Chronic Adverse Drug Reactions of Phenytoin: A Comprehensive Review

Authors

  • Jamdade Sonali Lala Department of pharmacology, Sudhakarrao Naik Institute of Pharmacy Pusad, District Yavatmal, University- Ssant Gadage baba (Amravati university), Maharashtra, India
  • Ayodhya Tanaji Pardhe Department of pharmacology, Sudhakarrao Naik Institute of Pharmacy Pusad, District Yavatmal, University- Ssant Gadage baba (Amravati university), Maharashtra, India
  • Dr. V. N. Deshmukha Department of pharmacology, Sudhakarrao Naik Institute of Pharmacy Pusad, District Yavatmal, University- Ssant Gadage baba (Amravati university), Maharashtra, India
  • Dr. Rajesh Mandade Department of pharmacology, Sudhakarrao Naik Institute of Pharmacy Pusad, District Yavatmal, University- Ssant Gadage baba (Amravati university), Maharashtra, India

DOI:

https://doi.org/10.22270/ajprd.v13i3.1572

Abstract

Phenytoin remains a cornerstone in the management of epilepsy and certain seizure disorders. However, its use is frequently complicated by a wide array of adverse drug reactions (ADRs) affecting multiple organ systems. This review aims to provide an in-depth overview of the chronic toxicities linked to phenytoin, discuss the underlying mechanisms, propose clinical management strategies, and highlight potential safer alternatives for long-term epilepsy management.

 

 

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Author Biographies

Jamdade Sonali Lala, Department of pharmacology, Sudhakarrao Naik Institute of Pharmacy Pusad, District Yavatmal, University- Ssant Gadage baba (Amravati university), Maharashtra, India

Department of pharmacology, Sudhakarrao Naik Institute of Pharmacy Pusad, District Yavatmal, University- Ssant Gadage baba (Amravati university), Maharashtra, India

Ayodhya Tanaji Pardhe, Department of pharmacology, Sudhakarrao Naik Institute of Pharmacy Pusad, District Yavatmal, University- Ssant Gadage baba (Amravati university), Maharashtra, India

Department of pharmacology, Sudhakarrao Naik Institute of Pharmacy Pusad, District Yavatmal, University- Ssant Gadage baba (Amravati university), Maharashtra, India

Dr. V. N. Deshmukha, Department of pharmacology, Sudhakarrao Naik Institute of Pharmacy Pusad, District Yavatmal, University- Ssant Gadage baba (Amravati university), Maharashtra, India

Department of pharmacology, Sudhakarrao Naik Institute of Pharmacy Pusad, District Yavatmal, University- Ssant Gadage baba (Amravati university), Maharashtra, India

Dr. Rajesh Mandade, Department of pharmacology, Sudhakarrao Naik Institute of Pharmacy Pusad, District Yavatmal, University- Ssant Gadage baba (Amravati university), Maharashtra, India

Department of pharmacology, Sudhakarrao Naik Institute of Pharmacy Pusad, District Yavatmal, University- Ssant Gadage baba (Amravati university), Maharashtra, India

References

Belete TB. Mechanism of action of phenytoin in neuropharmacology. [Journal Name]. 2023;[Volume(Issue)]:pages.

Patsalos PN, Perucca E. Clinically important drug interactions in epilepsy: interactions between antiepileptic drugs and other drugs. Lancet Neurol. 2003;2(8):473-481.

Perucca E. Pharmacoresistance in epilepsy: how should it be defined? CNS Drugs. 1998;10(3):171-179.

Brodie MJ, Kwan P. Current position of phenobarbital in epilepsy and its future. Epilepsia. 2012;53 Suppl 8:40-46.

Löscher W, Potschka H. Role of drug efflux transporters in the brain for drug resistance in epilepsy. Handb Exp Pharmacol. 2011;(201):445-473.

Rogawski MA, Löscher W. The neurobiology of antiepileptic drugs for the treatment of nonepileptic conditions. Nat Med. 2004;10(7):685-692.

McNamara JO. Pharmacotherapy of the epilepsies. In: Brunton LL, Hilal-Dandan R, Knollmann BC, editors. Goodman & Gilman's The Pharmacological Basis of Therapeutics. 13th ed. New York: McGraw-Hill; 2018. p. 275-301.

Hageman NS, Okun MS. Phenytoin-induced cerebellar degeneration. Neurology. 2001;56(5):686-688.

Perucca E. Adverse effects of antiepileptic drugs. Lancet Neurol. 2005;4(11):693-702.

Miller DR, Cohen PR. Phenytoin-induced cutaneous adverse drug reactions. South Med J. 1993;86(10):1148-1152.

Roujeau JC, Stern RS. Severe adverse cutaneous reactions to drugs. N Engl J Med. 1994;331(19):1272-1285.

Lacy CF, Armstrong LL, Goldman MP, Lance LL. Drug Information Handbook. 24th ed. Hudson (OH): Lexicomp; 2016.

Chalasani NP, Hayashi PH, Bonkovsky HL, Navarro VJ, Lee WM, Fontana RJ. ACG Clinical Guideline: The diagnosis and management of idiosyncratic drug-induced liver injury. Am J Gastroenterol. 2014;109(7):950-966.

Petty SJ, O'Brien TJ, Wark JD. Anti-epileptic medication and bone health. Osteoporos Int. 2007;18(2):129-142.

Pack AM. The association between antiepileptic drugs and bone disease. Epilepsy Curr. 2003;3(3):91-95.

Patsalos PN. Therapeutic drug monitoring of antiepileptic drugs by use of saliva. Ther Drug Monit. 1999;21(6):674-679.

Brodie MJ. Antiepileptic drug therapy the story so far. Seizure. 2010;19(10):650-655.

Bøttiger LE, Westerholm B. Megaloblastic anemia induced by anticonvulsant drugs. Epilepsia. 1970;11(4):377-383.

Perucca E. Clinical pharmacokinetics of new-generation antiepileptic drugs at the extremes of age. Clin Pharmacokinet. 2006;45(4):351-363.

Pack AM, Morrell MJ. Epilepsy and bone health in adults. Epilepsy Behav. 2004;5 Suppl 2:S24-S29.

Patsalos PN, Berry DJ, Bourgeois BF, Cloyd JC, Glauser TA, Johannessen SI, et al. Antiepileptic drugs—best practice guidelines for therapeutic drug monitoring: a position paper by the subcommission on therapeutic drug monitoring, ILAE Commission on Therapeutic Strategies. Epilepsia. 2008;49(7):1239-1276.

Shorvon S. The clinical efficacy of newer antiepileptic drugs. Epilepsia. 2004;45 Suppl 6:46-50.

Sander JW. The use of antiepileptic drugs—principles and practice. Epilepsia. 2004;45 Suppl 6:28-34.

Stephen LJ, Brodie MJ. Seizure freedom with more than one antiepileptic drug. Seizure. 2002;11(6):349-351.

Bhagavati S. Phenytoin toxicity: An overview. J Clin Neurosci. 2019;62:1-5. doi: 10.1016/j.jocn.2019.01.007.

Brodie MJ. Phenytoin: 80 years young, but with an uncertain future. Epilepsy Res. 2017;137:1-4. doi: 10.1016/j.eplepsyres.2017.08.007.

Herman ST, Walther E. Adverse effects of antiepileptic drugs: A brief overview. CNS Drugs. 2018;32(4):383-92. doi: 10.1007/s40263-018-0523-9.

McCormack M, Alfirevic A, Bourgeois S, Farrell JJ, Kasperavičiūtė D, Carrington M, et al. HLA-A*3101 and carbamazepine-induced hypersensitivity reactions in Europeans. N Engl J Med. 2011;364(12):1134-43. doi: 10.1056/NEJMoa1013297.

Pack AM. Epilepsy and bone health: The role of antiepileptic drugs. Curr Neurol Neurosci Rep. 2018;18(7):44. doi: 10.1007/s11910-018-0853-3.

Patsalos PN, Berry DJ, Bourgeois BF, Cloyd JC, Glauser TA, Johannessen SI, et al. Antiepileptic drugs—best practice guidelines for therapeutic drug monitoring: a position paper by the subcommission on therapeutic drug monitoring, ILAE Commission on Therapeutic Strategies. Epilepsia. 2008;49(7):1239-76. doi: 10.1111/j.1528-1167.2008.01561.x.

Published

2025-06-15

How to Cite

Jamdade Sonali Lala, Ayodhya Tanaji Pardhe, Dr. V. N. Deshmukha, & Dr. Rajesh Mandade. (2025). Chronic Adverse Drug Reactions of Phenytoin: A Comprehensive Review. Asian Journal of Pharmaceutical Research and Development, 13(3), 142–144. https://doi.org/10.22270/ajprd.v13i3.1572