Data provided by Applied Health
side effects, nutrient depletions, herbal interactions and health notes:
• Dilantin may be taken with or immediately after food to reduce stomach irritation.1
• Dilantin may cause poor absorption or depletion of biotin, carnitine, calcium, Vitamin D, Vitamin K, certain B vitamins, and folic acid. Supplementation may be beneficial. Dietary supplements should not be taken within two hours of taking the medicine.2
• Avoid alcohol3
• These herbs may increase the risk of seizures: Borage, Evening Primrose Oil, and Sage.4
• These herbs may have sedative properties and should be avoided: calamus, calendula, chamomile, California poppy, catnip, couch grass, elecampane, ginseng Siberian, goldenseal, gotu kola, hops, Jamaican dogwood, kava, lemon balm, sage, St. John's wort, sassafras, scullcap, shepherd's purse, stinging nettle, valerian, withania root, and yerba mansa.5
• Avoid ginkgo with anticonvulsants because of their seizure potential.6
References1 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
1 Pronsky, Z Food Medication Interactions, 11th edition, 1999
2 Reynolds EH, Milner G, Matthews DM, Chanarin I: Anticonvulsant therapy, megaloblastic haemopoiesis and folic acid metabolism, Quart J Med, 1966; 35:521-537.
2 Hahn TJ, Halstead LR: Anticonvulsant drug-induced osteomalacia: alterations in mineral metabolism and response to vitamin D administration, Calcif Tiss Internat. 1979; 27:13-18.
2 Mountain KR, Hirsch J, Gallus AS: Neonatal coagulation defect due to anticonvulsant drug treatment in pregnancy, Lancet, 1970; 1:265-268.
2 Hendal J, et al. The effects of carbamazepine and valproate on folate metabolism. Acta Neurol Scand 1984;69:226-31.
2 Berg MJ, Stumbo PH, Chenard CA, et al. Folic acid improves phenytoin pharmacokinetics. J Am Dietet Assoc 1995;95:352-56.
2 Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: ARI Publishing, 1985, 249 [review].
2 Cornelissen M, Steegers-Theunissen R, Kollee, L, et al. Increased incidence of neonatal vitamin K deficiency resulting from maternal anticonvulsant therapy. Am J Obstet Gynecol 1993;168:923-28.
2 Bone HG. Long-term anticonvulsant therapy and vitamin D metabolism. JAMA 1983; 249: 939 [review].
2 Mock DM, Mock NI, Nelson RP, et al: Disturbances in biotin metabolism in children undergoing long-term anticonvulsant therapy, J Pediatr Gastroenterol Nutr, 1998, 26(3):245-50.
2 Krause KH, Berlit P, Bonjour JP: Impaired biotin status in anticonvulsant therapy, Ann Neurol, 1982, 12(5):485-6.
2 Shafer RB, Nuttall FQ: Calcium and folic acid absorption in patients taking anticonvulsant drugs, J Clin endocrinol Metab, 1975, 41(06):1125-9.
2 Ch’ien LT, Krumdieck CL, Scott CW Jr, et al: Harmful effect of megadoses of vitamins -electroencephalogram abnormalities and seizures induced by intravenous folate in drug-treated epileptics, Am J Clin Nutr, 1975, 28(1):51-8.
2 Latham J, Gill DS, Wickramasinghe SN: Effects of phenytoin sodium on doubling time, deoxyuridine supression, 3H-Methotrexate uptake and 57 cocyanocobalamin uptake in HL60 cells, Clin Lab Haematol, 1990, 12(1):67-75.
2 Botez MI, Botez T, Ross-Chouinard A, et al: Thiamine and folate treatment of chronic epileptic patients - a controlled study with the Wechsler IQ scale, Epilepsy Res, 1993, 16(2):157-63.
2 Gascon-Barre M, Villeneuve JP, Lebrun LH: Effect of increasing doses of phenytoin on the plasma 25-Hydroxyvitamin D and 1,25-dihydroxyvitamin D concentrations, J Am Coll Nutr, 1985, 3(1):45-50.
2 Keith DA, Gundberg CM, Japour A, et al: Vitamin K-Dependent proteins and anticonvulsant medication, Clin Pharmacol Ther, 1983, 34(4):529-32.
2 Chung S, Cho J, Hyun T, et al. Alterations in the carnitine metabolism in epileptic children treated with valproic acid. J Korean Med Soc 1997;12:553-58.
2 Freeman JM, Vining EPG, Cost S, Singhi P. Does carnitine administration improve the symptoms attributed to anticonvulsant medications?: A double-blinded, crossover study. Pediatrics 1994;93:893-95.
2 Reinken L. The influence of antiepileptic drugs on vitamin B6 metabolism. Acta Vitaminol Enzymol 1975;291:252-54.
3 Rybacki JJ. The Concise Essential Guide to Prescription Drugs. HarperCollins, 1997.
3 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
4 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996:21,45,63,282.
4 Physician’s Desk Reference for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
5 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996:21,45,63,282.
5 PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
5 The Review of Natural Products, Clinisphere 2.0, Wolters Kluwer Company, 2000
6 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996
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The information in Drug Watch is provided as a courtesy to NewsTarget readers by Applied Health Solutions in cooperation with Healthway Solutions. Although the information is presented with scientific references, we do not wish to imply that this represents a comprehensive list of considerations about any specific drug, herb or nutrient. Nor should this information be considered a substitute for the advice of your doctor, pharmacist, or other healthcare practitioner. Please read the disclaimer about the intentions and limitations of the information provided on these pages. It is important to tell your doctor and pharmacist about all other drugs and nutritional supplements that you are taking if they are recommending a new medication. Copyright © 2007 by Applied Health Solutions, Inc. All rights reserved.