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Drug Interactions between fluoxetine and fosphenytoin

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

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Interactions between your drugs

Moderate

FLUoxetine fosphenytoin

Applies to: fluoxetine and fosphenytoin

MONITOR: Fluoxetine may increase serum hydantoin levels. The mechanism is unknown, but may be related to inhibition of hepatic CYP450 2C9 and 2C19 hydantoin metabolism.

MANAGEMENT: Close observation for clinical and laboratory evidence of hydantoin toxicity is recommended if these drugs must be used together. 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 (3)
  1. Jalil P (1992) "Toxic reaction following the combined administration of fluoxetine and phenytoin: two case reports." J Neurol Neurosurg Psychiatry, 55, p. 412-3
  2. Nightingale SL (1994) "Fluoxetine labeling revised to identify phenytoin interaction and to recommend against use in nursing mothers." JAMA, 271, p. 1067
  3. Shader RI, Greenblatt DJ, Vonmoltke LL (1994) "Fluoxetine inhibition of phenytoin metabolism." J Clin Psychopharmacol, 14, p. 375-6

Drug and food interactions

Moderate

FLUoxetine food

Applies to: fluoxetine

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 (4)
  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

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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