Drug information of ethotoin


Drug group: Anticonvulsants

Ethotoin is an anti-epileptic medicine, also called an anticonvulsant.

Ethotoin is used alone or in combination with other medicines to treat seizures in adults and children who are at least 1 year old

Mechanism of effect

Stabilizes the seizure threshold and prevents the spread of seizure activity


Saturable, hepatic; forms metabolites; the relationship between dose and ethotoin and metabolite concentrations is non-linear.
Urine (Naestoft 1976
Half-Life Elimination
 to 9 hours

Drug indications

Seizures: Control of generalized tonic-clonic (grand mal) and complex-partial (psychomotor) seizures


Seizures: Oral: Initial: ≤1 g/day, in 4 to 6 divided doses; increase dose over a period of several days; usual maintenance: 2 to 3 g/day.
Refer to adult dosing; use with caution.
Seizures: Children ≥1 year and Adolescents: Oral: Initial: ≤750 mg/day, in 4 to 6 divided doses; usual maintenance: 0.5 to 1 g/day; maximum: 3 g/day

Drug contraindications

Hepatic abnormalities; hematologic disorders

Side effects

Frequency not defined.
Cardiovascular: Chest pain
Central nervous system: Ataxia, dizziness, fatigue, headache, insomnia, numbness
Dermatologic: Skin rash, Stevens-Johnson syndrome
Gastrointestinal: Diarrhea, gingival hyperplasia, nausea, vomiting
Hematologic & oncologic: Hematologic disease, lymphadenopathy
Neuromuscular & skeletal: Lupus-like syndrome
Ophthalmic: Diplopia, nystagmus
Miscellaneous: Fever

Alcohol (Ethyl), Alizapride, Azelastine (Nasal), Blonanserin, Brexanolone, Brimonidine (Topical),
Bromopride, Buprenorphine, Cannabidiol, Cannabis, Chlormethiazole, Chlorphenesin Carbamate, CNS Depressants, Dimethindene (Topical), Doxylamine, Dronabinol, Droperidol,
Esketamine, Flunitrazepam, HydrOXYzine, Kava Kava, Lemborexant, Lisuride, Lofexidine,
Magnesium Sulfate, Mefloquine, Methotrimeprazine, Metoclopramide, MetyroSINE, Mianserin, Minocycline (Systemic), Nabilone, Opioid Agonists, Orlistat, Orphenadrine,
Oxomemazine, Oxybate Salt Products, OxyCODONE, Paraldehyde, Perampanel, Piribedil,
Pramipexole, ROPINIRole, Rotigotine, Rufinamide, Suvorexant, Tetrahydrocannabinol,
Tetrahydrocannabinol and Cannabidiol, Thalidomide, Trimeprazine, Vitamin K Antagonists (eg, warfarin), Zolpidem


Blood dyscrasias: Have been reported with use; patients with a previous history of adverse hematologic reaction to any drug may be at increased risk. Early detection of hematologic change is important; advise patients of early signs and symptoms including fever, sore throat, mouth ulcers, infections, easy bruising, petechial or purpuric hemorrhage. Discontinue therapy in patients with decreased blood counts. Hydantoin-like compounds may interfere with folic acid metabolism precipitating megaloblastic anemia. Contraindicated in patients with hematologic disorders

Suicidal ideation: Pooled analysis of trials involving various antiepileptics (regardless of indication) showed an increased risk of suicidal thoughts/behavior (incidence rate: 0.43% treated patients compared to 0.24% of patients receiving placebo); risk observed as early as 1 week after initiation and continued through duration of trials (most trials ≤24 weeks). Monitor all patients for notable changes in behavior that might indicate suicidal thoughts or depression; notify healthcare provider immediately if symptoms occur

Do not discontinue anticonvulsants abruptly because of the possibility of increasing seizure frequency; withdraw therapy gradually to minimize the potential of increased seizure frequency, unless safety concerns require a more rapid withdrawal

Points of recommendation

You should not use ethotoin if you have liver disease or a blood cell disorder (such as anemia, hemophilia, and others

You should not use ethotoin if you are allergic to ethotoin or if you have:
liver disease
a blood cell disorder (such as anemia, hemophilia, and others

To make sure ethotoin is safe for you, tell your doctor if you have:
mood problems, depression
a history of suicidal thoughts or actions
folic acid (or folate) deficiency
if you take a blood thinner (warfarin, Coumadin, Jantoven

If you switch to ethotoin from taking another anti-epileptic medicine, do not stop taking the other medicine without your doctor's advice. Carefully follow your doctor's instructions about timing and dosage when switching from one seizure medicine to another

Seizures are sometimes treated with a combination of drugs. Use all medicines as directed by your doctor. Read the medication guide or patient instructions provided with each medicine. Do not change your doses or medication schedule without your doctor's advice

Take ethotoin after eating. Take your doses at regular intervals to keep a steady amount of the drug in your body at all times

If a child is taking this medicine, tell your doctor if the child has any changes in weight. Ethotoin doses are based on weight in children

Ethotoin can lower blood cells that help your body fight infections and help your blood to clot. You may get an infection or bleed more easily. Call your doctor if you have unusual bruising or bleeding, or signs of infection (fever, chills, sore throat

While using ethotoin, you may need frequent blood and urine tests

Do not stop using ethotoin suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose

Wear a medical alert tag or carry an ID card stating that you take ethotoin. Any medical care provider who treats you should know that you take seizure medicine

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use

Pregnancy level


FDA pregnancy category D. Do not start or stop taking ethotoin during pregnancy without your doctor's advice. Seizure control is very important during pregnancy. Ethotoin may cause harm to an unborn baby, but having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant while taking ethotoin for seizures

Breast feeding warning

Ethotoin can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine

Drug forms


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