Journal Article

A Potentially Significant Interaction between Efavirenz and Phenytoin: A Case Report and Review of the Literature

Sarah M. Robertson, Scott R. Penzak, Jason Lane, Alice K. Pau and JoAnn M. Mican

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 41, issue 2, pages e15-e18
Published in print July 2005 | ISSN: 1058-4838
Published online July 2005 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/431208
A Potentially Significant Interaction between Efavirenz and Phenytoin: A Case Report and Review of the Literature

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Although it has not been demonstrated yet, phenytoin is expected to reduce efavirenz exposure through coinduction of cytochrome P450 (CYP) 3A4 and CYP2B6. Conversely, efavirenz has been shown in vitro to inhibit the enzymes responsible for phenytoin metabolism, CYP2C9 and CYP2C19. We report a case in which a potential bidirectional drug interaction between phenytoin and efavirenz resulted in lower-than-expected efavirenz concentrations and elevated phenytoin levels. Therapeutic drug monitoring was used in this case to ensure adequate efavirenz exposure.

Journal Article.  2459 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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