Possible Interaction: Albumin and Phenytoin

“We investigated whether the addition of albumin to dialysate affects dialytic clearance of VPA, CBZ and PHT.”

“Interaction of albumin with cytochrome P450 mediated phenytoin metabolism has been reported.”

“There was a statistically significant negative correlation between albumin concentration and the free fraction values of salicylic acid and sulfisoxazole (but not of phenytoin and only under special circumstances with warfarin) in normal subjects and of phenytoin, salicylic acid, and sulfisoxazole (but not warfarin) in rats.”

“Several ancillary treatments were utilized in an attempt to decrease serum phenytoin concentrations and limit toxicity including albumin boluses, phenobarbital administration, intravenous lipid infusion, and folic acid supplementation.”

“Weight, allometrically scaled for clearance and volume of distribution for the unbound and bound compartments, and albumin concentration significantly influenced the partition coefficient for protein binding of phenytoin.”

“Numerous drugs such as warfarin, phenytoin or salicylates may displace chemotherapeutic agents from albumin binding sites (Spina and Scordo, 2002).”

“Considering … phenytoin is bound to albumin with a large number of binding sites (n = 6) and a small binding constant (K = 6 x 10(3/)mol/L), the extent of adsorption to activated charcoal may depend on the magnitude of the binding constant of the drug to plasma proteins.”

“CONCLUSIONS: Phenytoin protein binding was significantly correlated with albumin and was more variable in ICU and convalescent patients with brain injuries than in healthy volunteers.”

“These findings suggest that glycation of albumin alters the binding of phenytoin in children and adolescents with type I DM.”

“We report a case in which the effects of profound DPH toxicity were attenuated after the intravenous administration of albumin.”