help with decreasing Dilantin dosage

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oldhat

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Hello,
I am new to the site so be patient while I try to post a question. We are supposed to decrease our sons Dilantin from 300mg/day to 250mg/day. The doctor said to space it however works for us. The last time he had us change his dosage from 300mg/day to a 200mg am/100mg pm-then 100am/100pm for a week alternating days.When his labs came back his Dilantin had decreased from 33mg% to 22mg% in the 7 day interval. He had 7 grand mal seizures in a matter of 2 days so he moved him back up to 300 mg/day.
With the new change has anyone had experience with using the 100mg Kapseal and the 50mg infatab and if so how did you space them? We were thinking 200mg Kapseal in the am and then the 50mg Infatab in the evening.
Anyone with experience with this combination? When I asked the doctor he didn't seem to care one way or the other. We sure don't want our son to go through the grandmals like last time.
If I am asking to much, please excuse-just desparate to have something go right for him

Thank you for your cconsideration.
Oldhat
 
I was on dilantin but have no experience with the infatab or Kapseal. From what I've readd they are both forms of phenytoin (dilantin). I would wonder if the issue lies in absorption of capsule as opposed to tablet.

Also... Welcome to the site.
 
Hi oldhat --

Your neurologist isn't very helpful, eh? Partly it's because there isn't any way to predict exactly -- drugs metabolize differently in different people, and with a combination of regular (infatab) and extended release (kapseal) it gets even trickier. But I think your instincts are right. Because your son's metabolism is probably slower at night then it makes sense to give him the infatab in the evening, since it will "last" longer.
 
Thank you for your response. By the time I get through the discussions with "me,myself and I" it is time for me to step back and check on what maybe the right way to proceed.
 
Oldhat,

I don't have any experience with Dilantin. But if your doctor doesn't care, maybe it's time for a new doctor? There is are a few regional epilepsy centers in the Northwest, with the best epi's who specialize in seizures. They are also extra-good with medications and special situations regarding seizures and meds.
 
Oldhat,

Years ago I took 300 mgs. of Dilantin capsules daily, but I wasn't a child at the time, so my metabolism was much different than a child's. And Dilantin didn't control seizures for me. Sounds like the doctor your son is seeing is too lackadaisical in his treatment. Time to see an epileptologist.
 
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