I was told by a pharmacist once that protein in food interacts with dilantin/phenytoin, thus it should not be taken near meal time. She said this is true to all forms of dilantin, except Phenytoin Sodium in Extended Release Caps. But she added that the Extended Release Caps must be taken whole, or else, dilantin within would not be protected by the special lattice of the capsule from protein interference. However, I searched the web, and only found references on Enteral Feeds affecting dilantin absorption. A couple of references went as far as saying that it is caused by the high concentration of protein in Enteral Feeds. So can so one shed some light on this? And if it is protein, would the protein in Enteral Feeds be any different from protein in "regular" food through oral intake?
replied to: chengasaurus
Replied to: I was told by a pharmacist once that protein in food...
I am not a medic, but I had cause to research phenytoin a year ago.
It seems that phenytoin binds to plasma protein. My relative had low levels of albumin as a result of illness and consequently developed toxic side effects from phenytoin. I would say that the pharmacokinetics of this drug and the side-effects are not widely known in the (UK) medical profession and the standard blood tests carried out in our NHS do not check for its free levels.
As far as directions for taking the drug are concerned, you should read the patient information leaflet that comes with the drug. I certainly did not discover any information regarding this drug's interaction with protein in food.
Also take a close look at the side effects and make sure you and your relatives/carers are aware of them.
Phenytoin does interact with other drugs (alcohol and vitamin supplements like calcium/antacids too I believe) and can increase or decrease its blood level. Check with your GP/specialist.
Also I seem to recall that phenytoin effected the metabolism of Vitamin D. It would be worth you doing some research into this to make sure that you suffer no long-term consequences of any deficiency and then double-check it with your health advisor.
I'm not sure of your location, but wherever you are it pays to be well-informed on your own health issues.
