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Dilantin and Adrenal Insufficiency

Prebtani, Ally MD, BScPhm, ABIM, FRCP(C); Rana, Punam MD, BHSc

doi: 10.1097/TEN.0b013e318156093c
Case Report

Various drugs may interact with a corticosteroid, altering its bioavailability. Phenytoin is one example which reduces the bioavailability of a corticosteroid via enzyme induction through the CYP450 system. In this case report, we examine an adrenally insufficient patient on steroid therapy who developed an acute adrenal crisis following phenytoin administration. We list other major drugs that interact with corticosteroids and discuss alternative antiepileptics that have less interaction.

From the Department of Medicine, Division of Endocrinology and Metabolism.

Reprints: Punam Rana, 1253 Main St West, Apt 4, Hamilton, Ontario, Canada, L8S 1C4. E-mail:

© 2007 Lippincott Williams & Wilkins, Inc.