PHENYTOIN AND TACROLIMUS

An isolated report describes an increase in serum phenytoin levels attributed to the use of tacrolimus. Phenytoin decreased tacrolimus levels in one case, and has been used to reduce tacrolimus levels after an overdose. Fosphenytoin, a prodrug of phenytoin, may interact similarly
No interaction is established, but based on the known metabolism of these drugs it would be prudent to monitor tacrolimus levels in a patient given phenytoin. Similarly, based on the single case of phenytoin toxicity, it may also be advisable to monitor phenytoin levels.
(32)
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