Sakurai Miyuki, Kawahara Kaori, Ueda Rie, Fukui Eiji, Yamada Ryuhei
Dept. of Pharmacy, Hyogo Prefectural Amagasaki Hospital.
Gan To Kagaku Ryoho. 2011 May;38(5):841-3.
We present a case of toxicity caused by a drug interaction between capecitabine and phenytoin (PHT). The drug combination elevated the plasma level of PHT in a patient on chemotherapy with capecitabine for colorectal cancer. Our patient was a 44-year-old woman diagnosed with epilepsy in her 20's, being treated with valproic acid (VPA) and PHT. Adjuvant chemotherapy with capecitabine began following surgery for colorectal cancer. Seven weeks later, she developed numbness, dizziness, dysarthria and difficulty walking, and was hospitalized for investigation. Her serum PHT level was elevated at 35. 1 μg/ mL. This case suggests that when capecitabine and PHT are coadministered, PHT levels should be monitored frequently, and that PHT dosage should be adjusted accordingly if it cannot be replaced by an alternative anticonvulsant.
我们报告了一例由卡培他滨与苯妥英钠（PHT）药物相互作用引起的毒性反应病例。该药物组合使一名正在接受卡培他滨化疗的结肠癌患者的血浆PHT水平升高。我们的患者是一名44岁女性，20多岁时被诊断为癫痫，一直在接受丙戊酸（VPA）和PHT治疗。结肠癌手术后开始使用卡培他滨进行辅助化疗。七周后，她出现麻木、头晕、构音障碍和行走困难，并因进行检查而住院。她的血清PHT水平升高至35.1μg/mL。该病例表明，当卡培他滨与PHT联合使用时，应频繁监测PHT水平，如果无法用替代抗惊厥药物替代，则应相应调整PHT剂量。
