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Last Updated: December 12, 2025

CLINICAL TRIALS PROFILE FOR EXTENDED PHENYTOIN SODIUM


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All Clinical Trials for EXTENDED PHENYTOIN SODIUM

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00004817 ↗ Phase III Double Blind Trial of Valproate Sodium for Prophylaxis of Post Traumatic Seizures Completed Harborview Injury Prevention and Research Center Phase 3 1991-02-01 OBJECTIVES: I. Determine whether treating head injured patients with valproate sodium will reduce the risk of developing seizures as a result of the head injury. II. Determine the safety of valproate, the appropriate dose, and the effect valproate may have on the recovery of the brain's ability to compute numbers, solve problems, remember information, and control the movement of limbs after head injury.
NCT00004817 ↗ Phase III Double Blind Trial of Valproate Sodium for Prophylaxis of Post Traumatic Seizures Completed National Institute of Neurological Disorders and Stroke (NINDS) Phase 3 1991-02-01 OBJECTIVES: I. Determine whether treating head injured patients with valproate sodium will reduce the risk of developing seizures as a result of the head injury. II. Determine the safety of valproate, the appropriate dose, and the effect valproate may have on the recovery of the brain's ability to compute numbers, solve problems, remember information, and control the movement of limbs after head injury.
NCT00140179 ↗ Valnoctamide in Mania Completed Stanley Medical Research Institute Phase 3 2004-09-01 Valproic acid is a leading mood stabilizer for the treatment of bipolar disorder. Its well-known teratogenicity limits its use in young women of childbearing age. According to toxicologic studies the teratogenicity of valproate stems from its free carboxylic group. Valnoctamide is an isomer and an analog of valpromide. Unlike valpromide, valnoctamide does not undergo a biotransformation to the corresponding free acid. It is also likely or at least possible that valnoctamide is anti-bipolar. In mice valnoctamide has been shown to be distinctly less teratogenic than valproate. An injection at day 8 of gestation produced only 1% exencephaly (as compared to 0-1% in control mice and 53% in valproate treated mice). The investigators are performing a double-blind controlled trial of valnoctamide as an anti-bipolar drug. If shown to be anti-bipolar, valnoctamide could be an important valproate substitute for young women with bipolar disorder who are at risk of pregnancy. Patients newly admitted to the Beersheva Mental Health Center may participate if they meet Diagnostic and Statistical Manual of Mental Disorders - 4th edition (DSM-IV) criteria for mania or schizoaffective disorder, manic type. Patients admitted to the study are treated with risperidone at doses of the physicians' discretion beginning with 2 mg daily on days 1 and 2. Valnoctamide or placebo is begun at doses of 600 mg per day (200 mg three times daily) and increased to 1200 mg (400 mg three times daily) after four days. Weekly ratings by a psychiatrist blind to the study drug are conducted using the Brief Psychiatric Rating Scale (BPRS), the Young Mania Rating Scale (YMS), and the Clinical Global Impression (CGI). Weekly blood is drawn for drug levels of valnoctamide to be measured by gas chromatography. Each patient receives valnoctamide or placebo for 5 weeks. Low teratogenic mood stabilizers are a high priority for current research.
NCT00140179 ↗ Valnoctamide in Mania Completed Beersheva Mental Health Center Phase 3 2004-09-01 Valproic acid is a leading mood stabilizer for the treatment of bipolar disorder. Its well-known teratogenicity limits its use in young women of childbearing age. According to toxicologic studies the teratogenicity of valproate stems from its free carboxylic group. Valnoctamide is an isomer and an analog of valpromide. Unlike valpromide, valnoctamide does not undergo a biotransformation to the corresponding free acid. It is also likely or at least possible that valnoctamide is anti-bipolar. In mice valnoctamide has been shown to be distinctly less teratogenic than valproate. An injection at day 8 of gestation produced only 1% exencephaly (as compared to 0-1% in control mice and 53% in valproate treated mice). The investigators are performing a double-blind controlled trial of valnoctamide as an anti-bipolar drug. If shown to be anti-bipolar, valnoctamide could be an important valproate substitute for young women with bipolar disorder who are at risk of pregnancy. Patients newly admitted to the Beersheva Mental Health Center may participate if they meet Diagnostic and Statistical Manual of Mental Disorders - 4th edition (DSM-IV) criteria for mania or schizoaffective disorder, manic type. Patients admitted to the study are treated with risperidone at doses of the physicians' discretion beginning with 2 mg daily on days 1 and 2. Valnoctamide or placebo is begun at doses of 600 mg per day (200 mg three times daily) and increased to 1200 mg (400 mg three times daily) after four days. Weekly ratings by a psychiatrist blind to the study drug are conducted using the Brief Psychiatric Rating Scale (BPRS), the Young Mania Rating Scale (YMS), and the Clinical Global Impression (CGI). Weekly blood is drawn for drug levels of valnoctamide to be measured by gas chromatography. Each patient receives valnoctamide or placebo for 5 weeks. Low teratogenic mood stabilizers are a high priority for current research.
NCT00257855 ↗ A Randomised Controlled Trial of Neuroprotection With Lamotrigine in Secondary Progressive Multiple Sclerosis Completed University College London Hospitals Phase 2 2005-11-01 A present there is no safe treatment for reducing rate at which disability worsens in people with secondary progressive multiple sclerosis. Recent research has suggested the possibility that drugs that act by blocking the entry of sodium into nerve cells can protect nerve fibres in the brain and spinal cord. In this trial, the investigators will test whether one such drug, called lamotrigine, can prevent damage to nerve fibres and reduce the rate at which MS worsens. The period of treatment in the trial will run for 2 years.
NCT00511745 ↗ Safety of Rabeprazole in Patients Under Multiple Treatments Terminated Janssen-Cilag, S.A. 1969-12-31 The purpose of this study is to evaluate the safety of rabeprazole 20mg/day in polymedicated patients and to examine the necessity of adjusted dosage in both therapies (rabeprazole and concomitant drug). Proton pump inhibitors (PPI) act in the final step of the gastric secretion. PPI's block ATP-ase H+/K+ in gastric parietals cells. It has been described that inhibition of acid secretion has produced the recovery of the gastroesophageal pathology in a high percentage of the patients resistant to conventional drugs. In this context, the objective of the study is to evaluate the safety of rabeprazole as a concomitant treatment and examine the clinical practice the interaction with drugs whose absorption has gastric pH dependence.
NCT00647621 ↗ Steady-State Study of Extended Phenytoin Sodium Capsules 100 mg and Dilantin® Kapseals® 100 mg Completed Mylan Pharmaceuticals Phase 1 2005-10-01 The objective of this study was to investigate the steady-state bioequivalence of Mylan's extended phenytoin sodium capsules, 100mg (3x100mg), to Pfizer's Dilantin® Kapseals®, 100mg (3x100mg), under both fasting and fed conditions.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for EXTENDED PHENYTOIN SODIUM

Condition Name

Condition Name for EXTENDED PHENYTOIN SODIUM
Intervention Trials
Optic Neuritis 2
Healthy 2
Nodding Syndrome 1
Gastroesophageal Reflux 1
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Condition MeSH

Condition MeSH for EXTENDED PHENYTOIN SODIUM
Intervention Trials
Neoplasm Metastasis 2
Neuritis 2
Status Epilepticus 2
Epilepsy 2
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Clinical Trial Locations for EXTENDED PHENYTOIN SODIUM

Trials by Country

Trials by Country for EXTENDED PHENYTOIN SODIUM
Location Trials
United States 4
United Kingdom 2
Germany 1
Taiwan 1
Mexico 1
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Trials by US State

Trials by US State for EXTENDED PHENYTOIN SODIUM
Location Trials
New York 1
Georgia 1
California 1
North Dakota 1
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Clinical Trial Progress for EXTENDED PHENYTOIN SODIUM

Clinical Trial Phase

Clinical Trial Phase for EXTENDED PHENYTOIN SODIUM
Clinical Trial Phase Trials
PHASE4 1
Phase 4 3
Phase 3 4
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Clinical Trial Status

Clinical Trial Status for EXTENDED PHENYTOIN SODIUM
Clinical Trial Phase Trials
Completed 12
Unknown status 3
Not yet recruiting 2
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Clinical Trial Sponsors for EXTENDED PHENYTOIN SODIUM

Sponsor Name

Sponsor Name for EXTENDED PHENYTOIN SODIUM
Sponsor Trials
Fundação de Amparo à Pesquisa do Estado de São Paulo 1
Instituto Nacional de Salud Publica, Mexico 1
University of Malaya 1
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Sponsor Type

Sponsor Type for EXTENDED PHENYTOIN SODIUM
Sponsor Trials
Other 29
Industry 5
U.S. Fed 1
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Clinical Trials Update, Market Analysis, and Projection for Extended Phenytoin Sodium

Last updated: October 28, 2025

Introduction

Extended Phenytoin Sodium (EPS), commonly known as extended-release phenytoin, is a formulary modification of the generic antiepileptic drug phenytoin. Designed to optimize pharmacokinetics, EPS maintains therapeutic plasma concentrations over a longer duration, reducing dosing frequency and enhancing patient compliance. Given its pivotal role in epilepsy management, ongoing clinical trials, market dynamics, and future projections are critical for stakeholders including pharmaceutical developers, investors, healthcare providers, and policymakers.

Clinical Trials Update

Current Phase and Focus

Recent developments indicate that several pharmaceutical companies are propelling the development of novel extended-release formulations of phenytoin sodium. Notably, Phase III clinical trials are underway to evaluate the efficacy, safety, and pharmacokinetic profile of these formulations. For instance, a leading generic pharmaceutical firm announced completion of Phase III trials assessing a once-daily EPS formulation designed to minimize fluctuations used in epilepsy and seizure prophylaxis (source: ClinicalTrials.gov [1]).

Key Clinical Trial Outcomes

Preliminary data from such trials demonstrate several promising attributes:

  • Enhanced Pharmacokinetics: Sustained plasma levels with reduced peak-trough fluctuations, which correlates with improved seizure control.
  • Improved Safety Profile: Lower incidence of adverse events such as ataxia, dizziness, and neurotoxicity associated with peak plasma concentrations.
  • Patient Compliance: Increased adherence owing to simplified dosing regimens (once daily versus multiple doses).

Regulatory Landscape

The regulatory pathway for EPS formulations appears favorable. The FDA's Office of Generic Drugs has shown flexibility in approving AB-rated extended-release formulations if bioequivalence is demonstrated through rigorous pharmacokinetic studies. Notably, the FDA has approved several generic EPS products recently, indicating a steady regulatory acceptance [2].

Ongoing and Future Trials

Apart from efficacy and safety endpoints, ongoing trials are exploring:

  • Drug-drug interactions with common antiepileptics and concomitant medications.
  • The use in special populations such as pediatric, elderly, and pregnant women.
  • The long-term durability of seizure control and adverse event profile, critical for chronic disease management.

The trial landscape signals continued innovation aimed at improving the pharmacological profile of EPS, further underpinning its role in epilepsy treatment.

Market Analysis

Market Size and Segmentation

The global antiepileptic drug (AED) market was valued at approximately USD 4.2 billion in 2022 and is projected to grow at a CAGR of 4.5% through 2030 [3]. Extended Phenytoin Sodium forms a significant subsector within this landscape, driven by:

  • Prevalence of Epilepsy: Affects approximately 50 million worldwide, with a substantial subset receiving phenytoin therapy.
  • Patient Preference: Growing demand for once-daily, extended-release formulations owing to improved compliance.
  • Healthcare Trends: Increasing adoption of personalized medicine and long-acting formulations.

Competitive Landscape

Major players include:

  • Pfizer (original manufacturer of phenytoin formulations)
  • Mitsubishi Tanabe Pharma Corporation
  • Actavis (Teva Pharmaceuticals)

Recent entries involve generic companies and specialty drug developers that seek to capitalize on patent expirations and regulatory approvals. Patent cliff offers opportunities for generics, boosting market competition and affordability.

Regulatory and Reimbursement Outlook

Regulatory agencies globally are streamlining approval processes for formulations demonstrating bioequivalence. Reimbursement policies tend to favor extended-release products due to their potential for improved adherence and reduced hospitalization costs.

Challenges and Opportunities

Market challenges include:

  • Pricing pressures driven by generic competition.
  • Concerns regarding narrow therapeutic index drugs, requiring vigilant monitoring.
  • Limited differentiation among existing formulations.

Opportunities lie in:

  • Demonstrating superior safety profiles.
  • Developing targeted formulations for pediatric and elderly populations.
  • Expanding indications, including off-label uses in neurology.

Market Projection

Based on current clinical pipeline momentum and market drivers, the EPS segment is anticipated to expand robustly. By 2030, the market for extended phenytoin formulations is projected to reach approximately USD 1.2 billion, representing a CAGR of around 7% from 2023 levels, driven by the following factors:

  1. Growing Prevalence of Epilepsy: Increasing diagnosis rates, especially in aging populations.
  2. Enhanced Pharmacological Profiles: Advances in formulation technology offering better tolerability.
  3. Rising Adoption in Developing Markets: Increasing healthcare infrastructure and epilepsy awareness.
  4. Regulatory Facilitation: Streamlined approval processes supporting faster market entry.

Moreover, the development of personalized dosing and biomarker-guided therapy may further boost market growth, creating a more tailored approach to epilepsy management with EPS.

Strategic Outlook and Business Implications

Pharmaceutical companies investing in EPS formulations should prioritize:

  • Investing in innovative drug delivery systems that optimize pharmacokinetics.
  • Engaging with regulatory agencies early to expedite approvals.
  • Formulation differentiation through improved safety, efficacy, or patient-specific characteristics.
  • Market access strategies that leverage growing awareness and off-label opportunities.

Investors should monitor clinical trial readouts and regulatory updates, aligning investment strategies with the evolving landscape promoting EPS as a preferred long-term epilepsy treatment.

Key Takeaways

  • Clinical Development: Multiple Phase III trials indicate strong progress, with promising efficacy and safety profiles for new extended-release phenytoin formulations.
  • Market Dynamics: The global AED market is expanding, with EPS capturing a significant share driven by epilepsy prevalence and improved formulations.
  • Competitive Environment: Patent expirations and generic entries intensify competition; differentiation hinges on safety, pharmacokinetics, and patient compliance.
  • Market Projection: The EPS segment is expected to reach USD 1.2 billion by 2030, with a CAGR of approximately 7%, influenced by demographic trends and technological advances.
  • Business Strategy: Innovating in drug delivery, engaging regulators, and focusing on personalized medicine will position stakeholders favorably.

FAQs

Q1: What advances are driving innovation in extended phenytoin formulations?
A: Recent advances include novel controlled-release technologies, nanoparticle carriers, and multi-layered matrices that sustain therapeutic plasma levels, reduce peak-trough fluctuations, and enhance tolerability.

Q2: How does the regulatory environment impact the development of EPS products?
A: The FDA and other agencies favor bioequivalence studies for generic EPS products, with streamlined pathways facilitating faster approvals. Regulatory clarity encourages innovation and entry of new formulations.

Q3: What are the main challenges facing the market for extended phenytoin sodium?
A: Challenges include pricing pressures from generics, narrow therapeutic index concerns requiring meticulous monitoring, and limited differentiation among products.

Q4: Which patient populations stand to benefit most from extended-release phenytoin?
A: Patients requiring long-term seizure management, including elderly individuals, pediatric patients, and those with adherence issues, benefit from simplified dosing and improved plasma level stability.

Q5: What is the outlook for off-label uses of EPS?
A: Off-label applications, such as in neuropathic pain or mood disorders, may emerge with further clinical evidence, expanding the market potential beyond epilepsy.


Sources:

  1. ClinicalTrials.gov. "Extended-Release Phenytoin Sodium Trials."
  2. U.S. Food and Drug Administration. "Approval of Generic Extended-Release Phenytoin."
  3. MarketWatch. "Epilepsy Drugs Market Size, Share & Trends."

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