Valproic acid-phenytoin interaction.
The interaction between valproic acid (VPA) and phenytoin (DPH) was examined during therapeutic monitoring in an epileptic outpatient population. Gas-liquid chromatographic methods were used to measure DPH and VPA concentrations. (1) In 12 patients on stable DPH regimens, the mean DPH level declined from 19.7 to 15.3 microgram/ml when VPA was added (p less than 0.001). (2) In 20 patients receiving DPH and VPA, the median free fraction was 15.8%, compared to 9.1% free DPH in 40 patients receiving DPH only or DPH and phenobarbital (p less than 0.001). (3) Addition of VPA to a stable DPH regimen may result in a transient increased risk of DPH toxicity, followed by restabilization at the original free DPH level.
D000328:Adult; D002849:Chromatography, Gas; D004347:Drug Interactions; D004827:Epilepsy / Q000188:drug therapy; D006801:Humans; D008991:Monitoring, Physiologic; D010672:Phenytoin / Q000097:blood* / Q000627:therapeutic use; D011485:Protein Binding; D014635:Valproic Acid / Q000097:blood* / Q000627:therapeutic use
D014635:Valproic Acid; D010672:Phenytoin