Phenytoin Acenocoumarol

Abad-Santos E, Carcas AJ, E-Capitan C, Frias J. Case report. Retroperitoneal haematoma in a patient treated with acenocoumarol, phenytoin and paroxetine. Clin Lab Haematol (1995) 17, 195-7. 

Acenocoumarol, amiodarone, celecoxib, coumadin, dexamethasone, diclofenac, etoposide, fluconazole, fluoxetine, fluvas-tatin, fluvoxamine, ghmepiride, ghpizide, glyburide, ibuprofen, irbesartan, isoniazid, losartan, midazolam, phenylbutazone, phenytoin, rifampin, teniposide, tenoxicam, thiotepa, tolbutamide, torsemide, vitamin D, warfarin... 

Clinically important, potentially hazardous interactions with acenocoumarol, alfuzosin, aminophylline, anisindione, anticoagulants, buprenorphine, butorphanol, caffeine, carmustine, dobazam, cocoa, dicumarol, dofetilide, duloxetine, epirubicin, eszopiclone, fentanyl, floxuridine, fluorouracil, galantamine, gliclazide, hydromorphone, itraconazole, ketoconazole, lidocaine, meptazinol, midazolam, mizolastine, modobemide, morphine, narcotic analgesics, oxprenolol, oxycodone, pentazocine, phenytoin, posaconazole, prednisone, propranolol, sufentanil, tolazoline, warfarin, xanthines, zaleplon, zofenopril, zolmitriptan, zolpidem... 

Clinically important, potentially hazardous interactions with acenocoumarol, alcohol, anisindione, anticoagulants, capsicum, cyclosporine, dicumarol, ethanolamine, ethotoin, fosphenytoin, mephenytoin, metronidazole, phenytoin, warfarin... 

A single ease report describes severe bleeding (abdominal haematoma) in a patient taking acenocoumarol and paroxetine when given phenytoin, but it is by no means elear whether the paroxetine had any part to play in what happened (see Phenytoin + Coumarins and related drugs , p.555). 

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