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Related Experiment Videos

Ticlopidine-induced phenytoin toxicity

S L Klaassen1

  • 1Cognitive Pharmaceutical Services, Ottumwa, IA 52501, USA. sklaassen@lisco.net

The Annals of Pharmacotherapy
|January 7, 1999
PubMed
Summary

Ticlopidine may cause phenytoin toxicity in patients. This drug interaction can lead to serious adverse events, necessitating close monitoring or avoidance of the combination.

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Area of Science:

  • Pharmacology
  • Clinical Toxicology

Background:

  • Ticlopidine is an antiplatelet medication.
  • Phenytoin is an anticonvulsant drug used to treat epilepsy.

Observation:

  • A 72-year-old male exhibited behavioral changes and ataxia 6 weeks after starting ticlopidine.
  • Phenytoin levels were significantly elevated (43.6 mcg/mL), resolving upon dose reduction.
  • Symptoms recurred upon rechallenge with phenytoin after ticlopidine discontinuation.

Findings:

  • Ticlopidine likely induced phenytoin toxicity through mechanisms involving cytochrome P450 metabolism.
  • This interaction highlights a potential for serious adverse drug events.

Implications:

  • Clinicians should be aware of the risk of phenytoin toxicity when co-prescribing ticlopidine.
  • Consider avoiding the phenytoin-ticlopidine combination or implementing vigilant therapeutic drug monitoring.

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