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Related Experiment Video

Updated: Jul 26, 2025

A Rapid and Specific Microplate Assay for the Determination of Intra- and Extracellular Ascorbate in Cultured Cells

A Rapid and Specific Microplate Assay for the Determination of Intra- and Extracellular Ascorbate in Cultured Cells

Published on: April 11, 2014

Phenytoin Toxicity with High Dose, Concomitant Ascorbic Acid Dosing.

Michael J Schuh¹, Kevin Mustain², Sheena Crosby¹

¹Mayo Clinic, Jacksonville, Florida.

Innovations in Pharmacy

|June 12, 2023

Summary

High-dose vitamin C (ascorbic acid) may increase phenytoin levels, risking toxicity. This case highlights potential adverse drug reactions, including seizures and ataxia, when combining high-dose ascorbic acid with phenytoin.

Keywords:

ascorbic acid phenytoin toxicity vitamin C

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High Content Screening Analysis to Evaluate the Toxicological Effects of Harmful and Potentially Harmful Constituents HPHC

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High Content Screening Analysis to Evaluate the Toxicological Effects of Harmful and Potentially Harmful Constituents HPHC

High Content Screening Analysis to Evaluate the Toxicological Effects of Harmful and Potentially Harmful Constituents HPHC

Published on: May 10, 2016

Area of Science:

Pharmacology
Clinical Toxicology
Neurology

Background:

Phenytoin is a widely used antiepileptic drug.
Ascorbic acid (vitamin C) is a common supplement.
Interactions between high-dose ascorbic acid and phenytoin are not well-established.

Purpose of the Study:

To report a case of potential phenytoin toxicity due to concomitant high-dose ascorbic acid administration.
To describe the adverse drug reactions observed in this patient.
To inform clinicians about a possible drug interaction.

Main Methods:

Case report detailing a patient's clinical course.
Observation of phenytoin levels and adverse events.
Discontinuation of interacting medications and initiation of alternative treatment.

Main Results:

Concomitant use of high-dose ascorbic acid with phenytoin led to elevated phenytoin levels.
The patient experienced adverse drug reactions including truncal ataxia and weakness.
Discontinuation of ascorbic acid and phenytoin, followed by lacosamide and gabapentin, resolved symptoms.

Conclusions:

High-dose ascorbic acid may potentiate phenytoin toxicity.
Clinicians should exercise caution when prescribing high-dose ascorbic acid to patients on phenytoin.
Monitoring of phenytoin levels and potential adverse effects is crucial in such cases.