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Medical Forum / Diseases and Disorders / Epilepsy / February 2006Levels of Dilantin
I was supposed to get elbow surgery next week, but my neurologist cancelled it because he said my dilantin level was 3.6, while I'm taking 4 100mg pills a day. They even accused me of not taking it. Any ideas? > I was supposed to get elbow surgery next week, but my neurologist > cancelled it That's a new one on me and I would have thought it would be your family doctor (internist) and the surgeon who would determine that matter one way or the other. > because he said my dilantin level was 3.6, while I'm taking > 4 100mg pills a day. That doesn't sound right and I wonder if they reran (or why they didn't rerun) that blood serum level test. Normal therapeutic range is ~10-20 and you should be there if you are taking 2x100mg in the morning and 2x100mg before bedtime. Normal dose is 300mg/day and that keeps me steady at the bottom of the range around 11. The 400 he started me on had me walking into walls and seeing double. > They even accused me of not taking it. Did they have anything informative to offer? if so, what? > Any ideas? Only you know if you are taking your pills correctly and other factors must be playing a role if you are. If you have just started, your system may not be loaded as yet and if you are a large heavy person, that could play a role. I believe you said earlier that this was all recent, but I wouldn't expect a test until levels had had a chance to stabilize. Alcohol consumption could influence that. A liver that is accustomed to metabolizing alcohol will also more rapidly metabolize Dilantin, resulting in a lower level. I know that grapefruit juice can effect Tegretol (another drug), but in the wrong direction and it effects quite a few drugs. Not sure about Dilantin though. Think about any factors in your diet or otherwise effecting your body. >> I was supposed to get elbow surgery next week, but my neurologist >> cancelled it [quoted text clipped - 26 lines] > > Alcohol consumption could influence that. I haven't drunk any alcohol since this stated, and previously only a few drinks of wine a week. A liver that is accustomed to > metabolizing alcohol will also more rapidly metabolize Dilantin, > resulting in a lower level. I know that grapefruit juice can effect > Tegretol (another drug), but in the wrong direction and it effects quite > a few drugs. Not sure about Dilantin though. Think about any factors in > your diet or otherwise effecting your body. I have no idea. >I was supposed to get elbow surgery next week, but my neurologist >cancelled it because he said my dilantin level was 3.6, while I'm taking >4 100mg pills a day. They even accused me of not taking it. > >Any ideas? Any number of factors could have caused this (other than not taking the right dose). The medicine itself could have been old (and lost its potency). This would be more likely with generic forms of the drug. Also, there are other medications which, taken together, can cause the level of Dilantin to be too low or too high. Discuss this with your neurologist. He/she is correct in cancelling the (elective) surgery when your Dilantin level is not within therapeutic range. Best, Bob Robert A. Fink, M. D. Neurological Surgery 2500 Milvia Street Suite 222 Berkeley, CA 94704-2636 USA 510-849-2555 ********************************** NOTE: The material above is not "medical advice". Medical advice can only be given after an in-person contact between doctor and patient. ********************************** |
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