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Dilantin (Phenytoin Sodium)


Trigeminal neuralgia (NTN) is a chronic disease that usually affects middle-aged and elderly and is characterized by severe paroxysmal pain in the eyes, nose, lips, jaw, forehead, or scalp. The attacks accompanied by excruciating pain may be caused by such conventional actions as brushing teeth, make-up, or even the imposition of a sudden breeze. NTN is often considered to be the most painful disease. Fortunately, you can cope with NTN - this disease responds well to treatment with the right approach and constant monitoring of any changes.

Many patients believe that NTN can be effectively cured with medicaments. Drug treatment should be initiated in case of NTN as soon as it is diagnosed. Although the pain may be decreased or even disappear, medication must be taken continuously to prevent recurrent attacks. Non-systematic treatment is ineffective, while the abrupt cessation of admission can cause various side effects. If there is no manifestation of the NTN for 4-6 weeks, the drugs can be phased out.

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Dilantin and medical treatment

Medicines that are most effective in NTN treatment are referred to as ‘anticonvulsants’, as they are also used to prevent seizures in epilepsy. Analgesics (from aspirin, dipyrone and etc.) are almost ineffective as pain attacks occur suddenly, plus the constant intake of analgesics (especially drugs) is extremely dangerous. The action is based on inhibition of NTN activity by anticonvulsants.

Dilantin is often used in patients with poorly tolerated finlepsin. It is also used for emergency patients with a bout of NTN, as is its form, which can be administered intravenously. Phenytoin is less effective than finlepsin, but elderly patients tolerate it easier than finlepsin.

The most frequent side effects of anticonvulsants are headaches, drowsiness, memory troubles, unsteadiness of gait and nausea. More serious complications are less frequent and include anemia, liver toxicity, kidney failure.

How it works?

The drug has an anticonvulsant effect without the expressed sedative effect, plus offers antiarrhythmic and hypotensive action. The peak concentrations in plasma are observed in 3-12 hours; after the absorption quickly distributed in various organs and tissues, including brain tissue. From 70 to 90% of the preparation is bound to plasma proteins. Less than 5% is excreted in unchanged form with the urine, the remainder is metabolized by enzymes of the liver.

How should I take it?

The medication is designed for peroral use: it can be consumed during or after a meal (consuming on empty stomach may lead to mucous membrane irritation). Adults are typically prescribed - 1-2.5 pills 2-3 times daily depending on the severity of the attacks, if necessary, the dosage can be increased up to 3-4 pills (the maximum daily dosage must not exceed 8 pills). Children under 5 years are typically prescribed a quarter of a pill 2 times a day, 5-8 years old kids typically receive a quarter of a pill 3-4 times.


A careful selection of dosage and a regular professional supervision are strongly recommended, as it usually takes 7-10 days of active treatment to determine the optimal concentration of drug in blood; elimination is the process where accumulation of preparation takes place and increasing the dose may be accompanied by a disproportionate increase in plasma level. If any adverse effects are manifested it is necessary to reduce the dose or cease the course immediately.

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