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Patients with Renal or Hepatic Disease: Increased fraction of unbound phenytoin in patients with renal or hepatic disease, or in those with hypoalbuminemia or hyperbilirubinemia has been reported see section 4. Phenytoin dosing requirements are highly variable and must be individualized see section 4. Phenytoin causes embryo fetal death and growth retardation in rats, mice, and rabbits.

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