Phenytoin metabolism during pregnancy

Eur J Clin Pharmacol. 1992;43(4):389-92. doi: 10.1007/BF02220614.

Abstract

The steady-state 72 h urinary excretion of various phenytoin metabolites has been measured in 10 epileptic women, whose plasma phenytoin concentrations relative to the phenytoin dose fell during pregnancy and rose again post-partum. In later pregnancy and post partum, a mean of 61.3% and 48.9%, respectively, of the total daily phenytoin dose was eliminated as 5-(4-hydroxyphenyl)-5-phenylhydantoin (p-HPPH). Even though p-HPPH accounts for not much more than half the total daily phenytoin dose, increased excretion of this metabolite sufficed to account for the elimination of the entire increase in the dose of phenytoin required during pregnancy. There was no definite increase in the excretion of any other (minor) metabolite measured. Thus pregnancy seems not to enhance uniformly the capacity of the various metabolic pathways of phenytoin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Epilepsy / blood
  • Epilepsy / urine*
  • Female
  • Humans
  • Phenytoin / analogs & derivatives*
  • Phenytoin / blood
  • Phenytoin / urine*
  • Pregnancy
  • Pregnancy Complications / blood
  • Pregnancy Complications / urine*
  • Time Factors

Substances

  • hydroxyphenytoin
  • Phenytoin