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What Could Be The Proper Dosage For Dilatin Before Weaning In Off?
I have been taking Dilatin (200mg) twice a day for about 20 years now. Because Dilatin has many side affects and I ve been on that drug for so long, we ve both decided that we should start to wean me off of it. So my doctor has now recently started me on Lamotrigine and has gradually increased my dosage to the desired amount which is 150mg, twice a day. So my concern is: I take Dilatin twice daily. In this process of decreasing my Dilatin, my doctor is saying to take 330mg just once a day for 2 weeks and then gradually decrease every 2 weeks which sounds fine except that it seems kind of unsafe to me in the sense that my body is used to taking that medication twice a day. Common sense tells me that I should take 130mg in the morning and 200mg in the evening. Does it matter or make any difference whether I take 330mg once a day vs. 130mg in the morning and 200mg in the evening??
Thu, 13 Dec 2018
Hello,
In most cases, it is preferable to reduce the dose of the drug (anti-epileptic) gradually over 2–3 months.
Most recurrences occur in the first 3 months after discontinuing therapy, and patients should avoid potentially dangerous situations such as driving or swimming during this period.
One component of a safe plan, applicable to most forms of epilepsy, is to obtain an EEG whenever withdrawal of medication is contemplated. If the tracing is abnormal by way of showing paroxysmal activity, it is generally better to continue treatment.
Because of the long half-lives (Serum half-life, h 12–36) of phenytoin, this drug needs to be taken only once daily, preferably at bedtime.
Twice a day dosage schedule hence is equally justified, because of wide variability. Extended-release form (300 mg) is always administered once-a-day dosing.
Eventually, you need to be on once-daily dosing, before the drug is completely withdrawn.
Hope I have answered your query. Let me know if I can assist you further.
Take care
Regards,
Dr Tushar Kanti Biswas, Internal Medicine Specialist
In most cases, it is preferable to reduce the dose of the drug (anti-epileptic) gradually over 2–3 months.
Most recurrences occur in the first 3 months after discontinuing therapy, and patients should avoid potentially dangerous situations such as driving or swimming during this period.
One component of a safe plan, applicable to most forms of epilepsy, is to obtain an EEG whenever withdrawal of medication is contemplated. If the tracing is abnormal by way of showing paroxysmal activity, it is generally better to continue treatment.
Because of the long half-lives (Serum half-life, h 12–36) of phenytoin, this drug needs to be taken only once daily, preferably at bedtime.
Twice a day dosage schedule hence is equally justified, because of wide variability. Extended-release form (300 mg) is always administered once-a-day dosing.
Eventually, you need to be on once-daily dosing, before the drug is completely withdrawn.
Hope I have answered your query. Let me know if I can assist you further.
Take care
Regards,
Dr Tushar Kanti Biswas, Internal Medicine Specialist
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