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Dilantin Infatabs and Fluorouracil

Determining the interaction of Dilantin Infatabs and Fluorouracil and the possibility of their joint administration.

Check result:

Dilantin Infatabs <> Fluorouracil

Relevance: 04.07.2023 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:

Using phenytoin together with fluorouracil may increase the effects of phenytoin. Contact your doctor if you experience twitching eye movements, slurred speech, loss of balance, tremor, muscle stiffness or weakness, nausea, vomiting, feeling light-headed, fainting, and slow or shallow breathing. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both 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.

Professional:

MONITOR: Concomitant administration with levamisole and 5-fluorouracil (5-FU) has been reported to increase serum levels of phenytoin. No mechanism has been established for this interaction, and it is unknown whether levamisole or 5-FU, or both, is responsible. However, 5-FU alone was implicated in one case report. A 66-year-old man who had been stabilized on phenytoin for more than 4 years developed symptoms of toxicity in association with elevated phenytoin serum concentrations 11 weeks after starting 5-FU and leucovorin treatment. Symptoms resolved following a reduction in phenytoin dosage, and phenytoin levels were monitored and dosage adjusted accordingly throughout the remainder of chemotherapy treatment. After completion of chemotherapy, the phenytoin dosage was gradually increased to original levels without further incident. The authors suggested that 5-FU may inhibit the metabolism of phenytoin via CYP450 2C9.

MANAGEMENT: Pharmacologic response to phenytoin should be monitored more closely whenever levamisole, 5-FU, or capecitabine (which is metabolized to 5-FU in vivo) is added to or withdrawn from therapy, and the phenytoin dosage adjusted as necessary. Patients should be advised to notify their physician if they experience symptoms of phenytoin toxicity, including drowsiness, visual disturbances, mental status changes, seizures, nausea, or ataxia. It is uncertain whether this interaction may also occur with other hydantoins.

References

Gilbar PJ, Brodribb TR "Phenytoin and fluorouracil interaction." Ann Pharmacother 35 (2001): 1367-70
"Product Information. Dilantin (phenytoin)." Parke-Davis, Morris Plains, NJ.
"Product Information. Cerebyx (fosphenytoin)." Parke-Davis, Morris Plains, NJ.
"Product Information. Ergamisol (levamisole)." Janssen Pharmaceutica, Titusville, NJ.

Dilantin Infatabs

Generic Name: phenytoin

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

Synonyms: Dilantin

What is Dilantin Infatabs?

Fluorouracil

Generic Name: fluorouracil

Brand name: Adrucil

Synonyms: Fluorouracil (injection), Fluorouracil (Systemic)

What is Fluorouracil?

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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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