Prescription medication · Anticonvulsant (Hydantoin)

phenytoin

Also sold as Dilantin. This medicine treats generalized tonic-clonic status epilepticus, a type of prolonged seizure.

Data updated 2026-05-15

20,453
FDA reportsModerately reported
147
InteractionsMany interactions
$1.61
Generic price (NADAC)

What the data shows

phenytoin (Dilantin) is a prescription Anticonvulsant (Hydantoin), reported at a middle-of-the-pack volume (20,453 FDA reports), with 147 documented drug interactions.

Reporting volume reflects how widely a drug is used and studied, not how dangerous it is, a FAERS report documents a temporal association, never proof of cause.

phenytoin (Dilantin) is a prescription Anticonvulsant (Hydantoin). This medicine treats generalized tonic-clonic status epilepticus, a type of prolonged seizure.

Phenytoin injection is used to treat certain types of seizures. It can also prevent seizures during or after neurosurgery.

Drug Pricing (NADAC)

Generic Price

$1.61/unit

Generic Available

Yes (13 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

Compare with Another Drug → Full Side Effects Report →

What it does

This medicine treats generalized tonic-clonic status epilepticus, a type of prolonged seizure.

Common side effects

No common side effects listed.

Key warnings

This medicine can cause serious heart problems if given too quickly.

The sections below are summarized in plain English from phenytoin's FDA-approved prescribing information. They describe what the official label says, and are not personal medical advice.

How It Works

Phenytoin works by slowing down the signals in the brain that cause seizures. It stabilizes nerve cell membranes, reducing excessive electrical activity. This helps to prevent seizures from starting or spreading.

Side Effects (from patient reports)

Based on 20,453 FDA adverse event reports.

Most-reported reactions

Adverse reactions in FAERS for phenytoin, by number of reports

reports

What this shows Bars show how often each reaction was reported, not how likely it is to happen, a report records a temporal association, never proof that the drug caused it.

Source FDA Adverse Event Reporting System (FAERS) As of 2025

Reports over time

Adverse-event reports filed for phenytoin each year to the FDA Adverse Event Reporting System (FAERS).

2004006008001,0001,2001,400 20042007201020132016201920222025 863

Year-to-year volume tracks usage, prescribing, and scrutiny, not a change in per-patient risk. Source: FDA FAERS.

Where phenytoin sits

phenytoin has more FDA adverse-event reports than 55% of the drugs FAERS tracks. A high position reflects how widely a drug is used and watched, not how dangerous it is.

fewest reports most reports

Percentile across all drugs PlainMeds tracks by FAERS report volume. The dot is phenytoin; the line is the median (50th percentile).

FDA Adverse Event Report Analysis

Detailed analysis of 20,453 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

20,453

Reports Mentioning Death

2,949

14.4% of reports — not proof of cause

Hospitalization Reports

8,381

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 8,573 (48%)
Male 9,243 (51%)

Age Distribution

0–17 2,264
18–44 4,572
45–64 4,394
65–74 1,955
75+ 1,394

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
2 DRUG INTERACTION 1,547
3 SEIZURE 1,382
4 TOXICITY TO VARIOUS AGENTS 1,353
5 CONVULSION 1,262
7 STATUS EPILEPTICUS 791
8 STEVENS-JOHNSON SYNDROME 770
9 PYREXIA 683
10 FALL 609
11 DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS 600
12 DIZZINESS 597
13 CONDITION AGGRAVATED 556
14 SOMNOLENCE 537
15 EPILEPSY 525
16 CONFUSIONAL STATE 520
17 VOMITING 520

Reactions in Death Reports

DEATH 364
COMPLETED SUICIDE 358
CARDIAC ARREST 237
TOXICITY TO VARIOUS AGENTS 236
SEPSIS 202
STATUS EPILEPTICUS 137
DRUG INTERACTION 130
TOXIC EPIDERMAL NECROLYSIS 130
PNEUMONIA 126
HYPOTENSION 120

Reactions in Hospitalization Reports

DRUG INTERACTION 848
TOXICITY TO VARIOUS AGENTS 813
SEIZURE 532
CONVULSION 468
PYREXIA 467
STATUS EPILEPTICUS 446
STEVENS-JOHNSON SYNDROME 430
FALL 413
DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS 390
CONFUSIONAL STATE 366

Source: FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

This medicine can cause serious heart problems if given too quickly. The injection rate should not be faster than 50 mg per minute for adults, and 1 to 3 mg/kg/min (or 50 mg per minute, whichever is slower) for children. Your heart will be monitored closely during and after the injection.

Known Drug Interactions

Anticonvulsants carbamazepine , phenobarbital, primidone, phenytoin ↓ nirmatrelvir/ritonavir Co-administration contraindicated due to potential loss of virologic response and possible resistance [see Contraindications (4) ] .

Mechanism: Phenytoin makes the body get rid of the antiviral medicine too quickly. This prevents the drug from working properly and could allow the virus to become harder to treat.

Interaction Drug Interaction Rifabutin, phenytoin, efavirenz, cimetidine, esomeprazole* Avoid coadministration unless the benefit outweighs the risks ( 7.6 , 7.7 , 7.8 , 7.9 ) Other drugs metabolized by CYP3A4 Consider dosage adjustment and monitor for adverse effects and toxicity ( 7.1 , 7.10 , 7.11 ) Digoxin Monitor digoxin plasma concentrations ( 7.12 ) Fosamprenavir, metoclopramide* Monitor for breakthrough fungal infections ( 7.6 , 7.13 ) *The drug interactions with esomeprazole and metoclopramide do not apply to posaconazole tablets. 7.8 Phenytoin Phenytoin induces UDP-glucuronidase...

Mechanism: Phenytoin causes the body to break down posaconazole much faster than usual, which can make the antifungal medicine less effective.

CYP3A Inducers Do not use ranolazine with CYP3A inducers such as rifampin, rifabutin, rifapentine, phenobarbital, phenytoin, carbamazepine, and St.

Mechanism: Phenytoin makes your body clear ranolazine much faster than it should, which lowers the drug's effectiveness.

Carbamazepine (CYP450 Induction) Not Studied In Vivo or In Vitro , but Likely to Result in Significant Reduction Contraindicated Long Acting Barbiturates (e.g., phenobarbital, mephobarbital) (CYP450 Induction) Not Studied In Vivo or In Vitro , but Likely to Result in Significant Reduction Contraindicated Phenytoin (CYP450 Induction) Significantly Reduced Increase voriconazole maintenance dose from 4 mg/kg to 5 mg/kg IV every 12 hours or from 200 mg to 400 mg orally every 12 hours (100 mg to 200 mg orally every 12 hours in patients weighing less than 40 kg). Phenytoin (CYP2C9 Inhibition)...

Mechanism: Phenytoin speeds up how fast the body gets rid of voriconazole, while voriconazole slows down the breakdown of phenytoin. This means the antifungal may not work well, and the seizure medicine could reach toxic levels.

moderate apixaban

7.2 Combined P-gp Strong CYP3A4 Inducers Avoid concomitant use of apixaban tablets with combined P-gp and strong CYP3A4 Inducers (e.g., rifampin, carbamazepine, phenytoin, St.

Mechanism: Phenytoin causes your body to get rid of apixaban much faster than it should. This means the medicine may not work well enough to stop blood clots from forming.

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This is a plain-language summary of FDA-label interaction records and does not provide individual medication-combination directions.

Common Questions

What should I tell my doctor before taking phenytoin?
Tell your doctor if you are allergic to phenytoin or any other hydantoins. Also, tell them if you have heart problems or liver disease.
Can I take phenytoin with other medicines?
Phenytoin can interact with many other medicines. Tell your doctor about all the medicines you take, including prescription and over-the-counter drugs, vitamins, and herbal supplements.
What are the signs of an allergic reaction to phenytoin?
Signs of an allergic reaction may include rash, hives, itching, swelling, trouble breathing, or wheezing. Seek medical attention right away if you experience any of these symptoms.
Will phenytoin cure my seizures?
Phenytoin helps control seizures, but it may not cure the underlying condition that causes them. You may need to take this medicine for a long time to manage your seizures.
Can I drink alcohol while taking phenytoin?
Drinking alcohol can change the level of phenytoin in your blood and may increase side effects. Talk to your doctor about whether it is safe for you to drink alcohol while taking this medicine.
What happens if I stop taking phenytoin suddenly?
Stopping phenytoin suddenly can increase the frequency of your seizures or cause status epilepticus. Talk to your doctor before stopping this medicine.
Does phenytoin affect birth control?
Phenytoin can make some birth control pills less effective. Talk to your doctor about other forms of birth control you can use while taking phenytoin.
Can phenytoin cause gum overgrowth?
Yes, phenytoin can cause gum overgrowth (gingival hyperplasia). Good oral hygiene can help prevent this. Talk to your dentist about how to care for your teeth and gums while taking phenytoin.
Will phenytoin affect my ability to drive or operate machinery?
Phenytoin can cause drowsiness or dizziness. Do not drive or operate machinery until you know how this medicine affects you.
How often will I need blood tests while taking phenytoin?
Your doctor will order blood tests to monitor the level of phenytoin in your blood and check for side effects. Follow your doctor's instructions about when to get blood tests.
Does phenytoin interact with other medications?
The registry has 147 documented interaction rows for phenytoin. Notable source-record pairings include nirmatrelvir/ritonavir, posaconazole, ranolazine. These rows are not a complete medication review.
What drug class is phenytoin?
phenytoin belongs to the Anticonvulsant (Hydantoin) drug class. It requires a prescription (Rx). This medicine treats generalized tonic-clonic status epilepticus, a type of prolonged seizure.
What pregnancy or breastfeeding source fields are listed for phenytoin?
The FDA label for phenytoin contains product-specific pregnancy or breastfeeding language. PlainMeds does not apply that source text to an individual.

Other drugs grouped near phenytoin - same-class peers and common alternatives.

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Compare beyond drug class

Nationwide peers by FAERS volume & death-report share

Two PlainMeds-derived comparison paths for phenytoin: nearest FDA FAERS report volume and nearest death-report share among drugs with at least 1,000 logged reports, excluding same-class neighbors listed above. Counts reflect reporting volume, not proven individual harm.

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What the FDA Data Shows for phenytoin

The FDA label for phenytoin (sold under brand names such as Dilantin) classifies it as a prescription-only medication in the Anticonvulsant (Hydantoin) class. This medicine treats generalized tonic-clonic status epilepticus, a type of prolonged seizure. Labeling covers dosing, contraindications, and monitoring requirements derived from clinical trials.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 20,453 voluntary reports. The database also lists 147 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $1.61.

Report counts do not establish causation, a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information are separate source-record fields. This page is a public FDA/CMS registry and does not provide medical, treatment, substitution, or medication-change directions.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. This registry does not provide medication decisions.

Last updated: April 9, 2024

PlainMeds is rendered directly from FDA openFDA/FAERS extracts, DailyMed labels, and CMS drug-pricing files, no number is typed in by an editor. FAERS counts, recalls, shortages, and price figures on this page are queried live from those federal extracts. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of 2026-05-15. Primary sources: openFDA / FAERS, DailyMed and CMS Part B ASP.

Data currency: FDA FAERS adverse-event reports through 2025, CMS NADAC acquisition-cost pricing effective December 2024, compiled from the source snapshot dated . See our methodology for per-source dates and refresh cadence. Spot a figure that looks wrong? Report a data issue.

All federal data sources used on this page