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Phenytoin Sodium and Vincristine (Liposomal)

Determining the interaction of Phenytoin Sodium and Vincristine (Liposomal) and the possibility of their joint administration.

Check result:

Phenytoin Sodium <> Vincristine (Liposomal)

Relevance: 26.07.2022 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:

Talk to your doctor before using phenytoin together with vinCRIStine liposome. Combining these medications may reduce the blood levels and effects of both medications. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Contact your doctor if your condition changes or you experience loss of seizure control during treatment. 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:

GENERALLY AVOID: Coadministration with potent inducers of CYP450 3A4 and/or P-glycoprotein such as phenytoin may significantly decrease the plasma concentrations of vinca alkaloids, which are substrates of both the hepatic microsomal isoenzyme and intracellular efflux transporter. Pharmacokinetic data are not available.

MONITOR: Cases have been reported in which patients receiving chemotherapy have experienced markedly reduced plasma phenytoin concentrations and seizures. The mechanism of this interaction has not been clearly established. One study showed that the absorption of phenytoin decreased significantly during chemotherapy. Intravenous phenytoin may be less likely to interact.

MANAGEMENT: The use of vinca alkaloids in combination with potent CYP450 3A4 and/or P-glycoprotein inducers such as phenytoin should generally be avoided.

References

"Product Information. Oncovin (vincristine)." Lilly, Eli and Company, Indianapolis, IN.
Jarosinski PF, Moscow JA, Alexander MS, et al "Altered phenytoin clearance during intensive chemotherapy for acute lymphoblastic leukemia." J Pediatr 112 (1988): 996-9
Sylvester RK, Lewis FB, Caldwell KC, Lobell M, Perri R, Sawchuk RA "Impaired phenytoin bioavailability secondary to cisplantin, vinblastine, and bleomycin." Ther Drug Monit 6 (1984): 302-5
Neef C, de Voogd-van der Straaten "An interaction between cytostatic and anticonvulsant drugs." Clin Pharmacol Ther 43 (1988): 372-5
Dofferhoff AS, Berendsen HH "Decreased phenytoin level after carboplatin treatment." Am J Med 89 (1990): 247
"Product Information. Marqibo (vinCRIStine liposome)." Talon Therapeutics Inc, South San Francisco,, CA.
Bollini P, Riva R, Albani F, Ida et al "Decreased phenytoin level during antineoplastic therapy: a case report." Epilepsia 24 (1983): 75-8
Grossman SA, Sheidler VR, Gilbert MR "Decreased phenytoin levels in patients receiving chemotherapy." Am J Med 87 (1989): 505-10
Fincham RW, Schottelius DD "Decreased phenytoin levels in antineoplastic therapy." Ther Drug Monit 1 (1979): 277-83

Phenytoin Sodium

Generic Name: phenytoin

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

Synonyms: n.a.

What is Phenytoin Sodium?

Vincristine (Liposomal)

Generic Name: vincristine liposome

Brand name: Marqibo

Synonyms: Vincristine liposome, VinCRIStine (Liposomal)

What is Vincristine (Liposomal)?

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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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