Phenytoin vs. Dilaudid for Epilepsy and Pain: Important Differences and Potential Risks.

Phenytoin

(Dilantin)

Dilaudid

(hydromorphone)

Summary for Phenytoin

Prescription only

Phenytoin (Dilantin) is an antiepileptic medication used to treat and prevent seizures in adults and children. It comes in a capsule, chewable tablet, and liquid suspension that you take by mouth. The dose depends on your age, weight, and how well your seizures are controlled. Common side effects include trouble with coordination, unpredictable eye movements, and sleepiness. You’ll need regular blood tests to avoid toxicity, which is when the amount of medication in your body is too high and could be dangerous.

Indications for Phenytoin

Treatment of tonic-clonic seizures
Treatment of psychomotor seizures
Prevention and treatment of seizures during and following brain surgery

Pros and Cons for Phenytoin

Pros

Available as a capsule, chewable tablet, and liquid suspension
Dose can be adjusted based on your response
Extended-release capsule can be taken once a day

Cons

Requires regular blood tests to check levels and determine the right dose
Common side effects include unpredictable eye movements and trouble with coordination
Can interact with a lot of other medications

Common Side Effects for Phenytoin

Unpredictable eye movements
Trouble with coordination
Slurred speech
Sleepiness
Confusion

Warnings for Phenytoin

Withdrawal seizures
Suicidal thoughts or behavior
Serious skin and allergic reactions
Heart problems
Liver problems
Lower blood cell count
Effects on Vitamin D and bone
Harm to unborn baby
High blood sugar levels
High phenytoin levels

Summary for Dilaudid

Prescription only

Dilaudid (hydromorphone) is an opioid medication that's used to help with pain when non-opioid medications don't provide enough pain relief. Dilaudid (hydromorphone) is available as pills, liquids, and rectal suppositories. The dosage depends on what form of Dilaudid (hydromorphone) you're using. In addition, some forms are immediate-release that help control sudden pain quickly, but others are extended-release for more long-lasting (chronic) pain. The most common side effects include dizziness, sleepiness, and nausea, among others. Dilaudid (hydromorphone) is available as a brand and generic medication.

Indications for Dilaudid

Pain that isn't relieved by non-opioid medications

Pros and Cons for Dilaudid

Pros

Relieves pain that isn't controlled with non-opioid pain medications
Can help with quick, sudden pain or chronic pain (depending on the form of the medication)
Available in liquid form and rectal suppositories for people who have trouble swallowing pills
Available as a lower-cost generic version

Cons

Can commonly cause constipation
Risk of dependence and tolerance with long-term use
Must slowly lower the dose before stopping if you've been taking for a long time to prevent bothersome side effects and uncontrolled pain
A controlled substance, so there are special requirements to get a prescription filled (highly regulated by the federal government because of risk of misuse)