From the Research
Penicillins, cephalosporins, and macrolides are generally safe to take with Dilantin (phenytoin), but it's crucial to monitor for potential interactions and adjust the Dilantin dose as needed. When considering antibiotic therapy in patients taking Dilantin, it's essential to be aware of the potential for drug interactions that can affect the efficacy and safety of both the antibiotic and Dilantin.
Key Considerations
- Certain antibiotics, such as trimethoprim-sulfamethoxazole, metronidazole, fluoroquinolones (ciprofloxacin), and certain antifungals (fluconazole), can increase Dilantin levels in the blood, potentially leading to toxicity 1.
- Conversely, rifampin can decrease Dilantin levels, making seizure control more difficult 2.
- The interactions between antibiotics and Dilantin occur because some antibiotics compete with Dilantin for liver enzyme metabolism or protein binding in the blood 3.
Safe Antibiotic Options
- Penicillins (amoxicillin, ampicillin)
- Cephalosporins (cefuroxime, ceftriaxone)
- Macrolides (azithromycin)
Monitoring and Precautions
- Monitor for signs of Dilantin toxicity, such as dizziness, slurred speech, unsteady gait, or confusion, when taking antibiotics with Dilantin 4.
- Inform your healthcare provider about all medications you're taking, including Dilantin, before starting any antibiotic treatment, as they may need to adjust your Dilantin dose or monitor levels more closely during antibiotic therapy 5.