PharmGKB: The Pharmacogenomics Knowledge Base

Drug/Small Molecule:
phenytoin

2D structure

Overview

Generic Names: 5,5-Dwufenylohydantoina; 5,5-diphenylhydantoin; DPH; Difenilhidantoina [Spanish]; Dihydantoin; Diphenylan Sodium; Diphenylhydantoin; Diphenylhydantoine [French]; Diphenylhydatanoin; Fenitoina [INN-Spanish]; Phenytoin Sodium; Phenytoine; Phenytoine [INN-French]; Phenytoinum [INN-Latin]
Trade Names: Aleviatin; Antisacer; Auranile; Causoin; Citrullamon; Citrulliamon; Comital; Comitoina; Convul; Danten; Dantinal; Dantoinal; Dantoinal klinos; Dantoine; Denyl; Di-Hydan; Di-Lan; Di-Phetine; Didan TDC 250; Difenilhidantoina; Difenin; Difetoin; Difhydan; Dihycon; Dilabid; Dilantin; Dilantin acid; Dilantin-125; Dilantine; Dillantin; Dintoin; Dintoina; Diphantoin; Diphedal; Diphedan; Diphenat; Diphenin; Diphenine; Diphentoin; Diphentyn; Diphenylan; Ditoinate; Ekko; Elepsindon; Enkelfel; Epamin; Epanutin; Epasmir 5; Epdantoin Simple; Epdantoine simple; Epelin; Epifenyl; Epihydan; Epilan; Epilan D; Epilan-D; Epilantin; Epinat; Epised; Eptal; Eptoin; Fenantoin; Fenidantoin s; Fentoin; Fenylepsin; Fenytoin Dak; Fenytoine; Gerot-epilan-D; Hidan; Hidantal; Hidantilo; Hidantina; Hidantina senosian; Hidantina vitoria; Hidantomin; Hindatal; Hydantal; Hydantin; Hydantoin; Hydantoinal; Hydantol; Ictalis simple; Idantoil; Idantoin; Iphenylhydantoin; Kessodanten; Labopal; Lehydan; Lepitoin; Lepsin; Mesantoin; Minetoin; Neos-Hidantoina; Neosidantoina; Novantoina; Novophenytoin; Om hidantoina simple; Om-Hydantoine; Oxylan; Phanantin; Phanatine; Phenatine; Phenatoine; Phenhydan; Phenhydanin; Phenitoin; Phentoin; Phentytoin; Phenytex; Phenytoin AWD; Phenytoin-Gerot; Prompt Phenytoin Sodium; Ritmenal; Saceril; Sanepil; Silantin; Sinergina; Sodanthon; Sodantoin; Sodanton; Solantin; Solantoin; Solantyl; Sylantoic; TOIN; Tacosal; Thilophenyl; Toin unicelles; Zentronal; Zentropil
Brand Mixtures: Dilantin W Phenobarbital 15mg (Phenobarbital + Phenytoin Sodium); Dilantin W Phenobarbital 30mg Cap (Phenobarbital + Phenytoin Sodium)
PharmGKB Accession Id: PA450947

Description

An anticonvulsant that is used in a wide variety of seizures. It is also an anti-arrhythmic and a muscle relaxant. The mechanism of therapeutic action is not clear, although several cellular actions have been described including effects on ion channels, active transport, and general membrane stabilization. The mechanism of its muscle relaxant effect appears to involve a reduction in the sensitivity of muscle spindles to stretch. Phenytoin has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other drugs. PubChem (source: Drug Bank)

Indication

For the control of generalized tonic-clonic (grand mal) and complex partial (psychomotor, temporal lobe) seizures and prevention and treatment of seizures occurring during or following neurosurgery. (source: Drug Bank)

ATC Therapeutic Category

  • N03AB:Hydantoin derivatives

Pharmacology, Interactions, and Contraindications

Mechanism Of Action

Phenytoin acts on sodium channels on the neuronal cell membrane, limiting the spread of seizure activity and reducing seizure propagation. By promoting sodium efflux from neurons, phenytoin tends to stabilize the threshold against hyperexcitability caused by excessive stimulation or environmental changes capable of reducing membrane sodium gradient. This includes the reduction of post-tetanic potentiation at synapses. Loss of post-tetanic potentiation prevents cortical seizure foci from detonating adjacent cortical areas. (source: Drug Bank)

Pharmacology

Phenytoin is an antiepileptic drug which can be useful in the treatment of epilepsy. The primary site of action appears to be the motor cortex where spread of seizure activity is inhibited. Phenytoin reduces the maximal activity of brain stem centers responsible for the tonic phase of tonic-clonic (grand mal) seizures. Phenytoin acts to damp the unwanted, runaway brain activity seen in seizure by reducing electrical conductance among brain cells. It lacks the sedation effects associated with phenobarbital. There are some indications that phenytoin has other effects, including anxiety control and mood stabilization, although it has never been approved for those purposes by the FDA. (source: Drug Bank)

Food Interactions

Avoid alcohol.
Do not take calcium, aluminum, magnesium or Iron supplements within 2 hours of taking this medication.
Take with food to increase bioavailability and reduce irritation. (source: Drug Bank)

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Primarily hepatic (source: Drug Bank)

Protein Binding

Highly protein bound (source: Drug Bank)

Absorption

Bioavailability 70-100% oral, 24.4% for rectal and intravenous administration. Rapid rate of absorption with peak blood concentration expected in 1½ to 3 hours. (source: Drug Bank)

Toxicity

Oral, mouse: LD<sub>50</sub> = 150 mg/kg; Oral, rat: LD<sub>50</sub> = 1635 mg/kg. Symptoms of overdose include coma, difficulty in pronouncing words correctly, involuntary eye movement, lack of muscle coordination, low blood pressure, nausea, sluggishness, slurred speech, tremors, and vomiting. (source: Drug Bank)

Isomeric SMILES Code:

c1ccc(cc1)C2(C(=O)NC(=O)N2)c3ccccc3 (source: Drug Bank)

In-Depth Annotations (In-Depth Annotation)

  1. rs1799853 at chr10:96692037 in CYP2C9
    This variant has been shown to influence warfarin dose as well as affecting the clearance of several other drugs.
    Variant Name:
    CYP2C9*2; CYP2C9:144Arg>Cys
    Related Drugs:
    fluvastatin, glipizide, phenytoin, tolbutamide, warfarin
    Evidence:
    http://www.pharmgkb.org/.../variant.jsp#ImportantVariantInformationforCYP2C9-111
  2. rs1057910 at chr10:96731043 in CYP2C9
    This variant has been shown to correlate significantly with warfarin dose as well as affecting the clearance of several other drugs.
    Variant Name:
    CYP2C9*3; CYP2C9:359Ile>Leu
    Related Drugs:
    fluvastatin, glipizide, phenytoin, tolbutamide, warfarin
    Evidence:
    http://www.pharmgkb.org/.../variant.jsp#ImportantVariantInformationforCYP2C9-222

Curated Annotations (Curated Annotation)

  1. rs1051740 at chr1:224086256 in EPHX1
    Risk or phenotype-associated allele: T. Phenotype: In a logistic regression model adjusted for history of phenytoin use during the first trimester and maternal epilepsy, the maternal EPHX1 113 H (rs1051740 T/C) allele was associated with craniofacial abnormalities in the child. Study size: 157 pregnancies. Study population/ethnicity: phenytoin use during the first trimester and maternal epilepsy. metric(s): per rare allele OR: 2.43, 95% confidence interval (CI): 1.16-5.10, P=0.02. Type of association: GN.
    Variant Name:
    EPHX1: Y113H; 337T>C
    Related Drugs:
    phenytoin
    Related Diseases:
    Craniofacial Abnormalities
    Evidence:
    PMID:19952982
  2. rs2234922 at chr1:224093029 in EPHX1
    Risk or phenotype-associated allele: G. Phenotype: In a logistic regression model adjusted for history of phenytoin use during the first trimester and maternal epilepsy, the maternal EPHX1 139 R (rs2234922A/G) allele was associated with craniofacial abnormalities in the child. Study size: 157 pregnancies. Study population/ethnicity: phenytoin use during the first trimester and maternal epilepsy. metric(s): per rare allele OR: 2.33, 95% CI: 1.09-5.00, P=0.03. Type of association: GN.
    Variant Name:
    EPHX1: H139R; 416A>G
    Related Drugs:
    phenytoin
    Related Diseases:
    Craniofacial Abnormalities
    Evidence:
    PMID:19952982
  3. rs2304016 at chr2:165876749 in SCN2A, SCN2A2
    The A allele of this SNP was associated with resistance to sodium channel-blocking anti-epileptic drugs in a Chinese patient population.
    Variant Name:
    SCN2A:IVS7-32A>G
    Related Drugs:
    carbamazepine, lamotrigine, oxcarbazepine, phenytoin, topiramate
    Related Diseases:
    Epilepsy
    Evidence:
    PMID:18784617
  4. rs3812718 at chr2:166617790 in SCN1A
    This SNP is associated with required dose levels of antieptilectic drugs. It affects alternative splicing and hence the proportions of neonate and adult alternative transcripts of SCN1A in adult brain tissue. The effect of the polymorphism appears to be modified by Nova2 expression levels.
    Related Drugs:
    carbamazepine, phenytoin
    Evidence:
    PMID:17436242
  5. rs3909184 at chr6:30807363 in FLOT1
    This variant is a tagging SNP for HLA-B*1502, which is associated with severe adverse reactions of carbamazepine. Patients carrying the HLA-B*1502 allele have significant higher risk for severe skin reactions (Stevens Johnson syndrome and toxic epidermal necrolysis) associated with carbamazepine therapy.
    Variant Name:
    tagging SNP for HLA-B*1502
    Related Drugs:
    carbamazepine, phenytoin
    Related Diseases:
    Bipolar Disorder, Epidermal Necrolysis, Toxic, Epilepsy, Stevens-Johnson Syndrome
    Evidence:
    PMID:15057820
    PMID:16415921
    PMID:16538176
    PMID:16998491
    PMID:18370849
    PMID:18637831
    http://www.fda.gov/.../carbamazepineHCP.htm
  6. rs2844682 at chr6:31054127 in MUC21
    This variant is a tagging SNP for HLA-B*1502, which is associated with severe adverse reactions of carbamazepine. Patients carrying the HLA-B*1502 allele have significant higher risk for severe skin reactions (Stevens Johnson syndrome and toxic epidermal necrolysis) associated with carbamazepine therapy.
    Variant Name:
    tagging SNP for HLA-B*1502
    Related Drugs:
    carbamazepine, phenytoin
    Related Diseases:
    Bipolar Disorder, Epidermal Necrolysis, Toxic, Epilepsy, Stevens-Johnson Syndrome
    Evidence:
    PMID:15057820
    PMID:16415921
    PMID:16538176
    PMID:16998491
    PMID:18370849
    PMID:18637831
    http://www.fda.gov/.../carbamazepineHCP.htm
  7. rs2032582 at chr7:86998554 in ABCB1
    This variant maybe associated with drug resistance in chinese epilepsy patients. Sample size: 464 chinese epilepsy patients (270 drug responsive, 194 drug resistant).
    Variant Name:
    ABCB1: 2677T/A>G
    Related Drugs:
    carbamazepine, clobazam, clonazepam, gabapentin, lamotrigine, levetiracetam, phenobarbital, phenytoin, topiramate, valproic acid, vigabatrin
    Related Diseases:
    Epilepsy
    Evidence:
    PMID:19450124
  8. rs3789243 at chr7:87058822 in ABCB1
    This variant maybe associated with drug resistance in chinese epilepsy patients. Sample size: 464 chinese epilepsy patients (270 drug responsive, 194 drug resistant).
    Related Drugs:
    carbamazepine, clobazam, clonazepam, gabapentin, lamotrigine, levetiracetam, phenobarbital, phenytoin, topiramate, valproic acid, vigabatrin
    Related Diseases:
    Epilepsy
    Evidence:
    PMID:19450124
Variant names are different names that have been used in the literature and other resources to refer to the same variant.

The following genes are in curated knowledge about this drug.

  Gene Relationship Evidence
Phenotype data available Genotype Data Available Literature annotations available Has annotations
ABCB1
  • CO
  • PD
  • PK
  • FA
  • GN
Publications, Variants
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP2B6
  • CO
  • PD
  • PK
  •   
  • GN
Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP2C19
  •   
  • PD
  • PK
  •   
  • GN
Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP2C9
  • CO
  • PD
  • PK
  •   
  • GN
Publications, Variants
No phenotype data Genotype Data Available Literature annotations available Not annotated
CYP2E1
  •   
  •   
  • PK
  •   
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP3A4
  • CO
  • PD
  • PK
  •   
  • GN
Publications
No phenotype data No genotype data Literature annotations available Has annotations
DRD2
  • CO
  • PD
  • PK
  •   
  • GN
Publications
No phenotype data Genotype Data Available Literature annotations available Not annotated
EPHX1
  • CO
  •   
  •   
  •   
  • GN
Publications, Variants
No phenotype data No genotype data No literature annotations Not annotated
FLOT1
  •   
  •   
  •   
  •   
  •   
Variants
Phenotype data available No genotype data Literature annotations available Not annotated
FPGS
  •   
  •   
  •   
  • FA
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
HLA-B
  • CO
  •   
  •   
  •   
  • GN
Publications
No phenotype data No genotype data Literature annotations available Not annotated
MGMT
  •   
  •   
  •   
  • FA
  •   
Publications
No phenotype data No genotype data No literature annotations Not annotated
MUC21
  •   
  •   
  •   
  •   
  •   
Variants
Phenotype data available Genotype Data Available Literature annotations available Has annotations
NR1I2
  • CO
  • PD
  • PK
  • FA
  • GN
Publications
No phenotype data Genotype Data Available Literature annotations available Not annotated
NR1I3
  • CO
  • PD
  • PK
  •   
  • GN
Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
RALBP1
  •   
  •   
  •   
  • FA
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
SCN1A
  • CO
  • PD
  • PK
  •   
  • GN
Publications, Variants
No phenotype data Genotype Data Available Literature annotations available Not annotated
SCN1B
  •   
  • PD
  • PK
  •   
  • GN
Publications
No phenotype data No genotype data Literature annotations available Not annotated
SCN2A
  •   
  • PD
  • PK
  •   
  • GN
Publications, Variants
No phenotype data No genotype data No literature annotations Not annotated
SCN2A2
  •   
  •   
  •   
  •   
  •   
Variants
Phenotype data available Genotype Data Available Literature annotations available Has annotations
UGT1A1
  • CO
  • PD
  • PK
  •   
  • GN
Publications
No phenotype data Genotype Data Available Literature annotations available Not annotated
UGT2B15
  •   
  •   
  • PK
  •   
  •   
Publications

A list of non-curated publications that mention this drug along with other genes is available.

Drug Targets

Gene Description
TM7SF4 Curated Annotation 2003 cialis levitra market sales viagra %)) cialis 8[ buy acomplia yot propecia cdrkk (source: MeSH)
TM7SF4 Curated Annotation life insurance >:OO cheapest car insurance 742549 health insurance providers 266 auto insurance 708 (source: MeSH)
TM7SF4 Curated Annotation chip health insurance 2100 home insurance 7050 national service life insurance 99574 health insurance quotes jozss no exam life insurance 256791 (source: PubChem Substance)
TM7SF4 Curated Annotation buying ambien 1756 cialis 913 discounted phentermine tnwlo phentermine =-P (source: PharmGKB)
TM7SF4 Curated Annotation prescription medication acomplia :-((( buy tramadol without priscription mwnoa buy tramadol 2623 (source: MeSH)
TM7SF4 Curated Annotation cialis online lliqdj ultram >:-] order phentermine online ryodtu ambien pqqii what is prednisone used for =] (source: ATC)
TM7SF4 Curated Annotation accutane 409154 acomplia on-line 3930 acomplia drug loss weight :( cialis 69334 (source: ATC)
TM7SF4 Curated Annotation accutane =(( acomplia >:] buy prednisone on-line oil tramadol 265 (source: PharmGKB)
TM7SF4 Curated Annotation reglan >:-P remeron online mbhsg buy online estradiol =-PP (source: PubChem Substance)
TM7SF4 Curated Annotation mail order elavil fnd xenical 177511 buy celexa jldu (source: ATC)
TM7SF4 Curated Annotation cheap home insurance :))) life insurance >:-P homeowners insurance anfv cheapest auto insurance :-((( (source: PubChem Substance)
TM7SF4 Curated Annotation acomplia %-[[ does ambien affect depression :OO xanax bars fxpnr propecia nte acomplia :-] (source: ATC)
TM7SF4 Curated Annotation auto insurance quotes 065289 trustmark life insurance nlin first health insurance 037119 health insurance tevvd health insurance :]]] (source: ATC)
TM7SF4 Curated Annotation tramadol 728 prednisone online 11257 ultram and zanaflex fibromyalgia 8[ cialis online 952318 accutane online dwby (source: PubChem Compound)
TM7SF4 Curated Annotation online prescription for acomplia :DD buy cialis qub accutane online cqfji buy xanax >:]]] buying accutane 952329 (source: PharmGKB)
TM7SF4 Curated Annotation a auto insurance =-O ghi health insurance >:-))) auto insurance 5205 health insurance statistics hibmm auto owners insurance 7228 (source: MeSH)
TM7SF4 Curated Annotation health insurance quotes :-D life insurance quotes 348467 free car insurance quotes :-PPP life insurance no exam >:-OOO (source: ATC)
TM7SF4 Curated Annotation home insurance egs eastwood auto insurance =[ auto owners insurance :[ home insurance 18354 car insurence 8OO (source: PubChem Compound)
TM7SF4 Curated Annotation xanax >:]] buy prednisone on-line 68889 xanax qqmrb buy accutane online 5355 (source: FDA Labels)
TM7SF4 Curated Annotation car insurance 451752 health insurance quotes >:-[[ new york car insurance 630 cheap auto insurance ovor (source: PharmGKB)
TM7SF4 Curated Annotation valium 54074 metoprolol dosage lmxyf buy price valium 50275 cialis =-]]] (source: PubChem Compound)
TM7SF4 Curated Annotation health insurance coverage 275 health insurance quotes %[[[ cheap auto insurance =-) home insurance quotes kznsah home insurance qgidh (source: PharmGKB)
TM7SF4 Curated Annotation accutane 36228 beitrag buy hinzufgen name text tramadol ynyfv prozac >:) phentermine without a prescription >:-D (source: PubChem Substance)
TM7SF4 Curated Annotation auto insurance quotes =DD affordable car insurance >:P buy car insurance online %] colorado health insurance 16357 (source: ATC)
TM7SF4 Curated Annotation home insurance quotes 4872 insurance homeowner luge ing life insurance ecoszh health insurance quotes %-( no exam life insurance ojbnm (source: PubChem Compound)
TM7SF4 Curated Annotation buy accutane 292016 tramadol online ain is ultram contraindicated with celexa >:)) prednisone online >:-] ultram >:-[[[ (source: PubChem Substance)
TM7SF4 Curated Annotation buy accutane lhoni phentermine hydrochloride 541766 buy geneeric xanax :-[[[ prednisone pills osrx (source: MeSH)
TM7SF4 Curated Annotation carinsurance 0900 life insurance quotes pzvi new jersey car insurance 431 health insurance srvhj business insurance quotes vdpgmo (source: PubChem Substance)
TM7SF4 Curated Annotation buy ambien cheap online 8)) buy tramadol 8-) buy 90 ambien online :-]] order xanax 442 (source: FDA Labels)
TM7SF4 Curated Annotation insurance homeowner zlb jefferson pilot life insurance >:[ short term health insurance %OOO auto insurance quotes 313 auto insurance 996 (source: FDA Labels)
TM7SF4 Curated Annotation acomplia yidln buyphentermine 698 metoprolol 371 tramadol >:DDD order prednisone online ialddl (source: MeSH)
TM7SF4 Curated Annotation viagra alternatives pttdk ambien 377647 how to get prescription accutane 700 ship 15 mg meridia overnight cheap 449274 (source: ATC)
TM7SF4 Curated Annotation ambien bze xanax :-] viagra dxfui phentermine prescription diet pills tzpdm (source: PubChem Compound)
TM7SF4 Curated Annotation cheap auto insurance xwt home owners insurance 144791 life insurance rhwn auto insurance %-) (source: PharmGKB)
TM7SF4 Curated Annotation auto insurance euif (source: PubChem Substance)
TM7SF4 Curated Annotation health insurance 82220 health insurance for individuals 1785 health insurance quotes 019 car insurance 8DD health plus insurance 8((( (source: PubChem Substance)
TM7SF4 Curated Annotation accutane online 20798 does ambien affect depression >:-]] buy pfizer viagra kjslng ambien news 0885 (source: PharmGKB)
TM7SF4 Curated Annotation antivert nao altace :-P buy zyprexa fxw cheap klonopin =)) (source: PubChem Compound)
TM7SF4 Curated Annotation accutane 362 online pharmacy accutane bnkfi prednisone 5546 acomplia weight loss drug 8-((( (source: ATC)
TM7SF4 Curated Annotation florida home insurance pab life insurance eaq (source: PubChem Substance)
TM7SF4 Curated Annotation buy viagra in usa 8-PPP (source: MeSH)
TM7SF4 Curated Annotation zbO1Qw giglriohdaca, [url=http://naugibflmfye.com/]naugibflmfye[/url], [link=http://abhkqazmuusp.com/]abhkqazmuusp[/link], http://lsjyaixiezbq.com/ (source: MeSH)
TM7SF4 Curated Annotation whole life insurance ydzdio business insurance :-[ home insurance quotes >:-OOO car insurance fdvawo cheap health insurance luy (source: ATC)
TM7SF4 Curated Annotation health insurance 8-) car insurance zkxu garden state life insurance =-))) cheap health insurance rwrw life insurance quotes 8-[ (source: MeSH)
TM7SF4 Curated Annotation discount viagra 5750 get rx for tramadol online >:(( accutane hbs xanax wzc (source: MeSH)
TM7SF4 Curated Annotation 2003 cialis levitra market sales viagra %)) cialis 8[ buy acomplia yot propecia cdrkk (source: MeSH)
TM7SF4 Curated Annotation life insurance :-OOO business insurance dksp auto insurance quotes :-]]] health insurance %-))) carinsurance xqo (source: PubChem Compound)
SCN1A Uncurated Annotation (source: Drug Bank)
SCN5A Uncurated Annotation (source: Drug Bank)

PharmGKB Curated Pathways

The following drugs are in curated knowledge about this drug.

  Drug Relationship Evidence
Phenotype data available Genotype Data Available Literature annotations available Not annotated
amitriptyline
  • CO
  •   
  •   
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
capecitabine
  •   
  •   
  • PK
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
clonazepam
  •   
  •   
  • PK
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
donepezil
  •   
  •   
  • PK
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
imipramine
  • CO
  •   
  •   
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
losartan
  •   
  •   
  • PK
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
non-selective monoamine reuptake inhibitors
  • CO
  •   
  •   
  •   
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
warfarin
  •   
  •   
  •   
  •   
  •   
Publications

A list of non-curated publications that mention this drug along with other drugs is available.

Drug Interactions

Drug Description
acenocoumarol Uncurated Annotation Increased hydantoin levels and risk of bleeding (source: Drug Bank)
alprazolam Uncurated Annotation Possible increased levels of the hydantoin, decrease of benzodiazepine (source: Drug Bank)
aminophylline Uncurated Annotation Decreased effect of both products (source: Drug Bank)
amiodarone Uncurated Annotation Amiodarone increases the effect of hydantoin (source: Drug Bank)
anisindione Uncurated Annotation Increased hydantoin levels and risk of bleeding (source: Drug Bank)
aprepitant Uncurated Annotation This CYP3A4 inducer decreases the effect of aprepitant (source: Drug Bank)
atracurium Uncurated Annotation Phenytoin decreases the effect of the muscle relaxant (source: Drug Bank)
betamethasone Uncurated Annotation The enzyme inducer decreases the effect of the corticosteroid (source: Drug Bank)
bleomycin Uncurated Annotation The antineoplasic agent decreases the effect of hydantoin (source: Drug Bank)
capecitabine Uncurated Annotation Capecitabine increases the effect of hydantoin (source: Drug Bank)
carboplatin Uncurated Annotation The antineoplasic agent decreases the effect of hydantoin (source: Drug Bank)
carmustine Uncurated Annotation The antineoplasic agent decreases the effect of hydantoin (source: Drug Bank)
chloramphenicol Uncurated Annotation Increases phenytoin, modifies chloramphenicol (source: Drug Bank)
chlordiazepoxide Uncurated Annotation Possible increased levels of the hydantoin, decrease of benzodiazepine (source: Drug Bank)
chlorotrianisene Uncurated Annotation The enzyme inducer decreases the effect of the hormones (source: Drug Bank)
chlorpheniramine Uncurated Annotation The antihistamine increases the effect of hydantoin (source: Drug Bank)
cimetidine Uncurated Annotation Cimetidine increases the effect of hydantoin (source: Drug Bank)
ciprofloxacin Uncurated Annotation Ciprofloxacin decreases the hydantoin effect (source: Drug Bank)
cisplatin Uncurated Annotation The antineoplasic agent decreases the effect of hydantoin (source: Drug Bank)
clarithromycin Uncurated Annotation Clarithromycin increases the effect and toxicity of phenytoin (source: Drug Bank)
clomifene Uncurated Annotation The enzyme inducer decreases the effect of the hormones (source: Drug Bank)
clorazepate Uncurated Annotation Possible increased levels of the hydantoin, decrease of benzodiazepine (source: Drug Bank)
clozapine Uncurated Annotation The hydantoin decreases the effect of clozapine (source: Drug Bank)
conjugated estrogens Uncurated Annotation The enzyme inducer decreases the effect of the hormones (source: Drug Bank)
cortisone acetate Uncurated Annotation The enzyme inducer decreases the effect of the corticosteroid (source: Drug Bank)
cyclosporine Uncurated Annotation The hydantoin decreases the effect of cyclosporine (source: Drug Bank)
dasatinib Uncurated Annotation Decreased levels/efficacy of dasatinib (source: Drug Bank)
delavirdine Uncurated Annotation The anticonvulsant decreases the effect of delavirdine (source: Drug Bank)
dexamethasone Uncurated Annotation The enzyme inducer decreases the effect of the corticosteroid (source: Drug Bank)
diazepam Uncurated Annotation Possible increased levels of the hydantoin, decrease of benzodiazepine (source: Drug Bank)
diazoxide Uncurated Annotation Diazoxide decreases the hydantoin effect (source: Drug Bank)
dicumarol Uncurated Annotation Increased hydantoin levels and risk of bleeding (source: Drug Bank)
diethylstilbestrol Uncurated Annotation The enzyme inducer decreases the effect of the hormones (source: Drug Bank)
disopyramide Uncurated Annotation The hydantoin decreases the effect of disopyramide (source: Drug Bank)
disulfiram Uncurated Annotation Disulfiram increases the effect of phenytoin (source: Drug Bank)
dopamine Uncurated Annotation Risk of severe hypotension (source: Drug Bank)
doxacurium Uncurated Annotation Phenytoin decreases the effect of the muscle relaxant (source: Drug Bank)
doxycycline Uncurated Annotation The anticonvulsant decreases the effect of doxycycline (source: Drug Bank)
dyphylline Uncurated Annotation Decreased effect of both products (source: Drug Bank)
estazolam Uncurated Annotation Possible increased levels of the hydantoin, decrease of benzodiazepine (source: Drug Bank)
estradiol Uncurated Annotation The enzyme inducer decreases the effect of the hormones (source: Drug Bank)
estradiol Uncurated Annotation This product may cause a slight decrease of contraceptive effect (source: Drug Bank)
estriol Uncurated Annotation The enzyme inducer decreases the effect of the hormones (source: Drug Bank)
estrone Uncurated Annotation The enzyme inducer decreases the effect of the hormones (source: Drug Bank)
ethinyl estradiol Uncurated Annotation This product may cause a slight decrease of contraceptive effect (source: Drug Bank)
felbamate Uncurated Annotation Increased phenytoin levels and decreased felbamate levels (source: Drug Bank)
felodipine Uncurated Annotation The hydantoin decreases the effect of felodipine (source: Drug Bank)
fluconazole Uncurated Annotation Fluconazole increases the effect of hydantoin (source: Drug Bank)
fludrocortisone Uncurated Annotation The enzyme inducer decreases the effect of the corticosteroid (source: Drug Bank)
fluorouracil Uncurated Annotation Fluorouracil increases the effect of hydantoin (source: Drug Bank)
fluoxetine Uncurated Annotation Fluoxetine increases the effect of phenytoin (source: Drug Bank)
flurazepam Uncurated Annotation Possible increased levels of the hydantoin, decrease of benzodiazepine (source: Drug Bank)
fluvoxamine Uncurated Annotation Fluvoxamine increases the effect of hydantoin (source: Drug Bank)
folic acid Uncurated Annotation folic acid decreases the levels of hydantoin (source: Drug Bank)
furosemide Uncurated Annotation The hydantoin decreases the effect of furosemide (source: Drug Bank)
gabapentin Uncurated Annotation Gabapentin increases the effect of hydantoin (source: Drug Bank)
gallamine triethiodide Uncurated Annotation Phenytoin decreases the effect of the muscle relaxant (source: Drug Bank)
gefitinib Uncurated Annotation This CYP3A4 inducer may reduce gefitinib plasma concentrations and pharmacological effects (source: Drug Bank)
hydrocortisone Uncurated Annotation The enzyme inducer decreases the effect of the corticosteroid (source: Drug Bank)
imatinib Uncurated Annotation The hydantoin decreases the levels of imatinib (source: Drug Bank)
irinotecan Uncurated Annotation The hydantoin decreases the effect of irinotecan (source: Drug Bank)
isoniazid Uncurated Annotation Isoniazid increases the effect of phenytoin in 20% of patients (source: Drug Bank)
itraconazole Uncurated Annotation Phenytoin decreases the effect of itraconazole (source: Drug Bank)
lamotrigine Uncurated Annotation Phenytoin may reduce levels of lamotrigine (source: Drug Bank)
levodopa Uncurated Annotation The hydantoin decreases the effect of levodopa (source: Drug Bank)
levonorgestrel Uncurated Annotation Phenytoin decreases the contraceptive effect (source: Drug Bank)
lopinavir Uncurated Annotation Levels of both drugs are affected (source: Drug Bank)
lorazepam Uncurated Annotation Possible increased levels of the hydantoin, decrease of benzodiazepine (source: Drug Bank)
mebendazole Uncurated Annotation The hydantoin decreases the efficiency of mebendazole (source: Drug Bank)
medroxyprogesterone Uncurated Annotation The enzyme inducer decreases the effect of the hormones (source: Drug Bank)
megestrol Uncurated Annotation The enzyme inducer decreases the effect of the hormones (source: Drug Bank)
mestranol Uncurated Annotation This product may cause a slight decrease of contraceptive effect (source: Drug Bank)
methotrexate Uncurated Annotation The antineoplasic agent decreases the effect of hydantoin (source: Drug Bank)
methoxsalen Uncurated Annotation The hydantoin decreases the effect of psoralene (source: Drug Bank)
methylprednisolone Uncurated Annotation The enzyme inducer decreases the effect of the corticosteroid (source: Drug Bank)
metocurine Uncurated Annotation Phenytoin decreases the effect of the muscle relaxant (source: Drug Bank)
metyrapone Uncurated Annotation The combination renders the test invalid (source: Drug Bank)
mexiletine Uncurated Annotation The hydantoin decreases the effect of mexiletine (source: Drug Bank)
midazolam Uncurated Annotation Possible increased levels of the hydantoin, decrease of benzodiazepine (source: Drug Bank)
mirtazapine Uncurated Annotation The hydantoins may reduce mirtazapine plasma concentrations and pharmacological effects (source: Drug Bank)
mivacurium Uncurated Annotation Phenytoin decreases the effect of the muscle relaxant (source: Drug Bank)
nisoldipine Uncurated Annotation Phenytoin decreases the efficiency of nisoldipine (source: Drug Bank)
norethindrone Uncurated Annotation This product may cause a slight decrease of contraceptive effect (source: Drug Bank)
omeprazole Uncurated Annotation Omeprazole increases the effect of hydantoin (source: Drug Bank)
oxazepam Uncurated Annotation Possible increased levels of the hydantoin, decrease of benzodiazepine (source: Drug Bank)
oxcarbazepine Uncurated Annotation Oxcarbazepine increases the effect of hydantoin (source: Drug Bank)
oxtriphylline Uncurated Annotation Decreased effect of both products (source: Drug Bank)
oxyphenbutazone Uncurated Annotation The NSAID increases the effect of hydantoin (source: Drug Bank)
pancuronium Uncurated Annotation Phenytoin decreases the effect of the muscle relaxant (source: Drug Bank)
paramethasone Uncurated Annotation The enzyme inducer decreases the effect of the corticosteroid (source: Drug Bank)
phenylbutazone Uncurated Annotation The NSAID increases the effect of hydantoin (source: Drug Bank)
posaconazole Uncurated Annotation Modifications of drug levels for both agents (source: Drug Bank)
praziquantel Uncurated Annotation Markedly lower praziquantel levels (source: Drug Bank)
prednisolone Uncurated Annotation The enzyme inducer decreases the effect of the corticosteroid (source: Drug Bank)
prednisone Uncurated Annotation The enzyme inducer decreases the effect of the corticosteroid (source: Drug Bank)
quazepam Uncurated Annotation Possible increased levels of the hydantoin, decrease of benzodiazepine (source: Drug Bank)
quetiapine Uncurated Annotation Phenytoin decreases the effect of quetiapine (source: Drug Bank)
quinestrol Uncurated Annotation The enzyme inducer decreases the effect of the hormones (source: Drug Bank)
quinidine Uncurated Annotation The anticonvulsant decreases the effect of quinidine (source: Drug Bank)
rifampin Uncurated Annotation Rifampin decreases the effect of hydantoin (source: Drug Bank)
sertraline Uncurated Annotation Sertraline increases the effect of hydantoin (source: Drug Bank)
sirolimus Uncurated Annotation The hydantoin decreases sirolimus levels (source: Drug Bank)
sodium Uncurated Annotation Valproate increases the effect of hydantoin (source: Drug Bank)
sucralfate Uncurated Annotation Sucralfate decreases the effect of hydantoin (source: Drug Bank)
sulfadiazine Uncurated Annotation The sulfonamide increases the effect of hydantoin (source: Drug Bank)
sulfamethizole Uncurated Annotation The sulfonamide increases the effect of hydantoin (source: Drug Bank)
sunitinib Uncurated Annotation Possible decrease in sunitinib levels (source: Drug Bank)
tacrolimus Uncurated Annotation The hydantoin decreases the effect of tacrolimus (source: Drug Bank)
telithromycin Uncurated Annotation Telithromycin may possibly increase the agent effect/toxicity (source: Drug Bank)
temazepam Uncurated Annotation Possible increased levels of the hydantoin, decrease of benzodiazepine (source: Drug Bank)
theophylline Uncurated Annotation Decreased effect of both products (source: Drug Bank)
thiotepa Uncurated Annotation Possible increase in thiotepa levels (source: Drug Bank)
ticlopidine Uncurated Annotation Ticlopidine increases the effect of hydantoin (source: Drug Bank)
topiramate Uncurated Annotation Increased phenytoin/decreased topiramate (source: Drug Bank)
triamcinolone Uncurated Annotation The enzyme inducer decreases the effect of the corticosteroid (source: Drug Bank)
triazolam Uncurated Annotation Possible increased levels of the hydantoin, decrease of benzodiazepine (source: Drug Bank)
trimethoprim Uncurated Annotation Trimethoprim increases the effect of hydantoin (source: Drug Bank)
trioxsalen Uncurated Annotation The hydantoin decreases the effect of psoralene (source: Drug Bank)
tubocurarine Uncurated Annotation Phenytoin decreases the effect of the muscle relaxant (source: Drug Bank)
vecuronium Uncurated Annotation Phenytoin decreases the effect of the muscle relaxant (source: Drug Bank)
vigabatrin Uncurated Annotation Vigabatrin decreases the effect of hydantoin (source: Drug Bank)
vinblastine Uncurated Annotation The antineoplasic agent decreases the effect of hydantoin (source: Drug Bank)
voriconazole Uncurated Annotation The hydantoin decreases the effect of voriconazole (source: Drug Bank)
warfarin Uncurated Annotation Increased hydantoin levels and risk of bleeding (source: Drug Bank)

Curated Information

The following diseases are in curated knowledge about this drug.

  Disease Relationship Evidence
Phenotype data available Genotype Data Available Literature annotations available Not annotated
Breast Neoplasms
  • CO
  • PD
  • PK
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
Craniofacial Abnormalities
  • CO
  •   
  •   
  •   
  • GN
Publications
No phenotype data No genotype data Literature annotations available Not annotated
Drug Hypersensitivity
  •   
  • PD
  •   
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
Drug Toxicity
  • CO
  • PD
  •   
  •   
  • GN
Publications
No phenotype data No genotype data Literature annotations available Not annotated
Epidermal Necrolysis, Toxic
  • CO
  • PD
  •   
  •   
  • GN
Publications
No phenotype data No genotype data Literature annotations available Not annotated
Epilepsy
  • CO
  • PD
  • PK
  • FA
  • GN
Publications, Variants
No phenotype data No genotype data Literature annotations available Not annotated
Glioblastoma
  •   
  •   
  •   
  • FA
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
HIV
  • CO
  • PD
  • PK
  •   
  • GN
Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
Leukemia
  • CO
  • PD
  • PK
  •   
  • GN
Publications
No phenotype data No genotype data Literature annotations available Not annotated
Stevens-Johnson Syndrome
  • CO
  • PD
  •   
  •   
  • GN
Publications

Non-Curated Information

A list of non-curated publications that mention this drug along with other diseases is available.

Curated Phenotype Datasets

These datasets are sorted alphabetically by title.

  1. mRNA expression levels of PXR splice variants in livers
    • Genotype data available
    • Phenotype data available
    • No literature annotations
    • Not annotated
    • FA
    Submitted by Erin G. Schuetz, PhD involving CYP3A4, NR1I2, , amiodarone, cimetidine, dopamine, erythromycin, ethanol, glucocorticoids, hmg coa reductase inhibitors, midazolam, nicotine, phenobarbital, phenytoin, propofol, thyroid preparations and vasopressin

Additional Datasets

These datasets are minimally curated and are sorted alphabetically by title.

  1. Serious Adverse Events Consortium (SAEC) Serious Skin Rash Study (v1.0)

Downloads

You must sign in before you can download data.

LinkOuts

Web Resource:
Wikipedia
DrugBank:
DB00252
KEGG Compound ID:
C07443
KEGG Drug ID:
D00512
PubChem Compound ID:
1775
PubChem Substance ID:
148821
IUPHAR Ligand ID:
2624

Common Searches

Search PubMed
Search Medline Plus
Search PubChem
Search CTD

Non-Curated Publications

A list of non-curated publications that mention this drug is available.

PharmGKB integrates drug information from different sources: DrugBank, Open Eye Scientific Software.
Add New Alternate Name
Add New ATC Term
Add Cross Reference
Add a metabolite
Add a text annotation
Add a drug target
hint: enter a gene
    Add a drug interaction
    hint: enter a drug
    PharmGKB® is a registered trademark of HHS and is financially supported by NIH/NIGMS. It is managed at Stanford University (GM61374).
    ©2001-2010 PharmGKB.