Document 0356
 DOCN  M9460356
 TI    Fluconazole-induced symptomatic phenytoin toxicity.
 DT    9408
 AU    Cadle RM; Zenon GJ 3rd; Rodriguez-Barradas MC; Hamill RJ; Department of
       Veterans Affairs Medical Center (VAMC), Pharmacy; Service, Houston, TX
       77030.
 SO    Ann Pharmacother. 1994 Feb;28(2):191-5. Unique Identifier : AIDSLINE
       MED/94227300
 AB    OBJECTIVE: To report two cases of fluconazole-induced symptomatic
       phenytoin toxicity and review literature related to this interaction.
       DATA SOURCES: Case reports and review articles identified by a
       computerized (MEDLINE) and manual (Index Medicus) search. DATA
       SYNTHESIS: Fluconazole is a broad-spectrum triazole antifungal agent
       primarily eliminated by renal mechanisms, although hepatic cytochrome
       P-450 inhibition and hepatotoxicity have been observed. We report two
       cases of fluconazole-induced symptomatic phenytoin toxicity. Both
       patients received high doses of the drug; one patient developed
       phenytoin toxicity only after long-term coadministration. Previously
       reported cases have occurred primarily with high-dose fluconazole and
       short-term coadministration. CONCLUSIONS: Fluconazole can increase
       phenytoin serum concentrations leading to toxicity. Constant and
       continuous monitoring of serum phenytoin concentrations with fluconazole
       doses as low as 200 mg/d is warranted.
 DE    Adult  Animal  AIDS-Related Opportunistic Infections/COMPLICATIONS/DRUG
       THERAPY  Case Report  Drug Interactions  Fluconazole/ADMINISTRATION &
       DOSAGE/*ADVERSE EFFECTS  Human  Male  Middle Age
       Phenytoin/ADMINISTRATION & DOSAGE/*ADVERSE EFFECTS/BLOOD
       Seizures/COMPLICATIONS/DRUG THERAPY  JOURNAL ARTICLE  REVIEW  REVIEW OF
       REPORTED CASES

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).