A pharmacokinetic evaluation of peritoneal dialysis for phenytoin intoxication

Despite the indications of previous case reports and standard references, peritoneal dialysis did not appreciably enhance the elimination of phenytoin in our patient. In view of our observations, the effectiveness of peritoneal dialysis for phenytoin poisoning should be seriously questioned. A careful reassessment of the efficiency of peritoneal dialysis for phenytoin should be performed and should consider the possible role of phenytoin metabolites contributing to toxicity. Until well-controlled studies support the use of any dialytic procedure for phenytoin overdosage, the management of these patients must rely on general measures to minimize absorption of the drug and on supportive treatment as indicated by the patient's condition.