Ethotoin (Peganone): Anticonvulsant for Epilepsy – Uses, Mechanism, Side Effects

Ethotoin (Peganone) is a hydantoin anticonvulsant, structurally related to phenytoin, used for:

• Generalized tonic-clonic (grand mal) seizures
• Complex partial (temporal lobe) seizures

Mechanism

Stabilizes neuronal membranes by enhancing GABAergic inhibition and limiting repetitive firing. Less gum hyperplasia than phenytoin.

Dosing & Monitoring

• Individualized by age, weight, response
• Therapeutic drug monitoring recommended
• Oral administration

Side Effects

Common: drowsiness, dizziness, nausea, vomiting, headache, tremor.
Rare but serious: Stevens-Johnson syndrome, hepatotoxicity, blood dyscrasias.

Pregnancy

Category D – teratogenic risk; avoid unless benefits outweigh risks. Counsel women of childbearing potential.

Summary

Effective second-line option with favorable cosmetic profile; requires monitoring.