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Dilantin-30 and Kenalog-40

Determining the interaction of Dilantin-30 and Kenalog-40 and the possibility of their joint administration.

Check result:
Dilantin-30 <> Kenalog-40
Relevance: 10.07.2022 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:

Using phenytoin together with triamcinolone can make triamcinolone less effective. Talk with your doctor before using these medications together. You may need a dose adjustment or special tests to safely take both medications. It is important that you to tell your doctor about all other medications that you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Phenytoin and other hydantoins may induce the CYP450 3A4 hepatic metabolism of corticosteroids and increase their clearance and decrease their half-lives, possibly reducing their therapeutic efficacy. In addition, results of the dexamethasone adrenal suppression test may be unreliable in patients concurrently taking phenytoin. Hydrocortisone appears to be affected to a lesser extent than other corticosteroids. Some corticosteroids have also been reported to cause increases or decreases in serum phenytoin levels; however, data have been inconsistent.

MANAGEMENT: Patients should be closely monitored for clinical and laboratory evidence of reduced corticosteroid effects and changes in phenytoin concentrations during concomitant therapy. Some patients may require increased corticosteroid dosages.

References
  • Lawson LA, Blouin RA, Smith RB, Rapp RP, Young AB "Phenytoin-dexamethasone interaction: a previously unreported observation." Surg Neurol 16 (1981): 23-4
  • Haque N, Thrasher K, Werk EE, Jr Knowles HC, Jr Sholiton LJ "Studies on dexamethasone metabolism in man: effect of diphenylhydantoin." J Clin Endocrinol Metab 34 (1972): 44-50
  • Wong DD, Longenecker RG, Liepman M, Baker S, LaVergne M "Phenytoin-dexamethasone: a possible drug-drug interaction." JAMA 254 (1985): 2062-3
  • Lackner TE "Interaction of dexamethasone with phenytoin." Pharmacotherapy 11 (1991): 344-7
  • Stjernholm MR, Katz FH "Effects of diphenylhydantoin, phenobarbital, and diazepam on the metabolism of methylprednisolone and its sodium succinate." J Clin Endocrinol Metab 41 (1975): 887-93
  • Frey BM, Frey FJ "Phenytoin modulates the pharmacokinetics of prednisolone and the pharmacodynamics of prednisolone as assessed by the inhibition of the mixed lymphocyte reaction in humans." Eur J Clin Invest 14 (1984): 1-6
Dilantin-30

Generic Name: phenytoin

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

Synonyms: Dilantin

Kenalog-40

Generic Name: triamcinolone

Brand name: Kenalog-40, Zilretta, Aristocort, Azmacort

Synonyms: Kenalog-40 (injection)

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.

Interaction with food and lifestyle
Disease interaction