Interactions

Drug-Drug

• Disulfiram, acute ingestion of alcohol, amiodarone, ethosuximide, isoniazid, chloramphenicol, sulfonamides, fluoxetine, gabapentin, H2 antagonists, benzodiazepines, omeprazole, ketoconazole, fluconazole, estrogens, succinamides, halothane, methylphenidate, phenothiazines, salicylates, ticlopidine, tolbutamide, topiramate, trazodone, felbamate, and cimetidine may phenytoin blood levels

• Barbiturates, carbamazepine, reserpine, and chronic ingestion of alcohol may phenytoin blood levels

• Phenytoin may the effects of amiodarone, benzodiazepines, carbamazepine, chloramphenicol, corticosteroids, disopyramide, warfarin, felbamate, doxycycline, lamotrigine, oral contraceptives, paroxetine, propafenone, rifampin, ritonavir, quinidine, tacrolimus, theophylline, topiramate, tricyclic antidepressants, zonisamide, methadone, cyclosporine, and estrogens

• IV phenytoin and dopamine may cause additive hypotension

• Additive CNS depression with other CNS depressants, including alcohol, antihistamines, antidepressants, opioids, and sedative/hypnotics

• Antacids may absorption of orally administered phenytoin

• systemic clearance of antileukemic drugs teniposide and methotrexate which has been associated with a worse event free survival, phenytoin use is not recommended in children undergoing chemotherapy for acute lymphocytic leukemia

• Calcium and sucralfate phenytoin absorption

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