Immunosuppression phenytoin

The anticonvulsant phenytoin, and to a lesser degree carbamazepine, can inhibit the synthesis of antibodies, and in some cases these drugs can result in lymphoproliferation [77-79]. These effects on the immune system could be viewed as a type of autoimmunity. The relationship between such effects and autoimmunity are still not clear, although the more recent observations that cytokines and anti-cytokines can cause autoimmunity support the existence of such a relationship. The previous edition of this book contained an extensive discussion of the possible relationship between immunosuppression and autoimmunity [80], Phenytoin and carbamazepine can also cause a lupus-like syndrome although the incidence is lower than with many other drugs. 

Gingival hyperplasia Antiepileptics (phenytoin), immunosuppressant drugs, calcium channel antagonists (felodipin, amlodipin, nifedipin)... 

Concurrent administration of other drugs may interfere with the metabolism and alter the effects of corticosteroids. Some of the effects appear to result from increased metabolism of administered steroid. Barbiturates, phenylbutazone, and phenytoin may enhance metabolism and reduce the anti-inflammatory and immunosuppressive potential of systemic steroids. Additionally, the response to anticoagulant therapy may be reduced by simultaneous administration of steroids. 

Sulfonamides, penicillins, diclofenac, oxyphenbutazone, piroxicam, phenytoin, carbamazepine (Same as for erythema multiforme) penicillamine, captopril, piroxicam, penicillins, rifampicin Frusemide, penicillamine, penicillin, PUVA therapy Immunosuppressants, mexiletine, thioridazine, penicillamine, moduretic , atenolol, quinacrine... 

Grigg-Damberger MM, Costanzo-Nordin R, Kelly MA, Bahamon-Dussan JE, Silver M, Zucker MJ, Celesia GG. Phenytoin may compromise efficacy of cyclosporine immunosuppression in cardiac transplant patients. Epilepsia (1988) 29, 693. 

Schweitzer EJ, Canafax DM, Gillingham KJ, Najarian JS, Matas AJ. Phenytoin administration in kidney recipients on CSA immunosuppression. J Am Soc Nephrol (1991) 2, 816. 

Renal allograft survival is decreased in patients taking prednisone and phenytoin, due (it is believed) to a reduction in the immunosuppressant effects of the corticosteroid. ... 

Studies on phenytoin-as ociated Hodgkin s disease have suggested that both chronic antigenic stimulation and immunosuppression by phenytoin are involved in the induction of the lymphoma (47 ). 

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