Muscle weakness phenytoin

Aluminum Hydroxide + Magnesium Hydroxide (Maalox) [OTC] [Antacid/Aluminum Magnesium Salts] Uses Hyper-acidity (peptic ulcer, hiatal hernia, etc) Action Neutralizes gastric acid Dose Adults. 10-20 mL or 2-4 tabs PO qid or PRN Feds. 5-15 mL PO qid or PRN Caution [C, ] Disp Tabs, susp SE May cause t Mg in renal insuff, constipation, D Interactions In addition to AlOH, X effects OF digoxin, quinolones, phenytoin, Fe supl, ketoconazole EMS None OD May cause constipation, loss of appetite, painful urination, heart rhythm changes, muscle weakness, and peripheral edema symptomatic and supportive... 

Evidence of an interaction currently appears to be limited to these two reports and the clinical significance remains unclear. The change in phenytoin levels seems unlikely to be clinically significant. There is a small risk that the concurrent use of fluvastatin and phenytoin could result in myopathy. Patients should be told to report any signs of myopathy and possible rhabdomyolysis (i.e. otherwise unexplained muscle pain, tenderness or weakness or dark coloured urine). If myopathy does occur, the statin should be stopped immediately. See also muscle toxicity , (p.l086), for further guidance on monitoring, and risk factors for muscle toxicity. 

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