Phenytoin Toxicity Associated With Ticlopidine Administration

Joseph P. Rindone; George Bryan II
Arch Intern Med. 1996;156(10):1113. doi:10.1001/archinte.1996.00040041113012.
Text Size: A A A
Published online


A case of phenytoin sodium toxicity that appeared to be related to the administration of ticlopidine hydrochloride was recently observed at the Prescott Veterans Affairs Medical Center in Arizona.

Report of a Case. A 71-year-old man had been taking ticlopidine for treatment of transient ischemic attacks. Concurrent medications included phenytoin sodium (350 mg/d), phenobarbital (90 mg/d), and cholestyramine resin (4 g at bedtime). The dosage of the phenytoin therapy had not been changed over the last 6 years (serum phenytoin concentrations, 60 to 80 μmol/L [15 to 20 mg/L]). A serum phenytoin concentration of 60 μmol/L (15 mg/L) was noted 2 weeks before ticlopidine therapy was initiated. The dosage of the phenobarbital therapy had not been changed for more than 2 years. After 1 month of ticlopidine hydrochloride therapy (250 mg twice daily), the patient began complaining of difficulty in walking and bilateral leg weakness. Serum concentrations of phenytoin and


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.