Is Dilantin Safe During Pregnancy?
Dilantin® (
phenytoin) may not be safe for women who are pregnant. In previous studies involving Dilantin and pregnancy, the drug caused birth defects and other problems.
Dilantin and Pregnancy Category D
The U.S. Food and Drug Administration (FDA) uses a pregnancy category system to classify the possible risks to a fetus when a specific medicine is taken during pregnancy. Pregnancy Category D is a classification given to medicines that have been shown to present a risk to the fetus in studies of pregnant women. A pregnancy Category D medicine may still be given to a pregnant woman if the healthcare provider believes that the benefits to the woman outweigh the possible risks to the unborn child.
Many studies have shown that Dilantin may cause birth defects in humans. Sometimes, these birth defects can be very severe. However, uncontrolled
epilepsy can also be dangerous to both a pregnant woman and the fetus. You and your healthcare provider must discuss the specific benefits and risks of using Dilantin during pregnancy in your particular situation. If your epilepsy is very mild (or if you have not had a
seizure in several years), you may consider stopping Dilantin. However, if your epilepsy is severe or difficult to control, it may be best for you to stay on Dilantin. No matter what, do not stop taking Dilantin suddenly
(see Dilantin Withdrawal).
If you and your healthcare provider decide that it is best for you to continue taking Dilantin, you will need frequent blood tests to measure your Dilantin levels. Pregnancy can affect the way your body handles Dilantin, and it is important to keep your dose at the lowest effective level (to help protect your fetus). Your healthcare provider may suggest a higher-than-usual dose of
folic acid, as this may also help protect the fetus. Also, you may need to take vitamin K during the last part of your pregnancy to protect your baby from vitamin K deficiency.