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Drug Interactions between ethosuximide and fosphenytoin

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

ethosuximide fosphenytoin

Applies to: ethosuximide and fosphenytoin

MONITOR: Succinimides may increase serum hydantoin levels. The pharmacologic and toxic effects of hydantoins may be increased. The mechanism is not fully understood, but may be related to inhibition of the hepatic metabolism of hydantoins. In addition, phenytoin has been associated with reductions in succinimide levels.

MANAGEMENT: If a succinimide and a hydantoin must be used together, close observation for evidence of altered hydantoin effect is recommended. Patients should be advised to notify their physician if they experience symptoms of possible hydantoin toxicity, including drowsiness, visual disturbances, change in mental status, seizures, nausea, or ataxia.

References

  1. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  2. Rambeck B (1979) "Pharmacological interactions of mesuximide with phenobarbital and phenytoin in hospitalized epileptic patients." Epilepsia, 20, p. 147-56
  3. Browne TR, Feldman RG, Buchanan RA, et al. (1983) "Methsuximide for complex partial seizures: efficacy, toxicity, clinical pharmacology, and drug interactions." Neurology, 33, p. 414-8
  4. Mendez JS, Cotzias GC, Mena I, Papavasiliou PS (1975) "Diphenylhydantoin: blocking of levodopa effects." Arch Neurol, 32, p. 44-6
  5. Giaccone M, Bartoli A, Gatti G, Marchiselli R, Pisani F, Latella MA, Perucca E (1996) "Effect of enzyme inducing anticonvulsants on ethosuximide pharmacokinetics in epileptic patients." Br J Clin Pharmacol, 41, p. 575-9
View all 5 references

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Drug and food interactions

Moderate

ethosuximide food

Applies to: ethosuximide

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
View all 4 references

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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