[wildhorses353]

Does anyone take this med? Have you tried to fill an rx just lately? I have been on this med for 40 years. Recently when I went to fill my rx I noticed that the actual pill was completely different. The pills I have always taken were white with an orange band. Now these pills are half white and half orange. They are made by Pfizer. Did anyone else get different pills when trying to get a refill for this rx? I called Pfizer to ask them if this med is exactly the same and they did not tell me yes or no. They said someone will call me back. I thought that was strange. And I dont see why they should change the way the pill looks. Any other dilantin users have this experience? If so, what is your take on it?

[schultz]

Have you contacted your pharmacy about this? They will tell you if the medication has been changed as for as the way it looks. I don't know why but some companies do change the way medication looks. My husband was on blood pressure medication and they changed the looks of the medication. He waited a whole weekend before he could get back to the pharmacist to see if he had the correct med. Hope you find the answer out soon. I know you should not be without medication for seizures because I am epileptic also.

[nitelite]

well I have found out that the contents of the new dilanin capsule have not changed...just the shell of the capsule. I am still trying to find out if that will affect the dissolution of the medication. for this med that is very important in maintaining a therapeutic blood level. two people on other message boards have already started taking the new med within the last few days and so far are doing ok. but it has only been a few days so we will have to see. if anyone knows or finds out how the change in ingredients in the capsule shell might affect how the med works in the body...please post it here. bbl

[nitelite]

I found this article on the new dilantin capsule. At the end of the article it addresses the absorption of the new dilantin versus the old dilantin.

http://www.epilepsy.com/articles/ar_1193933450.html

Medication alert – Dilantin® 100 mg. Capsules:
What Every Person Using This Medication Needs to Know

By Rita Watson, MPH

Dilantin 100 mg capsules are undergoing a transformation. According to Pfizer, the Food and Drug Administration approved manufacturing changes for Dilantin® (phenytoin sodium). Given this change, which was noted in a September 23, 2007, letter to some pharmacists at the corporate level, we have compiled the following information about:

The product itself
Availability for those who use it

How this change may affect patients in terms of seizure control and side effects
To prepare this article, we talked with media relations at Pfizer, visited various pharmacies in Massachusetts and Rhode Island and spoke with Patty Schafer, RN, MN, the epilepsy.com Resource Specialist, and Barry Gidal, PharmD, at the University of Wisconsin-Madison, and member of the epilepsy.com editorial board.

The new Dilantin

Dilantin® 100 mg extended oral capsules (half orange and half white) are now being manufactured and will replace Dilantin Kapseal® 100 mg. – white with an orange band in the center — which are being discontinued.
The notice from Pfizer can be viewed at http://professionals.epilepsy.com/pdfs/PFZ_DIL_173_LetterPH_D01.pdf
The medication sheet at www.epilepsy.com has been updated and can be viewed at http://www.epilepsy.com/pdfs_med/epilepsy_phenytoin.pdf

Jack Cox of Pfizer Media Relations told epilepsy.com “Pfizer did not increase the price with this change.” (However, we are looking into anecdotal reports from pharmacies and patients that are telling us that patient co-pays may be higher.)

Availability of the new Dilantin

Some pharmacies ran out of the original Dilantin and had the new Dilantin on back order. This shortage is expected to be temporary for these pharmacies and the new Dilantin can be drop shipped within a week.

Mike DeAngelis, director of public relations for CVS Pharmacy told epilepsy.com “Our pharmacies will continue to dispense [Dilantin Kapseals] until our inventory is depleted and Pfizer will replenish our supply with the new version. Our customers will receive messaging on their prescription bags explaining the change in appearance.”

This change does not affect the generic versions of Dilantin®, called phenytoin, that are available, nor the 30 mg Dilantin Kapseal.

How this change may affect patients in terms of seizure control and side effects

Patty Shafer said, “We want to encourage users to be proactive. Here are some steps they may want to follow if they are using brand Dilantin:

Talk to pharmacists before refills are due.

Make certain the pharmacy has ordered the new formulation.
Inform the prescribing physician if the pharmacy is not able to get the new Dilantin and in its place the pharmacy gives you a generic version (phenytoin). It is important to be aware that some people have reported changes in seizures and side effects when changing from a brand to generic or from generic to brand. As such, always keep the physician in the loop.

Barry Gidal said, “We don’t have a lot of information from Pfizer regarding why this formulation occurred, or exactly what, if any changes in absorption we can expect with the ‘new’ Dilantin. It is important that patients recognize there is a change in appearance in the medication. In the short term, this may cause some confusion.”

“As for how the ‘old’ Dilantin and the ‘new’ Dilantin compare with respect to absorption; there is again very little information available from Pfizer. The information that is available suggests that the two formulations are bioequivalent according to FDA standards, with perhaps the new formulation actually being slightly better absorbed, at least when taken on an empty stomach.”

He added, “Until we know more specifics, it would seem prudent that patients note when they begin taking the new formulation, and if they experience any change in either side effects or seizure frequency they should contact their physician.”

Edited by Steven C. Schachter, MD
Submitted: 11/01/07

[mvi222]

Like yourself I have been taking Dilantin Kapseals for about 40 years and am controled. I received a letter from Kaiser last week saying Kapseals were no longer being made (half-truth)and I would be switched to a generic version. All my research revealed the generic does not absorb into the system at the same rate and studies report an increase of siezures and side effects. Kaiser's letter states "safe and effective" which is causing me great stress. As well, all advice from my neurologists over the years has been to avoid the generic version. I don't understand why obsorbtion rates have not been made available on the new Dilantin. If anyone has had experience with the generic version please let me know. Thanks.

[nitelite]

I have also always heard that switching to generic is problematic. To the best of my understanding, part of the problem is that when you are on a generic you can be receiving different brands of generic from time to time. And each different brand could be slightly different from the last one. From what I understand so far the new Dilantin brand capsule has a slightly better absorption rate than the kapseals. That could be a good thing unless you are on a really high dose. But when it comes to generic it can go either way. If I were forced onto a generic I would at least try to get the generic from the same manufacturer each time. Another thing I might try is to get the Dilantin brand....even though it is new and there might be a copay to get the brand name. At least if you are on Dilantin brand name then you will get the same med every time. Keep us posted on what you do because we are all scared too and are trying to decide what to do. Best of luck.

[DebAngel]

I have been on dilantin 25 years, when the generic was first released I received it in a refill I took it not realizing it was not dilantin and I did not feel the same and immediately went back to dilantin. Has your doctor made any comments about changing medication? I recently saw a neurologist for the first time in 15 years I passed out and am still not sure if it was a sezuire or just lack of sleep, eating and stressful job. This doctor said 25yrs was too long to be on dilanitn and there are many new drugs that are better. Has anyone been told the same?

[karensims7]

Subject: New Dilantin pills

My name is Karen. The night before last I took the last of my Dilantin medicine and went to open
a new bottle. Sure enough, half of the pill was orange and half of the pill was white. I almost had a fit because I though that my physician had ordered the wrong medicine. I contacted a Blue Cross and Blue Shield nurse who really did not help. She came to the conclusion that they had sent me the generic form of Dilantin. The next day I went to my pharmacy where I was informed that the company had decided to change the appearance of the drug. I hope that is all it is. I noticed that both bottles have approximately the same words, just rearranged. However, if anyone knows anymore then I do, please share.