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Using eptoin for seizure disorder. Having fungal infection on thigh, penis and scalp. Using zole ointment. Related?

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I am 28 year old male. I have two queries.
First one: I am under medication for seizure disorder for the last 12 years. I have been using eptoin 100mg three tablets a day. I would like to know if there are any long term permanent side effects of this medicine especially with regard to liver or kidney or heart.

Second Question: I have some kind of fungal infection on my thighs. My doctor suggested Zole ointment. This was 12 or 13 years back. However I did not use it properly and it never went off. Infact it has now spread and I think it covers my penis as the skin on my penis has turned dark and I also have itch on other parts of the body and more recently on the scalp region. I have ignored it for too long and regret it. Is it completely curable now. How many months will it take? Also, is it okay if i apply zole ointment on the part of my body beginning with thighs and penis. Can the infection enter my body and affect the XXXXXXX organs like bladder or kidney through my penis. I find applying ointment tedious as I am never convinced I have applied it on all the affected areas. Please help!
Posted Tue, 21 May 2013 in General Health
Answered by Dr. Satyadeo Choubey 2 hours later

Thanks for your query.

Phenytoin (Eptoin) is relatively safer drug to be prescribed in seizure disorders. Regarding its side effect on chronic use, let me tell use system-wise:

Brain: Can cause nystagmus, Cerebellar atrophy, suicidal tendencies.
Blood: Can cuse anemia due to folic acid deficiency.
Gums: can cause gum hypertrpohy.
Skin: Can cause dermatitis, itching, coarsening of facial structures.
Liver: May exacerbate the preceding liver disease, may lead to hepatitis and liver failure otherwise safe. Special precaution in patients with porphyria.
Diabetes: may increase the sugar level.
Kidney:No major effects.
Heart : may cause rhythm problem. so a word of caution for cardiac problem.

Since you have taken for a longer period and if you have not documented these, continue without hesitation. XXXXXXX your doctor if you feel any of them.

Now your second question
I think you must XXXXXXX a dermatologist to be clear twice that you have got fungal infection. You may try zole ointment and if you get symptomatic improvement, probably you have fungal infection. After this you may also try systemic antifungals like fluconazole.

Fungal infection is quiet common in the area you told. Getting fungal infection on XXXXXXX body parts is less likely, unless you are immunocompromised like having diabetes, AIDS, on steroids etc.

Hopefully answered your query.

Best wishes,

Above answer was peer-reviewed by
Follow-up: Using eptoin for seizure disorder. Having fungal infection on thigh, penis and scalp. Using zole ointment. Related? 2 hours later
Wow, pretty fast and elaborate reply. I really appreciate you taking the time to explain my query. Thank you!

I was suggested to take Folygel capsule along with Eptoin tablet. However, all these years I never bothered with it. I have now started taking it in the last one month. Could you please tell me if there will be any permanent or irreversible damage because of not taking this medication till now? I have started taking it now as I said earlier and will continue taking it till I stop with the Eptoin medication.

If there is any damage due to not taking the medication, can you please tell me if it will be set right as long as I continue taking Folygel from now on?
Answered by Dr. Satyadeo Choubey 18 minutes later
Thanks for follow up,

From what I found, folygel is a folic acid supplement.

Before I proceed to explain can you confirm if you have spelled the medication right. If yes, can you confirm its constituent.

Awaiting your reply...
Above answer was peer-reviewed by
Follow-up: Using eptoin for seizure disorder. Having fungal infection on thigh, penis and scalp. Using zole ointment. Related? 48 minutes later
Yes, it is a folic acid supplement.

Its constituent as given on the strip is :

Folic acid I.P 5mg

Hope that helps!
Answered by Dr. Satyadeo Choubey 59 minutes later
Phenytoin leads to deficiency of folic acid. As I have stated earlier, this may cause anemia and possibly gum hypertrophy. So it is better to go for its supplementation.

Do not be worried; continue the folic acid supplement religiously.

Best wishes
Above answer was peer-reviewed by
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