Analysis of a clinically important interaction between phenytoin and Shankhapushpi, an Ayurvedic preparation

During the course of routine plasma drug level monitoring an unexpected loss of seizure control and reduction in plasma phenytoin levels was noticed in two patients who were also taking 'Shankhapushpi' (SRC), an Ayurvedic preparation. Therefore, the present study was undertaken in rats to...

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Published inJournal of ethnopharmacology Vol. 35; no. 3; p. 285
Main Authors Dandekar, U P, Chandra, R S, Dalvi, S S, Joshi, M V, Gokhale, P C, Sharma, A V, Shah, P U, Kshirsagar, N A
Format Journal Article
LanguageEnglish
Published Ireland 01.01.1992
Subjects
Administration, Oral
Animals
Anticonvulsants - pharmacology
Drug Interactions
Female
Injections, Intraperitoneal
Male
Medicine, Ayurvedic
Phenytoin - blood
Phenytoin - pharmacology
Plant Extracts - pharmacology
Rats
Rats, Inbred Strains
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Summary:During the course of routine plasma drug level monitoring an unexpected loss of seizure control and reduction in plasma phenytoin levels was noticed in two patients who were also taking 'Shankhapushpi' (SRC), an Ayurvedic preparation. Therefore, the present study was undertaken in rats to investigate any SRC-phenytoin interaction from both pharmacokinetic (serum levels) and pharmacodynamic (electroshock seizure prevention) aspects. Single dose SRC and phenytoin (oral/i.p.) coadministration did not have any effect on plasma phenytoin levels but decreased the antiepileptic activity of phenytoin significantly. On multiple-dose coadministration, SRC reduced not only the antiepileptic activity of phenytoin but also lowered plasma phenytoin levels. SRC itself showed significant antiepileptic activity compared to placebo and is worth further investigation. However, the clinical combination of SRC with phenytoin is not advised.
ISSN:0378-8741
DOI:10.1016/0378-8741(92)90026-n