Precautions While Using This Medicine

Your doctor should check your progress at regular visits , especially during the first few months of treatment with this medicine. During this time the amount of medicine you are taking may have to be changed often to meet your individual needs.

Do not start or stop taking any other medicine without your doctor's advice. Other medicines may affect the way this medicine works .

This medicine will add to the effects of alcohol and other CNS depressants (medicines that may make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; other medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine .

Do not take this medicine within 2 to 3 hours of taking antacids or medicine for diarrhea. Taking these medicines and hydantoin anticonvulsants too close together may make the hydantoins less effective.

Do not change brands or dosage forms of phenytoin without first checking with your doctor. Different products may not work the same way. If you refill your medicine and it looks different, check with your pharmacist.

If you have been taking this medicine regularly for several weeks or more, do not suddenly stop taking it . Your doctor may want you to reduce gradually the amount you are taking before stopping completely.

Your doctor may want you to carry a medical identification card or bracelet stating that you are taking this medicine.

For diabetic patients:

• This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.

Before you have any medical tests, tell the doctor in charge that you are taking this medicine. The results of some tests (including the dexamethasone, metyrapone, or Schilling tests, and certain thyroid function tests) may be affected by this medicine.

Before having any kind of surgery, dental treatment, or emergency treatment, tell the medical doctor or dentist in charge that you are taking this medicine . Taking hydantoin anticonvulsants together with medicines that are used during surgery or dental or emergency treatments may cause increased side effects.

This medicine may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. After you have taken this medicine for a while, this effect may not be so bothersome. However, make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert .

Oral contraceptives (birth control pills) containing estrogen or progestin, contraceptive progestin injections (e.g., Depo-Provera), and implant contraceptive forms of progestin (e.g., Norplant) may not work properly if you take them while you are taking hydantoin anticonvulsants. Unplanned pregnancies may occur. You should use a different or additional means of birth control while you are taking hydantoin anticonvulsants . If you have any questions about this, check with your health care professional.

For patients taking phenytoin or mephenytoin :

• In some patients (usually younger patients), tenderness, swelling, or bleeding of the gums (gingival hyperplasia) may appear soon after phenytoin or mephenytoin treatment is started. To help prevent this, brush and floss your teeth carefully and regularly and massage your gums. Also, see your dentist every 3 months to have your teeth cleaned. If you have any questions about how to take care of your teeth and gums, or if you notice any tenderness, swelling, or bleeding of your gums, check with your doctor or dentist .