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what is the danger of not lowering dilantin blood levels ? I have had epilepsy for most of my life. It is completely controlled now , with 4 capsules a day. Last winter my dr. lowered my intake by 1 capsule a day, due to high blood levels of it. 1 week later, i had a siezure.She once again wants to lower my intake , due to what she says is dangerously high levels. I do not want to lower it , if it means more problems.

samantha f replied: "oh my goodness.....get a second opinion....if it was fine with the 4 a day now it is out of control again DEFINITELY get a second opinion don't go back to her until you do"

Sherry T replied: "phenytoin blood concentration of 25mcg/ml (toxic) may produce ataxia (muscular incoordiantion), nystagmus (rhythmic oscillation of eyes), double vision. As level increases, extreme lethargy to comatose states occur."

keltillos replied: "With a blood dilantin level that is above the therapeutic range, you risk (get this) seizures, as well as side effects such as slurred speech, swollen gums, confusion, fever, and vomiting. IF your dilantin level is too high, you may enter a coma. You may also wish to consider if you are having issues with your dilantin level due to your diet and scheduling. If you take dilantin within 1 hour before or after consuming anything containing calcium (ALL meats, milk, hard water, orange juice and other citrus juices, etc), this reduces the absorption of dilantin into your system. The doctor checks your blood level, finds it too low...raises your dose. Then, you go a day without mixing calcium and dilantin, you get checked...your blood level is higher. Discuss this with your doctor. As she is YOUR employee, you should make a list of questions for her before your next appointment and get them all answered, to your satisfaction, in terms that you understand. Ask these among them: 1. Would you consider supplementing phenytoin (dilantin) with another drug, such as Librium or Tegretol, in order to reduce the amount of dilantin that I need? 2. Can we adjust my dilantin level using an alternate day dosing schedule...say, 300 mg on day 1, 200 mg on day 2, 300 mg on day three, or something like that?"

TweetyBird replied: "Dilantin isn't a Heart Disease but it's important to remain within and maintain therapeutic phenytoin levels. As an anticonvulsant, the therapeutic levels are 10-20 mcg/mL. Anything above 20 may manifest as signs & symptoms of toxicity. These would be nystagmus, slurred speech, ataxia, drowsiness, lethargy, confusion and rash. Dangerously high blood levels can lead to cardiac arrest. Calcium may decrease the effectiveness of Dilantin but doesn't affect serum levels. These still need to be checked before titration. Eating within 1-2 hours before and after Dilantin can decrease absorption of the med. Don't dump the doctor. She knows what she's doing. I don't want you have more seizures either but you've got to get your levels down. Talk to her about this. If she has to decrease Dilantin perhaps she can add Depakene."

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