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Active substance(s): PHENYTOIN SODIUM

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Assessed against
the UK PIL dated
March 2016


Package Leaflet: Information for the user

By Caroline McDermott at 4:50 pm, Sep 07, 2016

Epanutin® 50 mg Hard Capsules
(phenytoin sodium)

Read all of this leaflet carefully before you start taking this medicine
because it contains important information for you.
 Keep this leaflet. You may need to read it again.
 If you have any further questions, ask your doctor or pharmacist.
 This medicine has been prescribed for you only. Do not pass it on to
others. It may harm them, even if their signs of illness are the same as
 If you get any side effects, talk to your doctor or pharmacist. This
includes any possible side effects not listed in this leaflet.
See section 4.
What is in this leaflet:
1) What Epanutin 50 mg Hard Capsules are and what they are used for
2) What you need to know before you take Epanutin 50 mg Hard
3) How to take Epanutin 50 mg Hard Capsules
4) Possible side effects
5) How to store Epanutin 50 mg Hard Capsules
6) Contents of the pack and other information
Epanutin 50 mg Hard Capsules are one of a group of medicines called
anti-epileptic drugs; these medicines are used to treat epilepsy.
Epanutin 50 mg Hard Capsules can be used to control a variety of
epileptic conditions, to control or prevent seizures during or after brain
surgery or severe head injury. Epanutin 50 mg Hard Capsules can also
be used to treat trigeminal neuralgia (facial nerve pain).
You should ask your doctor if you are unsure why you have been given
Epanutin 50 mg Hard Capsules.
Do not take Epanutin 50 mg Hard Capsules
 if you are allergic to Phenytoin, or any of the other ingredients of this
medicine (listed in section 6).
 if you are allergic to other medicines with a similar chemical structure
to Phenytoin (e.g. hydantoins).
Warnings and precautions
Talk to your doctor or pharmacist before taking Epanutin 50 mg Hard
Medicines are not always suitable for everyone. Your doctor needs to
know before you take Epanutin 50 mg Hard Capsules if you suffer from
or have suffered in the past from any of the following conditions:
 Liver disease.
 Porphyria (an inherited disease that affects haemoglobin biosynthesis).
A small number of people being treated with antiepileptics such as
phenytoin sodium have had thoughts of harming or killing themselves.
If at any time you have these thoughts, immediately contact your doctor.
Serious skin side effects can rarely occur during treatment with Epanutin
50 mg Hard Capsules. This risk may be associated with a variant in
genes in a subject with Chinese or Thai origin. If you are of such origin
and have been tested previously carrying this genetic variant (HLAB*1502), discuss this with your doctor before taking Epanutin 50 mg Hard
Other medicines and Epanutin 50 mg Hard Capsules
Tell your doctor or pharmacist if you are taking, have recently taken or
might take any other medicines.
Some medicines can affect the way Epanutin 50 mg Hard Capsules
work and Epanutin 50 mg Hard Capsules themselves can reduce the
effectiveness of other medicines taken at the same time. These
 Medicines used for heart and circulation problems (amiodarone,
digoxin, furosemide, reserpine, warfarin, calcium channel blockers e.g.
diltiazem, mexiletine, nicardipine, nifedipine, nimodipine, and
 Medicines used to lower blood cholesterol, (e.g. atorvastatin,
fluvastatin and simvastatin)
 Medicines used for epilepsy (carbamazepine, lamotrigine,
oxcarbazepine, phenobarbital, sodium valproate, topiramate and
valproic acid, succinimides e.g. ethosuximide and vigabatrin)

 Medicines used to treat fungal infections (e.g. amphotericin B,
fluconazole, itraconazole, ketoconazole, miconazole, posaconazole
and voriconazole)
 Medicines used for tuberculosis and other infections (chloramphenicol,
clarithromycin, isoniazid, rifampicin, sulphonamides, sulfadiazine,
sulfamethoxazole-trimethoprim, doxycycline, ciprofloxacin, efavirenz,
fosamprenavir, indinavir, lopinavir/ritonavir, ritonavir and saquinavir)
 Medicines used for stomach ulcers (omeprazole, sucralfate, the
medicines known as H2 antagonists e.g. cimetidine and some
 Medicines used for asthma and bronchitis (theophylline)
 Medicines used for pain and inflammation (salicylates e.g. aspirin and
 Medicines used for sleeplessness, depression and psychiatric
disorders (chlordiazepoxide, clozapine, diazepam, disulfiram,
fluoxetine, methylphenidate, paroxetine, phenothiazines, trazodone,
tricyclic antidepressants, fluvoxamine, quetiapine and sertraline)
 Medicines used for diabetes (tolbutamide)
 Some hormone replacement therapies (oestrogens), oral
contraceptives (the birth control pill)
 Medicines used for organ and tissue transplants, to prevent rejection
(ciclosporin and tacrolimus)
 Medicines used for cancer (antineoplastic agents, e.g. bleomycin,
capecitabine, carboplatin, cisplatin, doxorubicin, fluorouracil and
 Muscle relaxants used for surgery (neuromuscular blockers), some
anaesthetic drugs (methadone)
 Some products available without a prescription (folic acid, theophylline,
St John’s Wort, vitamin D).
Your doctor may need to test the amount of Phenytoin in your blood to
help decide if any of these medicines are affecting your treatment.
The herbal preparation St John’s Wort (Hypericum perforatum) should
not be taken at the same time as this medicine. If you already take
St John’s Wort, consult your doctor before stopping the St John’s Wort
Epanutin 50 mg Hard Capsules may also interfere with certain laboratory
tests that you may be given.
Epanutin 50 mg Hard Capsules with food and drink
Epanutin 50 mg Hard Capsules can be taken before or after food and
drinks. Drinking a lot of alcohol can also affect the concentration of
Phenytoin in your blood.
Pregnancy and breast-feeding
If you are pregnant or breast-feeding, think you might be pregnant or are
planning to have a baby, ask your doctor or pharmacist for advice before
taking this medicine. If you find out you are pregnant, then you should
continue to take your medicine until you have spoken to your doctor for
advice. This is because Epanutin 50 mg Hard Capsules should only be
used during pregnancy, especially early pregnancy, under the advice of
your doctor because it can be harmful to unborn children when taken by
a woman during pregnancy. Do not stop taking your medicine until your
doctor tells you to.
You should not take Epanutin 50 mg Hard Capsules if you are breastfeeding.
Driving and using machines
Epanutin 50 mg Hard Capsules may cause dizziness or drowsiness,
especially during the first few weeks of treatment. If you experience these
symptoms, do not drive or use any tools or machinery.
Epanutin 50 mg Hard Capsules contain lactose, a type of sugar.
If you have been told that you have an intolerance to some sugars,
contact your doctor before taking this medicinal product.
Always take this medicine exactly as your doctor or pharmacist has told
you. Check with your doctor or pharmacist if you are not sure.
It is best to take Epanutin 50 mg Hard Capsules at the same time each
Swallow the capsules whole, with plenty of water.

The amount of Epanutin 50 mg Hard Capsules needed varies from one
person to another. Most adults need between 200 mg and 500 mg a day
either as a single or divided dose. Occasionally higher doses are needed.
Use in children and adolescents
Infants and children usually start on a dose that depends on their weight
(5 mg per day for every kg they weigh) and is given as a divided dose,
twice a day. The dose is then adjusted up to a maximum of 300 mg a
The dose of Epanutin 50 mg Hard Capsules for elderly patients who may
be taking other medicines may also need careful consideration and
adjustment by their doctor.
If you take more Epanutin 50 mg Hard Capsules than you should
Epanutin 50 mg Hard Capsules are dangerous in overdose. If you
accidentally take too much Epanutin 50 mg Hard Capsules contact your
doctor at once or go to the nearest hospital casualty department.
Always take the labelled medicine package with you, whether there are
any Epanutin 50 mg Hard Capsules left or not.
If you forget to take Epanutin 50 mg Hard Capsules
If you forget to take a dose, take it as soon as you remember unless it is
time for your next dose. Do not take a double dose to make up for a
forgotten dose.
If you stop taking Epanutin 50 mg Hard Capsules
Do not stop taking Epanutin 50 mg Hard Capsules unless your doctor
tells you to. If you suddenly stop taking this medicine you may have a
Should you need to stop taking Epanutin 50 mg Hard Capsules, your
doctor will have decided which is the best method for you.
If you have any further questions on the use of this medicine, ask your
doctor or pharmacist.
Like all medicines, this medicine can cause side effects, although not
everybody gets them.
Tell your doctor immediately if you experience any of the following
symptoms after taking this medicine. Although they are very rare, these
symptoms can be serious.

 Effects on your hands, face and body: changes in the hands with
difficulty in straightening the fingers, changes in facial features,
enlarged lips or gums, increased or abnormal body or facial hair.
 Effects on medical tests: increased levels of blood sugar, or
decreased levels of blood calcium, folic acid and vitamin D. If you also
do not get enough vitamin D in your diet or from exposure to sunlight,
you may suffer from bone pain or fractures.
 Effects on your respiratory system: problems breathing,
inflammation of the lining of the lung.
 Effects on your immune system: problems with the body’s defence
against infection, inflammation of the wall of the arteries.
 Effects on your bones: There have been reports of bone disorders
including osteopenia and osteoporosis (thinning of the bone) and
Check with your doctor or pharmacist if you are on long-term
antiepileptic medication, have a history of osteoporosis, or take
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This
includes any possible side effects not listed in this leaflet. You can also
report side effects directly via
By reporting side effects you can help provide more information on the
safety of this medicine.
 Keep out of the sight and reach of children.
 Do not store above 25°C.
 Do not use this medicine after the expiry date which is stated on the
pack. The expiry date refers to the last day of that month.
 Store in the original package in order to protect from light.
 If your capsules become discoloured or show any signs of
deterioration, return them to your pharmacist.
 Medicines should not be disposed of via waste water or household
waste. Ask your pharmacist how to dispose of medicines no longer
required. These measures will help to protect the environment.
What Epanutin 50 mg Hard Capsules contain
The active substance is phenytoin sodium. Each hard capsule contains
50 mg Phenytoin Sodium.

 Sudden wheeziness, difficulty in breathing, swelling of eyelids, face or
lips, rash or itching (especially affecting the whole body).
 If you develop a severe skin rash that causes blistering, (this can also
affect the mouth and tongue). These may be signs of a condition
known as Stevens Johnson Syndrome, or toxic epidermal necrolysis
(TEN). Your doctor will stop your treatment in these cases.
 If you notice bruising, fever, you are looking pale or you have a severe
sore throat. These may be the first signs of an abnormality of the
blood, including decreases in the number of red cells, white cells or
platelets. Your doctor may take regular blood samples to test for these
 Skin rash and fever with swollen glands, particularly in the first two
months of treatment, as these may be signs of a hypersensitivity
reaction. If these are severe and you also experience pain and
inflammation of the joints this could be related to a condition called
systemic lupus erythematosus.
 If you experience confusion or have a severe mental illness, as this
may be a sign that you have high amounts of phenytoin in your blood.
On rare occasions, when the amount of phenytoin in the blood remains
high, irreversible brain injury has occurred. Your doctor may test your
blood to see how much phenytoin is in the blood and may change your

The other ingredients are:
Core: lactose monohydrate, magnesium stearate, sodium laurilsulphate
Shell: gelatin, titanium dioxide (E171), erythrosine (E127) and
quinoline yellow (E104)
Printing ink: shellac, black iron oxide (E172) and propylene glycol.
This medicinal product may also include Potassium Hydroxide.

Other side-effects that may occur are:
 Effects on your nervous system: Unusual eye movements,
unsteadiness, difficulty in controlling movements, shaking, abnormal or
uncoordinated movements, slurred speech, confusion, pins and
needles or numbness, drowsiness, dizziness, vertigo, sleeplessness,
nervousness, twitching muscles, headaches, and taste change.
 Effects on your skin: skin rash including measles-like reactions which
are mild.
 Effects on your stomach and intestines: feeling sick, being sick and
 Effects on your blood and lymph system: swelling of the lymph
 Effects on your liver and kidney: inflammation of the kidneys and
liver, liver damage (seen as yellowing of the skin and whites of the
 Effects on your reproductive system: changes in the shape of the
penis, painful erection.

Repackaged by MPT Pharma Ltd

What Epanutin 50 mg Hard Capsules look like and contents of the
Epanutin 50 mg Hard Capsules are hard gelatin capsules with a white
opaque body and a flesh-coloured cap, radially printed “EPANUTIN 50”
on both the body and cap. The capsules are packed in a white container
which contains a dessicant.
Epanutin 50 mg Hard Capsules are available in packs containing 28
Manufactured by
Pfizer Manufacturing Deutschland GmbH, Betriebsstatte Freiburg,
Mooswaldallee 1, 79090 Freiburg, Germany.
Procured from within the EU by the product licence holder:
MPT Pharma Ltd, Westgate Business Park, Unit 5-7 Tintagel Way,
Aldridge, Walsall WS9 8ER

PL 33532/0502
Leaflet dated 5th September 2016
Leaflet coded xxxxxxxx
Epanutin® is a registered trademark of Parke, Davis & Company LLC,

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Further information

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