Cytomegalovirus Immune Globulin (Intravenous-Human) and Phenytoin Sodium

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.

The use of phenytoin and other similar anticonvulsants has been associated with an allergic reaction that causes inflammation of the heart, liver, or other organs. There is limited evidence to suggest that immune globulins may increase the risk of developing the reaction, although it has not been proven. Before receiving treatment with cytomegalovirus immune globulin, let your doctor know if you are using phenytoin. Contact your doctor immediately if you develop a rash, skin redness, itching, fever, joint pain or swelling, unusual bleeding or bruising, loss of appetite, fatigue, nausea, vomiting, dark-colored urine, light-colored stools, yellowing of the skin or eyes, difficulty breathing, chest tightness, or chest pain during treatment with these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: A possible interaction between phenytoin and intravenous immunoglobulin (IVIG) was suspected in a case of fatal hypersensitivity myocarditis. The mechanism of interaction has not been described. The case patient was a 43-year-old man with a past history of alcohol abuse who had been receiving phenytoin for the treatment of partial epilepsy for eight years. He was given intravenous immunoglobulin 0.4 g/kg for 5 days for suspected Guillain-Barre syndrome. On the second day after the last administration, the patient complained of abdominal pain, aching shoulders, and backache. He subsequently developed hypotension and died after attempts at resuscitation. An autopsy confirmed Guillain-Barre syndrome and revealed signs of a slight hepatitis with eosinophils as well as hypersensitivity (eosinophilic) myocarditis. There were no signs of alcoholic cardiomyopathy. Since phenytoin alone has been associated with hypersensitivity myocarditis, a contributory role for IVIG could not be established. Moreover, IVIG has been used successfully in some cases to treat anticonvulsant hypersensitivity syndrome, including that associated with phenytoin.

MANAGEMENT: Due to the serious nature of the possible interaction, clinicians should consider monitoring hematologic parameters such as eosinophil counts as well as blood pressure and ECG tracings if immunoglobulins are used in patients receiving phenytoin.

Cytomegalovirus Immune Globulin (Intravenous-Human)

Generic Name: cytomegalovirus immune globulin

Brand name: CytoGam

Synonyms: Cytomegalovirus immune globulin (CMV IG) (injection), Cytomegalovirus Immune Globulin IV

What is Cytomegalovirus Immune Globulin (Intravenous-Human)?

Phenytoin Sodium

Generic Name: phenytoin

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

Synonyms: n.a.

What is Phenytoin Sodium?