease the effect of the corticosteroid, hydrocortisone. Imatinib: The hydantoin decreases the levels of imatinib Isoniazid: Isoniazid increases the effect of phenytoin in 20% of patients Itraconazole: Phenytoin decreases the effect of itraconazole Lamotrigine: Phenytoin may reduce levels of lamotrigine Levonorgestrel: Phenytoin decreases the contraceptive effect Mebendazole: The hydantoin decreases the efficiency of mebendazole Medroxyprogesterone: The enzyme inducer, ethotoin, decreases the effect of the hormone agent, medroxyprogesterone. Megestrol: The enzyme inducer, ethotoin, decreases the effect of the hormone agent, megestrol. Methadone: The hydantoin decreases the effect of methadone Methotrexate: The antineoplasic agent decreases the effect of hydantoin Methoxsalen: The hydantoin decreases the effect of psoralene Mexiletine: The hydantoin decreases the effect of mexiletine Midazolam: Ethotoin may increase the metabolism of midazolam via CYP3A4. Mirtazapine: The hydantoins may reduce mirtazapine plasma concentrations and pharmacological effects Norethindrone: This product may cause a slight decrease of contraceptive effect Omeprazole: Omeprazole increases the effect of hydantoin Oxcarbazepine: Oxcarbazepine increases the effect of hydantoin Oxtriphylline: Decreased effect of both products Oxyphenbutazone: The NSAID, oxyphenbutazone, may increase the hydantoin effect of ethotoin. Phenylbutazone: The NSAID, phenylbutazone, may increase the hydantoin effect of ethotoin. Prednisolone: The enzyme inducer, ethotoin, may decrease the effect of the corticosteroid, prednisolone. Prednisone: The enzyme inducer, ethotoin, may decrease the effect of the corticosteroid, prednisone. Quetiapine: Phenytoin decreases the effect of quetiapine Rifampin: Rifampin decreases the effect of the hydantoin Theophylline: Decreased effect of both products Ticlopidine: Ticlopidine increases the effect of hydantoin Triamcinolone: The enzyme inducer, ethotoin, may decrease the effect of the corticosteroid, triamcinolone. Triazolam: Ethotoin may increase the metabolism of triazolam via CYP3A4. Triprolidine: The CNS depressants, Triprolidine and Ethotoin, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy. |