Fluconazole and Phenytoin: Drug Interaction Guide
Quick answer: This combination requires caution. Fluconazole and Phenytoin can be used together with adjustments and monitoring.
How Fluconazole interacts with Phenytoin
Fluconazole inhibits CYP2C9 and CYP2C19, the principal enzymes metabolizing phenytoin, leading to elevated phenytoin levels with risk of nystagmus, ataxia, and confusion.
What you should do
Monitor phenytoin trough levels within 5-7 days of starting or stopping fluconazole and adjust dose to maintain free or total concentrations in therapeutic range.
Key facts
Severity
Moderate — caution required
Mechanism
Fluconazole inhibits CYP2C9 and CYP2C19, the principal enzymes metabolizing phenytoin, leading to elevated phenytoin lev...
Action
Monitor phenytoin trough levels within 5-7 days of starting or stopping fluconazole and adjust dose to maintain free or ...
Frequently asked questions
Can I take Fluconazole and Phenytoin together?
With caution. Monitor phenytoin trough levels within 5-7 days of starting or stopping fluconazole and adjust dose to maintain free or total concentrations in therapeutic range.
What is the severity of this interaction?
The interaction between Fluconazole and Phenytoin is classified as Moderate — caution required. Fluconazole inhibits CYP2C9 and CYP2C19, the principal enzymes metabolizing phenytoin, leading to elevated phenytoin levels with risk of nystagmus, ataxia, and confusion.
What should I do if I'm prescribed both?
Monitor phenytoin trough levels within 5-7 days of starting or stopping fluconazole and adjust dose to maintain free or total concentrations in therapeutic range. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.