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Related Experiment Videos

Fluconazole-induced symptomatic phenytoin toxicity

R M Cadle1, G J Zenon, M C Rodriguez-Barradas

  • 1Department of Veterans Affairs Medical Center (VAMC), Pharmacy Service, Houston, TX 77030.

The Annals of Pharmacotherapy
|February 1, 1994
PubMed
Summary

Fluconazole can cause phenytoin toxicity by increasing its serum levels. Continuous monitoring of phenytoin levels is recommended, even with low fluconazole doses, to prevent adverse drug reactions.

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Area of Science:

  • Pharmacology
  • Clinical Toxicology

Background:

  • Fluconazole is a widely used antifungal agent.
  • Phenytoin is an anticonvulsant medication with a narrow therapeutic index.

Observation:

  • Two cases of symptomatic phenytoin toxicity are reported following fluconazole administration.
  • Toxicity occurred in patients receiving high-dose fluconazole, with one case developing after long-term coadministration.

Findings:

  • Fluconazole can significantly increase serum phenytoin concentrations.
  • This drug interaction can lead to potentially severe phenytoin toxicity.

Implications:

  • Close monitoring of phenytoin serum levels is crucial when coadministered with fluconazole.
  • This monitoring is advised even with fluconazole doses as low as 200 mg/day to ensure patient safety.

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