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Tong, T.G. et al.

Phenytoin-induced methadone withdrawal.

Methadone-maintained volunteers experienced moderately severe opiate withdrawal symptoms within 3 or 4 days of beginning phenytoin in therapeutic doses. The area under the methadone plasma concentration-time curve decreased while the ratio of the pyrrolidine-to-metabolite excretion in urine to this area increased significantly. This suggests that phenytoin accelerates methadone metabolism. Methadone dosing adjustments should be anticipated when phenytoin is initiated or discontinued in methadone-maintained patients.[1]

References

Phenytoin-induced methadone withdrawal. Tong, T.G., Pond, S.M., Kreek, M.J., Jaffery, N.F., Benowitz, N.L. Ann. Intern. Med. (1981) [Pubmed]

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