Epsolin 100mg Tablet

Interactions

Drug :- acetaminophen: Possibly hepatotoxicity, decreased acetaminophen effects.

activated charcoal, antacids, calcium salts, enteral feedings, sucralfate: Decreased absorption of oral phenytoin.

allopurinol, benzodiazepines, chloramphenicol, cimetidine, disulfiram, fluconazole, isoniazid, itraconazole, methylphenidate, metronidazole, miconazole, omeprazole, phenacemide, ranitidine, sulfonamides, trazodone, trimethoprim: Decreased metabolism and increased effects of phenytoin.

amiodarone, ticlopidine: Possibly increased blood phenytoin level.

antifungals azole: Increased blood phenytoin level, decreased blood antifungal level.

antineoplastics, nitrofurantoin, pyridoxine: Decreased phenytoin effects.

barbiturates: Variable effects on blood phenytoin level.

bupropion, clozapine, loxapine, MAO inhibitors, maprotiline, molindone, phenothiazines, pimozide, thioxanthenes, tricyclic antidepressants: Decreased seizure threshold, decreased anticonvulsant effects.

calcium channel blockers: Increased metabolism and decreased effects of these drugs, possibly increased blood phenytoin level.

carbamazepine: Decreased blood level and effects of carbamazepine, possibly phenytoin toxicity.

carbonic anhydrase inhibitors: Increased riskof osteopenia from phenytoin.

chlordiazepoxide, diazepam: Possibly increased blood phenytoin level, decreased effects of these drugs.

clonazepam: Possibly decreased blood level and effects of clonazepam, possibly phenytoin toxicity.

corticosteroids, cyclosporine, dicumarol, digoxin, disopyramide, doxycycline, estrogens, furosemide, lamotrigine, levodopa, methadone, metyrapone, mexiletine, oral contraceptives, quinidine, sirolimus, tacrolimus, theophylline: Increased metabolism and decreased effects of these drugs.

dopamine: Increased risk of severe hypotension and bradycardia with I.V. phenytoin.

fluoxetine: Increased blood phenytoin level and risk of phenytoin toxicity.

folic acid, leucovorin: Decreased blood phenytoin level, increased risk of seizures.

haloperidol: Decreased effects of haloperidol, decreased anticonvulsant effect of phenytoin.

halothane anesthetics: Increased risk of hepatotoxicity and phenytoin toxicity.

ifosfamide: Decreased phenytoin effects, possibly increased toxicity.

influenza virus vaccine: Possibly decreased phenytoin effects.

insulin, oral antidiabetic drugs: Possibly hyperglycemia, increased blood phenytoin level with tolbutamide.

levonorgestrel, mebendazole, streptozocin, sulfonylureas: Decreased effects of these drugs.

lidocaine, propranolol possibly other beta blockers: Increased cardiac depressant effects with I.V. phenytoin, possibly decreased blood level and increased adverse effects of phenytoin.

lithium: Increased risk of lithium toxicity, increased risk of neurologic symptoms with normal blood lithium level.

meperidine: Increased metabolism and decreased effects of meperidine, possibly meperidine toxicity.

methadone: Possibly increased metabolism of methadone and withdrawal symptoms.

neuromuscular blockers: Shorter duration of action and decreased effects of neuromuscular blockers.

oral anticoagulants: Decreased metabolism and increased effects of phenytoin, early increase and then decrease in anticoagulation.

paroxetine: Decreased bioavailability of both drugs.

phenylbutazone, salicylates: Increased phenytoin effects, possibly phenytoin toxicity primidone: Increased primidone effects, possibly primidone toxicity rifampin: Increased hepatic metabolism of phenytoin.

valproic acid: Possibly decreased phenytoin metabolism, resulting in increased phenytoin effects, possibly decreased blood valproic acid level vitamin D: Possibly decreased vitamin D effects, resulting in rickets or osteomalacia with long-term use of phenytoin.

Activity :- alcohol use: Additive CNS depression, increased phenytoin clearance.