DDInter1460 DDInter1008
Phenytoin is classified as a hydantoin derivative and despite its narrow therapeutic index, it is one of the most commonly used anticonvulsants.[A33595,A188832,A189219] Since it's introduction about 80 years ago, phenytoin has not only been established as an effective anti-epileptic, but has also been investigated for several other indications such as bipolar disorder, retina protection, and wound healing.[A188826,A188832] Clinicians are advised to initiate therapeutic drug monitoring in patients who require phenytoin since even small deviations from the recommended therapeutic range can lead to suboptimal treatment, or adverse effects.[A189219,A35884] Both parenteral and oral formulations of phenytoin are available on the market.
Ketoconazole is an imidazole antifungal agent used in the prevention and treatment of a variety of fungal infections.[FDA Label] It functions by preventing the synthesis of ergosterol, the fungal equivalent of cholesterol, thereby increasing membrane fluidity and preventing growth of the fungus.[A181802,T116] Ketoconazole was first approved in an oral formulation for systemic use by the FDA in 1981. At this time it was considered a significant improvement over previous antifungals, [miconazole] and [clotrimazole], due to its broad spectrum and good absorption. However, it was discovered that ketoconazole produces frequent gastrointestinal side effects and dose-related hepatitis.[A188054,A188057] These effects combined with waning efficacy led to its eventual replacement by triazole agents, [fluconazole], [itraconazole], [voriconazole], and [posaconazole]. Ketoconazole and its predecessor [clotrimazole] continue to be used in topical formulations.
Phenytoin {u} (Compound) binds {v} (Gene) CYP3A4
CYP3A4 {u} (Gene) is bound by {v} (Compound) Ketoconazole
Phenytoin {u} (Compound) causes {v} (Side Effect) Hypersensitivity
Hypersensitivity {u} (Side Effect) is caused by {v} (Compound) Ketoconazole
Phenytoin {u} (Compound) binds {v} (Gene) CYP3A4
CYP3A4 {u} (Gene) is bound by {v} (Compound) Itraconazole
Itraconazole {u} (Compound) resembles {v} (Compound) Ketoconazole
Phenytoin {u} (Compound) binds {v} (Gene) CYP11B1
CYP11B1 {u} (Gene) interacts with {v} (Gene) CYP11B2
CYP11B2 {u} (Gene) is bound by {v} (Compound) Ketoconazole
Phenytoin {u} (Compound) causes {v} (Side Effect) Hypersensitivity
Hypersensitivity {u} (Side Effect) is caused by {v} (Compound) Itraconazole
Itraconazole {u} (Compound) resembles {v} (Compound) Ketoconazole
Phenytoin {u} (Compound) causes {v} (Side Effect) Epistaxis
Epistaxis {u} (Side Effect) is caused by {v} (Compound) Posaconazole
Posaconazole {u} (Compound) resembles {v} (Compound) Ketoconazole
Phenytoin {u} (Compound) binds {v} (Gene) ABCB1
ABCB1 {u} (Gene) is bound by {v} (Compound) Posaconazole
Posaconazole {u} (Compound) resembles {v} (Compound) Ketoconazole
Phenytoin {u} (Compound) binds {v} (Gene) ABCB1
ABCB1 {u} (Gene) regulates {v} (Gene) ALDOC
ALDOC {u} (Gene) is upregulated by {v} (Compound) Ketoconazole
Phenytoin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Miconazole
Miconazole {u} (Compound) resembles {v} (Compound) Econazole
Econazole {u} (Compound) resembles {v} (Compound) Ketoconazole
Phenytoin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Miconazole
Miconazole {u} (Compound) binds {v} (Gene) CYP3A4
CYP3A4 {u} (Gene) is bound by {v} (Compound) Ketoconazole
Phenytoin (Compound) binds CYP3A4 (Gene) and CYP3A4 (Gene) is bound by Ketoconazole (Compound)
Phenytoin (Compound) causes Hypersensitivity (Side Effect) and Hypersensitivity (Side Effect) is caused by Ketoconazole (Compound)
Phenytoin (Compound) binds CYP3A4 (Gene) and CYP3A4 (Gene) is bound by Itraconazole (Compound) and Itraconazole (Compound) resembles Ketoconazole (Compound)
Phenytoin (Compound) binds CYP11B1 (Gene) and CYP11B1 (Gene) interacts with CYP11B2 (Gene) and CYP11B2 (Gene) is bound by Ketoconazole (Compound)
Phenytoin (Compound) causes Hypersensitivity (Side Effect) and Hypersensitivity (Side Effect) is caused by Itraconazole (Compound) and Itraconazole (Compound) resembles Ketoconazole (Compound)
Phenytoin (Compound) causes Epistaxis (Side Effect) and Epistaxis (Side Effect) is caused by Posaconazole (Compound) and Posaconazole (Compound) resembles Ketoconazole (Compound)
Phenytoin (Compound) binds ABCB1 (Gene) and ABCB1 (Gene) is bound by Posaconazole (Compound) and Posaconazole (Compound) resembles Ketoconazole (Compound)
Phenytoin (Compound) binds ABCB1 (Gene) and ABCB1 (Gene) regulates ALDOC (Gene) and ALDOC (Gene) is upregulated by Ketoconazole (Compound)
Phenytoin may cause a moderate interaction that could exacerbate diseases when taken with Miconazole and Miconazole (Compound) resembles Econazole (Compound) and Econazole (Compound) resembles Ketoconazole (Compound)
Phenytoin may cause a moderate interaction that could exacerbate diseases when taken with Miconazole and Miconazole (Compound) binds CYP3A4 (Gene) and CYP3A4 (Gene) is bound by Ketoconazole (Compound)