When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to phenytoin or similar medicines, or if you are pregnant.

How to Use This Medicine:
Capsule, Long Acting Capsule, Liquid, Chewable Tablet

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• You may take this medicine with food if it upsets your stomach. Take this medicine at the same time each day.
• Capsule: Swallow whole. Do not open, crush, or chew it.
• Chewable tablet: May be chewed, swallowed whole, or crushed before you swallow it.
• Oral liquid: Shake just before each use. Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
• Feeding tube: This medicine should be given at least 2 hours before or 2 hours after a feeding.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Do not freeze the oral liquid.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine together with delavirdine.
• The list below includes some of the medicines that can interact with phenytoin. There are many other drugs not listed. Make sure your doctor knows the names of all the medicines you use.
  
  • Tell your doctor if you are using St John's wort, albendazole, amiodarone, aspirin, chlordiazepoxide, cyclosporine, diazepam, diazoxide, digoxin, disulfiram, folic acid, furosemide, isoniazid, methylphenidate, nisoldipine, praziquantel, quinidine, reserpine, rifampin, sucralfate, theophylline, tolbutamide, or vitamin D.
  • Tell your doctor if you are using cancer medicine, birth control pills, medicine to treat an infection (including a sulfa drug, medicine to treat HIV/AIDS, or medicine for a fungus infection), a steroid medicine, medicine to lower cholesterol, medicine to treat depression, a phenothiazine medicine, a stomach medicine, or a blood thinner (such as ticlopidine, warfarin).
• Do not take an antacid or supplement that contains calcium, aluminum, or magnesium at the same time you take phenytoin. Take the antacid or supplement at a different time of day.
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
• Tell your doctor if you are breastfeeding, or if you have kidney disease, liver disease, depression, diabetes, or porphyria.
• This medicine may cause the following problems:
  
  • An increased risk of suicidal thoughts
  • Serious skin reactions (may happen after treatment has stopped)
  • Drug reaction with eosinophilia and systemic symptoms (DRESS), which may damage organs such as the liver, kidney, or heart
  • Liver damage
  • Decreased levels of blood cells, which may cause bleeding problems or increase your risk for infection
  • Weak bones
  • Higher blood sugar levels
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• This medicine may make you drowsy. Do not drive or do anything that could be dangerous until you know how this medicine affects you.
• This medicine may damage your gums. Brush and floss your teeth regularly and visit your dentist to help prevent these problems.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, or red skin rash
• Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Feeling depressed, irritable, or restless
• Fever, chills, cough, sore throat, and body aches
• Fever, skin rash, or swollen glands in your armpits, neck, or groin
• Severe confusion, problems with balance or walking, slurred speech, tremors
• Thoughts of hurting yourself, other unusual thoughts or behaviors
• Unusual bleeding, bruising, or weakness

If you notice these less serious side effects, talk with your doctor:

• Constipation, nausea, vomiting
• Dizziness or headache
• Feeling of constant movement of self or surroundings
• Mild confusion, slurred speech, clumsiness, problems with balance

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088