Drug General Information (ID: DDIHQC10YJ)
Drug Name			Mephenytoin		Drug Info		Tetanus Immune Globulin		Drug Info
Drug Type		Small molecule				Polyclonal antibody
Therapeutic Class		Anticonvulsants				Immune Globulins

Mechanism of Mephenytoin-Tetanus Immune Globulin Interaction (Severity Level: Moderate)
Increased risk of other adverse reactions (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Mephenytoin				Tetanus Immune Globulin
Mechanism		Hypersensitivity myocarditis				Hypersensitivity myocarditis
Key Mechanism Factor 1
		Factor Name		Adverse reactions
		Factor Description		An adverse reaction is an unexpected negative reaction to a medication or treatment that happens even when it's used correctly.
Mechanism Description		Increased risk of adverse reactions by the combination of Mephenytoin and Tetanus Immune Globulin

Recommended Action
Management		Due to the serious nature of the possible interaction, clinicians should consider monitoring hematologic parameters such as eosinophil counts as well as blood pressure and ECG tracings if immunoglobulins are used in patients receiving phenytoin.

References
1	Fenoglio JJ, McAllister HA, Mullick FG "Drug related myocarditis: I. Hypersensitivity myocarditis." Hum Pathol 12 (1981): 900-7. [PMID: 7298049]
2	Koehler PJ, Koudstaal J "Lethal hypersensitivity myocarditis associated with the use of intravenous gammaglobulin for Guillan-Barre syndrome, in combination with phenytoin." J Neurol 243 (1996): 366-7. [PMID: 8965113]
3	Mostella J, Pieroni R, Jones R, Finch CK "Anticonvulsant hypersensitivity syndrome: treatment with corticosteroids and intravenous immunoglobulin." South Med J 97 (2004): 319-21. [PMID: 15043348]