Drug General Information (ID: DDIGODWX20)
  Drug Name Phenytoin Drug Info Dexmethylphenidate Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Anticonvulsants Norepinephrine-Dopamine Reuptake Inhibitor
  Structure

 Mechanism of Phenytoin-Dexmethylphenidate Interaction (Severity Level: Minor)
     CYP450 enzyme inhibition Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Phenytoin Dexmethylphenidate
      Mechanism CYP450 substrate CYP450 inhibitor
      Key Mechanism Factor 1
Factor Name Cytochrome P450 Structure Sequence
Protein Family Cytochrome P450 family
Protein Function
A cytochrome P450 monooxygenase involved in the metabolism of sterols, steroid hormones, retinoids and fatty acids (PubMed:10681376, PubMed:11093772, PubMed:11555828, PubMed:14559847, PubMed:12865317, PubMed:15373842, PubMed:15764715, PubMed:20702771, PubMed:19965576, PubMed:21490593, PubMed:21576599). Mechanistically, uses molecular oxygen inserting one oxygen atom into a substrate, and reducing the second into a water molecule, with two electrons provided by NADPH via cytochrome P450 reductase (NADPH--hemoprotein reductase). Catalyzes the hydroxylation of carbon-hydrogen bonds (PubMed:2732228, PubMed:14559847, PubMed:12865317, PubMed:15373842, PubMed:15764715, PubMed:21576599, PubMed:21490593). Exhibits high catalytic activity for the formation of hydroxyestrogens from estrone (E1) and 17beta-estradiol (E2), namely 2-hydroxy E1 and E2, as well as D-ring hydroxylated E1 and E2 at the C-16 position (PubMed:11555828, PubMed:14559847, PubMed:12865317). Plays a role in the metabolism of androgens, particularly in oxidative deactivation of testosterone (PubMed:2732228, PubMed:15373842, PubMed:15764715, PubMed:22773874). Metabolizes testosterone to less biologically active 2beta- and 6beta-hydroxytestosterones (PubMed:2732228, PubMed:15373842, PubMed:15764715). Contributes to the formation of hydroxycholesterols (oxysterols), particularly A-ring hydroxylated cholesterol at the C-4beta position, and side chain hydroxylated cholesterol at the C-25 position, likely contributing to cholesterol degradation and bile acid biosynthesis (PubMed:21576599). Catalyzes bisallylic hydroxylation of polyunsaturated fatty acids (PUFA) (PubMed:9435160). Catalyzes the epoxidation of double bonds of PUFA with a preference for the last double bond (PubMed:19965576). Metabolizes endocannabinoid arachidonoylethanolamide (anandamide) to 8,9-, 11,12-, and 14,15-epoxyeicosatrienoic acid ethanolamides (EpETrE-EAs), potentially modulating endocannabinoid system signaling (PubMed:20702771). Plays a role in the metabolism of retinoids. Displays high catalytic activity for oxidation of all-trans-retinol to all-trans-retinal, a rate-limiting step for the biosynthesis of all-trans-retinoic acid (atRA) (PubMed:10681376). Further metabolizes atRA toward 4-hydroxyretinoate and may play a role in hepatic atRA clearance (PubMed:11093772). Responsible for oxidative metabolism of xenobiotics. Acts as a 2-exo-monooxygenase for plant lipid 1,8-cineole (eucalyptol) (PubMed:11159812). Metabolizes the majority of the administered drugs. Catalyzes sulfoxidation of the anthelmintics albendazole and fenbendazole (PubMed:10759686). Hydroxylates antimalarial drug quinine (PubMed:8968357). Acts as a 1,4-cineole 2-exo-monooxygenase (PubMed:11695850). Also involved in vitamin D catabolism and calcium homeostasis. Catalyzes the inactivation of the active hormone calcitriol (1-alpha,25-dihydroxyvitamin D(3)) (PubMed:29461981).
    Click to Show/Hide
      Mechanism Description
  • Decreased metabolism of Phenytoin caused by Dexmethylphenidate mediated inhibition of CYP450 enzyme

References
1 Garrettson LK, Perel JM, Dayton PG "Methylphenidate interaction with both anticonvulsants and ethyl biscoumacetate." JAMA 207 (1969): 1053-6. [PMID: 5818377]
2 Ghofrani M "Possible phenytoin-methylphenidate interaction." Dev Med Child Neurol 30 (1988): 267. [PMID: 3133263]
3 Kupferberg HJ, Jeffery W, Hunninghake DB "Effect of methylphenidate on plasma anticonvulsant levels." Clin Pharmacol Ther 13 (1972): 201-4. [PMID: 4552820]
4 Mirkin BL, Wright F "Drug interactions: effect of methylphenidate on the disposition of diphenylhydantoin in man." Neurology 21 (1971): 1123-8. [PMID: 5166217]
5 Product Information. Focalin (dexmethylphenidate). Mikart Inc, Atlanta, GA.
6 Product Information. Ritalin (methylphenidate). Novartis Pharmaceuticals, East Hanover, NJ.