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Drug Interactions between fosphenytoin and Trokendi XR

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

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Interactions between your drugs

Moderate

fosphenytoin topiramate

Applies to: fosphenytoin and Trokendi XR (topiramate)

MONITOR: Topiramate administered with phenytoin has been reported to have led to a 25% increase in phenytoin plasma concentrations, particularly in those patients receiving phenytoin twice a day. Additionally, the concentration of topiramate decreased by 48%. Topiramate may decrease the metabolism of phenytoin (or other hydantoins) while hydantoins may increase the metabolism of topiramate.

MANAGEMENT: Patients should be closely observed for clinical response and signs of hydantoin toxicity if these drugs must be given concurrently and serum concentrations should be monitored. Patients should be advised to notify their physician if they experience loss of seizure control or symptoms of hydantoin toxicity, including drowsiness, visual disturbances, change in mental status, seizures, nausea, or ataxia. Addition or withdrawal of hydantoins during therapy with topiramate may require a dose adjustment of topiramate and/or the hydantoin.

References (2)
  1. Bourgeois BF (1996) "Drug interaction profile of topiramate." Epilepsia, 37(suppl 2, s14-7
  2. (2001) "Product Information. Topamax (topiramate)." Ortho McNeil Pharmaceutical

Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

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.

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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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