|Hep Cured - Seizures Not!
Dec 4, 2007
As mentioned here before, my second go-round with hep treatment was successful. But my latest neurology appointment got me thinking. I've heard that Dilantin can be a bit rough on the liver, while Keppra is less so (or perhaps not at all affective). After having the blessing of HCV being gone, do you think I can wait until Keppra goes generic in April 2010, or would it be worth the expense liver-wise to go back on it now? I also have to consider the 2 1/2 years of added expense vis à vis the other expenses I may incur if my CD4 goes back below 200 again. If not for my disinclination to the brand-name expense, my neurologist would have put me back on Keppra last week.
Response from Dr. McGovern
Dilantin can cause a hypersensitivity syndrome with fever, rash, enlarging lymph nodes and liver injury. This occurs usually within about six weeks. Dilantin may also cause elevations of liver function tests with chronic exposure.
I would have your neurologist speak with your liver specialist to discuss the best management in light of your current situation since I do not know how much liver disease you do have. Although your HCV is cured, it does take time for your liver disease to regress further.
I would also have liver function test monitoring if you do go on Dilantin. This way you can monitor your individual reaction to the medication. Also review the symptoms of drug toxicity with your physician.
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