Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For dione anticonvulsants, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to anticonvulsant medicines. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—There have been reports of increased birth defects when dione anticonvulsants were used during pregnancy. The use of an effective method of birth control is recommended during treatment with dione anticonvulsants. Be sure you have discussed this with your doctor before taking this medicine. Dione anticonvulsants may also cause a bleeding problem in the mother during delivery and in the newborn. Doctors can help prevent this by giving vitamin K to the mother before and during delivery, and to the baby immediately after birth.

Breast-feeding—It is not known whether this medicine passes into breast milk. However, dione anticonvulsants may have serious unwanted effects, and breast-feeding is not recommended.

Children—Although there is no specific information comparing use of dione anticonvulsants in children with use in other age groups, these medicines are not expected to cause different side effects or problems in children than they do in adults.

Older adults—This medicine has been tested in a very small number of older people. Dione anticonvulsants are removed from the body more slowly in older people than in younger people. Higher blood levels of the medicine may occur, which may increase the chance of unwanted effects. Your doctor may give you a different dose than a younger person would receive.

Other medicines—Although certain medicines should not be used together at all, in other cases 2 different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking dione anticonvulsants, it is especially important that your health care professional know if you are taking any of the following:

• Central nervous system (CNS) depressants (medicine that causes drowsiness) or
• Tricyclic antidepressants (medicine for depression)—Using these medicines together may increase the CNS depressant effects

Other medical problems—The presence of other medical problems may affect the use of the dione anticonvulsants. Make sure you tell your doctor if you have any other medical problems, especially:

• Blood disease or
• Diseases of the eye or optic nerve or
• Kidney disease or
• Liver disease—Dione anticonvulsants may make the condition worse. Liver disease may cause higher blood levels of this medicine, which may increase the chance of side effects

• Porphyria—Trimethadione may make the condition worse