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CanesOral and Phenytek

Determining the interaction of CanesOral and Phenytek and the possibility of their joint administration.

Check result:

CanesOral <> Phenytek

Relevance: 07.08.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Before taking fluconazole, tell your doctor if you also use phenytoin. You may need dose adjustments or special tests in order to safely take both medications together. This combination may affect the phenytoin levels in your body. You should notify your doctor if you have symptoms such as drowsiness, visual disturbances, changes in behavior, nausea, or poor muscle coordination. It is important that you tell your healthcare provider about all other medications that you are using including vitamins and herbs. Do not stop using your medications without first talking to your doctor first.

Professional:

MONITOR CLOSELY: The concomitant use of fluconazole may increase serum hydantoin levels and risk of hydantoin toxicity. The mechanism is inhibition of CYP450 2C9 and 2C19 hepatic metabolism. In 10 healthy male volunteers, a mean increase in phenytoin AUC of 88% (with a range of 16% to 247%) was observed after 4 days of phenytoin administration (200 mg orally per day for 3 days followed by 250 mg IV once) with fluconazole (200 mg orally per day for 16 days) compared to phenytoin administration alone. Repeated concomitant administration of phenytoin (250 mg IV) and fluconazole (200 mg) also resulted in increased phenytoin AUC24 and Cmin by 75% and 128%, respectively.

MANAGEMENT: Close clinical monitoring of patient response, tolerance, and serum hydantoin concentrations is recommended whenever fluconazole is added, discontinued, or the dose changed. Patients should be advised to notify their doctor if they experience symptoms of toxicity (drowsiness, visual disturbances, change in mental status, nausea, or ataxia). A reduction in hydantoin dosage may be necessary.

References

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Cadle RM, Zenon GJ III, Rodriguez-Barradas MC, Hamil RJ "Fluconazole-induced symptomatic phenytoin toxicity." Ann Pharmacother 28 (1994): 191-5
Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Cerner Multum, Inc. "Australian Product Information." O 0
"Product Information. Diflucan (fluconazole)." Roerig Division, New York, NY.
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"Product Information. Dilantin (phenytoin)." Parke-Davis, Morris Plains, NJ.
Vincent-Ballereau FN, Patey ON, Lafaix C "Fluconazole: review and situation among antifungal drugs in the treatment of opportunistic mycoses of human immuno-deficiency virus infections." Pharm Weekbl Sci 13 (1990): 45-57
Holechek MJ "Medication review: fluconazole." ANNA J 18 (1991): 585-6
Touchette MA, Chandrasekar PH, Milad MA, Edwards DJ "Contrasting effects of fluconazole and ketoconazole on phenytoin and testosterone disposition in man." Br J Clin Pharmacol 34 (1992): 75-8
Howitt KM, Oziemski MA "Phenytoin toxicity induced by fluconazole." Med J Aust 151 (1989): 603-4
Morrow JD "Fluconazole: a new triazole antifungal agent." Am J Med Sci 302 (1991): 129-32
Mitchell AS, Holland JT "Fluconazole and phenytoin: a predictable interaction." Br Med J 298 (1989): 1315
Blum RA, Wilton JH, Hilligoss DM, et al "Effect of fluconazole on the disposition of phenytoin." Clin Pharmacol Ther 49 (1991): 420-5

CanesOral

Generic Name: fluconazole

Brand name: Diflucan

Synonyms: Fluconazole

What is CanesOral?

Phenytek

Generic Name: phenytoin

Brand name: Dilantin, Phenytek, Dilantin Infatabs, Phenytoin Sodium, Prompt

Synonyms: n.a.

What is Phenytek?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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