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Posted by ellen on March 05, 2000 at 09:20:11:

In Reply to: Elevated Dilantin Levels and High Altitude posted by Chuck on February 19, 2000 at 11:53:00:

: Since coming to Colorado about 7 years ago, I noticed that my Dilantin levels had progressively increased.
: I reached high of 2600 on 300 mg/day. When I lived at sea level, my levels were around 1300-1400. While
: attempting to adjust the dosage two years ago, my level dropped to around 850, the lab did not notify me and I
: had a breakthrough seizure. It was the worst one as I was sitting at the computer with my feet up and hit
: the floor smashing my nose. I had asked my wife not to call an ambulance when I had a seizure as we
: would only have to return home on our own. This time the pool of blood was rather large and I awoke to a room full
: of firefighters trying to stop the bleeding and start an IV. I then had a great ride in the back of the Paramedics
: ambulance with the siren going. Last week I phoned Parke Davis and spoke to a pharmacist who said while
: there was no carved in stone research regarding Dilantin and high altitude, he has been asked that question
: before and could only suggest that at lower oxygen levels Dilantin tends not to metabolize as fast. For instance,
: a week and half ago, 8 hours after my 300 mg dose (I take the whole works in the morning) my level was
: 2400. Some days later prior to the morning dose, having been without Dilantin for nearly 28 hours, my level
: was 1340. The only thing I have done on two occasions only is to take only 200 mg on the fourth day of the week.
: Parke Davis told me that my blood should be drawn six days after the last time I took 200 mg. That will be early next
: week and I will report back to the message board. I am also going to L.A. in two weeks where I will have blood
: drawn about 5 or 6 days after arrival to see if the level drops. Parke Davis was interested in that. I would suggest
: that anyone with a Dilantin question call Parke Davis at 1-800-223-0432. Just ask to speak to a pharmacist. A few
: days later a nurse from PD phoned me with further questions and asked if they could do followup.
: My liver profile was drawn also and everything is normal. BTW the ER doc suggested I see a neurologist.
: He also mentioned Neurontin but I am afraid of switching for fear of having seizures. I don't really know what
: to do at this point. Feel free to e-mail me if you like but posting will let everyone keep in touch.

: Chuck

Chuck, your message is very interesting as I always feel extremely tired & weak at altitude. Could that be due to the way Dilantin works at high altitude? Please keep us posted as this is very important.

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