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Related Experiment Videos

Phenytoin-folic acid interaction

D P Lewis1, D C Van Dyke, L A Willhite

  • 1College of Pharmacy, University of Iowa, Iowa City 52242, USA.

The Annals of Pharmacotherapy
|July 1, 1995
PubMed
Summary
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Concurrent folic acid supplementation is recommended when starting phenytoin therapy. This prevents folate deficiency, improves seizure control, and avoids altering phenytoin levels, ensuring better patient outcomes.

Area of Science:

  • Pharmacology
  • Nutritional Science
  • Clinical Pharmacy

Background:

  • Phenytoin is an anticonvulsant medication.
  • Folic acid is a vital nutrient.
  • Drug-nutrient interactions can impact therapeutic efficacy and safety.

Purpose of the Study:

  • To review the drug-nutrient interaction between phenytoin and folic acid.
  • To examine the effects of phenytoin on folate levels and vice versa.

Main Methods:

  • Literature search of MEDLINE and other sources (1983-1995).
  • Included human studies on phenytoin's effect on folate and folic acid's effect on phenytoin.
  • Extracted data on demographics, dosing, folate levels, pharmacokinetics, and adverse events.

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Main Results:

  • Phenytoin therapy alone decreases serum folate levels.
  • Folic acid supplementation can alter phenytoin pharmacokinetics, potentially lowering serum concentrations and leading to breakthrough seizures.
  • Folate may act as a cofactor in phenytoin metabolism.

Conclusions:

  • Initiate folic acid supplementation concurrently with phenytoin therapy.
  • This approach prevents folate deficiency, mitigates adverse effects, and improves seizure control without negatively impacting phenytoin pharmacokinetics.