MajorAntiepileptic, hydantoin derivative (sodium channel blocker)×HMG-CoA reductase inhibitors (statins)
Updated · Methodology
Mechanism
Phenytoin induces CYP3A4. Simvastatin level falls 60%, lipid-lowering effect is lost. LDL cholesterol returns to baseline, cardiovascular risk rises.
Symptoms
LDL returns to baseline over 4–6 weeks.
Management
Alternative statin: pravastatin or rosuvastatin (not CYP3A4-metabolised). Alternative anticonvulsant: levetiracetam.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
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