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M9460737.TXT
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1994-06-25
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Document 0737
DOCN M9460737
TI Fluconazole-induced symptomatic phenytoin toxicity.
DT 9408
AU Cadle RM; Zenon GJ 3rd; Rodriguez-Barradas MC; Hamill RJ; Department of
Veterans Affairs Medical Center (VAMC), Pharmacy; Service, Houston, TX
77030.
SO Ann Pharmacother. 1994 Feb;28(2):191-5. Unique Identifier : AIDSLINE
MED/94227300
AB OBJECTIVE: To report two cases of fluconazole-induced symptomatic
phenytoin toxicity and review literature related to this interaction.
DATA SOURCES: Case reports and review articles identified by a
computerized (MEDLINE) and manual (Index Medicus) search. DATA
SYNTHESIS: Fluconazole is a broad-spectrum triazole antifungal agent
primarily eliminated by renal mechanisms, although hepatic cytochrome
P-450 inhibition and hepatotoxicity have been observed. We report two
cases of fluconazole-induced symptomatic phenytoin toxicity. Both
patients received high doses of the drug; one patient developed
phenytoin toxicity only after long-term coadministration. Previously
reported cases have occurred primarily with high-dose fluconazole and
short-term coadministration. CONCLUSIONS: Fluconazole can increase
phenytoin serum concentrations leading to toxicity. Constant and
continuous monitoring of serum phenytoin concentrations with fluconazole
doses as low as 200 mg/d is warranted.
DE Adult Animal AIDS-Related Opportunistic Infections/COMPLICATIONS/DRUG
THERAPY Case Report Drug Interactions Fluconazole/ADMINISTRATION &
DOSAGE/*ADVERSE EFFECTS Human Male Middle Age
Phenytoin/ADMINISTRATION & DOSAGE/*ADVERSE EFFECTS/BLOOD
Seizures/COMPLICATIONS/DRUG THERAPY JOURNAL ARTICLE REVIEW REVIEW OF
REPORTED CASES
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).