II. Mechanism

  1. Hydantoin anticonvulsant similar to Phenytoin
  2. Alters Sodium and Calcium Ion influx (repolarization, depolarization) and presynaptic Calcium uptake
  3. Stabilizes Neuronal membranes by inhibiting Neuronal firing and prevents the propagation of Seizure activity within the motor cortex

IV. Contraindications

  1. Pregnancy
  2. Hepatic dysfunction
  3. Hematologic disorders

V. Dosing

  1. Therapeutic Level: 15 to 50 mcg/ml
  2. Adults
    1. Start up to 1000 mg/day divided in 4 to 6 doses after meals
    2. Target: 2000 to 3000 mg/day in divided doses
  3. Children
    1. Start up to 750 mg/day divided in 4 to 6 doses after meals
    2. Target: 500 to 1000 mg/day in divided doses
    3. Maximum: 2000 to 3000 mg/day in divided doses

VI. Metabolism

  1. Hepatic Metabolism

VII. Safety

  1. Pregnancy Category X (Known Teratogen)
    1. See Fetal Hydantoin Syndrome
  2. Unknown Safety in Lactation
    1. Secreted into Breast Milk
  3. Monitoring (periodic recheck)
    1. Complete Blood Count (CBC)
    2. Liver Function Tests
    3. Urinalysis

IX. References

  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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Related Studies

Ontology: Ethotoin (C0015046)

Definition (NCI) A hydantoin anticonvulsant with anti-epileptic activity. The mechanism of action is not completely known, but is thought to be fairly similar to phenytoin. Ethotoin influences synaptic transmission by altering sodium and calcium ion influx across neuronal membranes in the repolarization, depolarization, and membrane stability phase and interferes with the calcium uptake in presynaptic terminals. This inhibits neuronal firing and results in the stabilization of neuronal membranes, thereby preventing the spread of seizure activity at the motor cortex.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C084606
SnomedCT 64463006, 371384002
LNC LP16138-7, MTHU016713
English ethotoin, 2,4-Imidazolidinedione, 3-ethyl-5-phenyl-, 3-ethyl-5-phenyl-2,4-imidazolidinedione, Hydantoin, 3-ethyl-5-phenyl-, ethotoin (medication), ETHOTOIN, ethotoin [Chemical/Ingredient], Ethylphenylhydantoin, Ethotoin (substance), Ethotoin product (product), Ethotoin product, Ethotoin
Spanish etotoína (producto), etotoína, producto (producto), etotoína, producto, etilfenilhidantoína, etotoína (sustancia), etotoína

Ontology: Peganone (C0702073)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C084606
English Peganone, Abbott brand of ethotoin