Tong T G, Pond S M, Kreek M J, Jaffery N F, Benowitz N L
Ann Intern Med. 1981 Mar;94(3):349-51. doi: 10.7326/0003-4819-94-3-349.
Methadone-maintained volunteers experienced moderately severe opiate withdrawal symptoms within 3 or 4 days of beginning phenytoin in therapeutic doses. The area under the methadone plasma concentration-time curve decreased while the ratio of the pyrrolidine-to-metabolite excretion in urine to this area increased significantly. This suggests that phenytoin accelerates methadone metabolism. Methadone dosing adjustments should be anticipated when phenytoin is initiated or discontinued in methadone-maintained patients.
接受美沙酮维持治疗的志愿者在开始服用治疗剂量苯妥英钠后的3至4天内出现了中度严重的阿片类戒断症状。美沙酮血浆浓度-时间曲线下面积减小，而尿液中吡咯烷代谢物排泄量与该面积的比值显著增加。这表明苯妥英钠加速了美沙酮的代谢。在美沙酮维持治疗的患者开始或停用苯妥英钠时，应预计到需要调整美沙酮剂量。
