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The Annals of Pharmacotherapy: Vol. 32, No. 12, pp. 1295-1298. DOI 10.1345/aph.17296
© 1998 Harvey Whitney Books Company.
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Research Articles

Ticlopidine-induced phenytoin toxicity

SL Klaassen

OBJECTIVE: To report a probable case of ticlopidine-induced phenytoin toxicity. CASE SUMMARY: A 72-year-old white man suddenly developed combative behavior, refused to leave his room, stopped eating, and began falling to the floor 6 weeks after being given ticlopidine. The total phenytoin concentration was measured at 43.6 micrograms/mL; the dosage of phenytoin was decreased and the symptoms later resolved. After ticlopidine was discontinued, the patient was rechallenged with the same dose of phenytoin without symptoms of toxicity. DISCUSSION: Possible mechanisms of the drug interaction are discussed with emphasis on cytochrome P450 metabolism. CONCLUSIONS: Clinicians should be aware of this potentially serious drug interaction and either avoid the phenytoin-ticlopidine combination, or monitor closely for phenytoin toxicity.


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Copyright © 1998 by Harvey Whitney Books Company.