phenytoin / Generic mfg. - LARVOL DELTA

Differential effects of sodium channel blockers on SCN8A gain-of-function variants associated with drug-responsive or -resistant epilepsy. (PubMed, Pharmacol Res) - "In contrast, PRAX-330, a new SCB, which showed much faster binding rates than phenytoin, was effective for both groups of variants by markedly reducing neuronal firing through rapidly and persistently stabilizing NaV1.6 in the inactivated state. Our findings provide new pharmacogenetic insights into the mechanism of drug-resistance in SCN8A related epilepsy and support PRAX-330 and compounds with similar pharmacological properties as promising candidates for targeted therapies."

Journal • CNS Disorders • Epilepsy • NAV1 • SCN8A

Investigating seizures in bariatric surgery patients: Pre- and postoperative perspectives: A systematic review. (PubMed, Obes Pillars) - "Others experienced persistent or recurrent seizures, commonly associated with reduced postoperative absorption of valproate or phenytoin, requiring dose escalation or drug substitution...Seizure outcomes after bariatric surgery are variable and influenced by altered drug absorption and postoperative metabolic complications. Most patients maintain seizure control, but a subset develops breakthrough or new-onset seizures, highlighting the need for AED monitoring and careful evaluation of metabolic causes."

Journal • Review • Cardiovascular • CNS Disorders • Epilepsy • Gastrointestinal Disorder • Genetic Disorders • Hypoglycemia • Metabolic Disorders • Obesity

Compairing Micro Needling With Phenytoin Versus Microneedling Alone on Striae Alba (clinicaltrials.gov) - P=N/A | N=30 | Completed | Sponsor: Al-Azhar University

New trial

Functional and pharmacological characterization of the SCN2A variant p.C258R with mixed gain and loss of function causing developmental and epileptic encephalopathy type 11. (PubMed, Epilepsy Behav Rep) - "We aimed to electrophysiologically analyze the functional consequences of this mutation and to examine the in vitro properties of phenytoin, lamotrigine, and topiramate, which resulted in clinical improvement. The C258R mutation impairs NaV1.2 function through both LoF and GoF mechanisms. Sodium channel blockers with a strong use-dependence, such as phenytoin, may be preferential for seizure control in such cases."

Journal • CNS Disorders • Developmental Disorders • Epilepsy • Psychiatry • NAV1

A Drug-drug Interaction Study to Assess the Effect of Phenytoin and Itraconazole on the Pharmacokinetics of Pelabresib in Healthy Participants (clinicaltrials.gov) - P1 | N=30 | Recruiting | Sponsor: Novartis Pharmaceuticals | Not yet recruiting ➔ Recruiting

Enrollment open

Valproate-Associated Hyperammonemic Encephalopathy Despite Nontoxic Serum Levels and Preserved Liver Function: A Case Report. (PubMed, Cureus) - "We report a 49-year-old man with intellectual disability and long-standing drug-resistant epilepsy treated with valproate, phenytoin, phenobarbital, cenobamate, levetiracetam, and several psychotropic medications. This was followed by sustained neurological recovery and a decrease in serum ammonia to 43.1 µmol/L. This case emphasizes the importance of measuring serum ammonia in patients receiving valproate who develop otherwise unexplained altered mental status, particularly in the setting of intellectual disability and extensive antiseizure polytherapy."

Journal • CNS Disorders • Developmental Disorders • Epilepsy • Immunology • Mental Retardation

Drug-drug Interaction Study of Clemizole (EPX-100) in Healthy Participants (clinicaltrials.gov) - P1 | N=54 | Completed | Sponsor: Epygenix

New P1 trial

Fixed Drug Eruption Triggered by Phenytoin Use During Acute Seizure Episodes (EADV 2026) - No abstract available

CNS Disorders • Epilepsy

Discovery of 1,4-diaryl-1,3-dihydro-2H-imidazole-2-thione anticonvulsants integrating AMPA receptor antagonism, Nav1.2 channel blockade, redox modulation, and favorable pharmacokinetic properties. (PubMed, Eur J Med Chem) - "Quantitative evaluation showed an MES ED50 of 11.03 mg/kg, close to phenytoin, but with a markedly wider protective index (45.3 vs 6.89) and no neurotoxicity up to (TD50 > 500 mg/kg)...Oral brain exposure exceeded the AMPAR and VGSC IC50 values by 6.38- and 11.57-fold, respectively, confirming pharmacologically relevant target coverage. Together, these findings identify compound 6a as a brain-penetrant AMPAR/Nav1.2-modulating anticonvulsant lead."

Journal • PK/PD data • CNS Disorders • Epilepsy • CYP2C9 • CYP3A4 • NAV1

Phenytoin Intoxication Masquerading as Generalized Chorea: A Case of Iatrogenic Double-Prescribing (MDS Congress 2026) - No abstract available

Clinical • CNS Disorders • Movement Disorders

Clinical utility and tolerability of ketamine as adjunctive rescue therapy for refractory neonatal status epilepticus: a case report of a late preterm infant with multifocal hemorrhagic brain injury. (PubMed, Front Pediatr) - "Although phenobarbital remains the recommended first-line antiseizure medication (ASM), followed by agents such as phenytoin or levetiracetam, seizure control is not always achieved. Continuous EEG monitoring remains essential for evaluating treatment response. Prospective neonatal studies are needed to define the optimal timing, dosing strategies, efficacy, and long-term safety of ketamine in RNSE."

Journal • Cardiovascular • CNS Disorders • Epilepsy • Hematological Disorders • Vascular Neurology

Performance of large language models on narrow therapeutic index drug monitoring: Implications for clinical pharmacy practice. (PubMed, J Am Pharm Assoc (2003)) - "The evaluated LLMs performed strongly in recognizing TDM problems in structured vignettes but showed variability in reasoning-intensive tasks, with overconfident reasoning representing a potential patient safety concern. Pharmacist oversight remains essential for TDM tasks."

Journal

Pharmacological modulation of peripheral nerve excitability-a novel way to investigate sodium channel subtypes in humans. (PubMed, Pain) - "A novel electrical stimulation protocol-the Sodium channel Excitability Nociceptor Testing protocol-was used to identify alterations in Nav1.7, 1.8, and 1.9 after applying 3 (5% lidocaine, 10% phenytoin, and 2% mepyramine) topical pharmacological drugs. The Sodium channel Excitability Nociceptor Testing protocol can be used to investigate differential pharmacological alterations of specific Nav subtypes. This may lead to better insight of neurophysiological mechanisms of sensory afferents, forming the basis for targeted drug development, leading the way to stratified treatment regimens of peripheral pain."

Journal • Diabetic Neuropathy • Neuralgia • Pain • Peripheral Neuropathic Pain • NAV1

Innovative Compounded Topical Powder for Post-Digital Amputation Care: A Clinical Case Study in Wound Healing. (PubMed, Int J Pharm Compd) - "A compounded topical powder was prescribed, containing phenytoin, piperacillin, tazobactam, misoprostol, aloe vera, and beta glucan in a novel powder-to-hydrogel, film-forming topical compounding base (EctoSeal P2G™). By the end of treatment, both clinical progress and patient-reported outcomes indicated significant improvement. This case supports the key role of pharmacist-led, individualized wound therapies in post-amputation care."

Journal • Cardiovascular • Diabetes • Infectious Disease • Metabolic Disorders • Pain

Phenytoin Derivatives as Antagonists of AMPA Receptors and Voltage-Gated Sodium Channels: A Structure-Function Study. (PubMed, Int J Mol Sci) - "The enhanced action on sodium channels is due to an increase in tonic block, whereas the effects on inactivated and open channels remain unchanged. These results suggest a new possibility for tuning the activities of phenytoin derivatives against both primary targets to obtain anticonvulsants with novel properties."

Journal

Association between CYP2D6 and CYP2C19 genotypes and venlafaxine treatment failure: a retrospective study on two cohorts from Norway and the UK. (PubMed, Lancet Psychiatry) - "CYP2D6 PM status was consistently associated with increased risk of venlafaxine treatment failure in two large, real-life cohorts, suggesting that pre-emptive genotyping could facilitate personalised venlafaxine therapy."

Journal • Observational data • Retrospective data • CNS Disorders • Depression • Major Depressive Disorder • Psychiatry • CYP2C19

Cryo-emulsion gel patches as versatile platform for dual drug delivery to wounds. (PubMed, Int J Pharm) - "The two-phase structure enabled dual drug loading using hydrophilic N-acetylcysteine and lipophilic phenytoin, which complement each other in wound healing. Peel adhesion testing revealed very low adhesion of the C-EG patches on both bloody and dry wound surfaces. Overall, PVA-based C-EGs provide a stable and cytocompatible platform for incorporating emulsions into cryogel patches, representing an attractive strategy for advanced wound care applications."

Journal

Topical Phenytoin-Loaded Hydrogel Dressing for Postoperative Wound Management After Oral Squamous Cell Carcinoma Resection (clinicaltrials.gov) - P=N/A | N=24 | Completed | Sponsor: Mansoura University

New trial • Head and Neck Cancer • Oncology • Oral Cancer • Solid Tumor • Squamous Cell Carcinoma • Squamous Cell Carcinoma of Head and Neck

The Anticoagulation Dilemma: Concurrent Traumatic Brain Hemorrhage and Cerebral Venous Thrombosis in a Blast Injury Patient. (PubMed, Clin Case Rep) - "The patient received mannitol for cerebral edema management, phenytoin for seizure prophylaxis, and broad-spectrum antibiotics...He was referred for neurosurgical evaluation and intensive rehabilitation, with anticoagulation initiated one week later. This case underscores that blast-related TBI can produce severe central motor deficits without spinal injury, and that the coexistence of hemorrhagic contusion and CVST often contraindicates early anticoagulation, requiring individualized risk-benefit assessment and multidisciplinary decision-making in severe neurotrauma."

Journal • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Epilepsy • Hematological Disorders • Musculoskeletal Diseases • Orthopedics • Pulmonary Disease • Respiratory Diseases • Thrombosis

Metasurface-Enhanced Infrared Spectroscopy for Quantitative Molecular Sensing: A Proof-of-Concept Study for Therapeutic Drug Monitoring. (PubMed, ACS Sens) - "Using this design, we are able to consistently detect phenytoin in serum below the therapeutic range of 10-20 µg/ml by achieving a limit of detection of 1.4 μg/ml, which is limited by the drying process. This proof of concept for TDM at concentrations in the sub-clinical level highlights the significant potential for metasurface-enhanced spectroscopy and offers a path toward compact, high-performance infrared sensors for healthcare applications."

Journal

A Drug-drug Interaction Study to Assess the Effect of Phenytoin and Itraconazole on the Pharmacokinetics of Pelabresib in Healthy Participants (clinicaltrials.gov) - P1 | N=30 | Not yet recruiting | Sponsor: Novartis Pharmaceuticals

New P1 trial

When control cost too much: phenytoin induced adverse drug reactions with psychiatric morbidity in a woman with epilepsy (WFSBP 2026) - "Long-term phenytoin therapy requires vigilant monitoring for adverse reactions, especially in women with epilepsy who face unique psychosocial and reproductive health challenges. Early recognition and rational AEM substitution, coupled with integrated psychiatric care, are essential to prevent morbidity."

Adverse drug reaction • Clinical • CNS Disorders • Epilepsy • Psychiatry

Treatment patterns and access among people with epilepsy of childbearing potential in Peru. (PubMed, Front Neurol) - "ASMs were categorized according to pregnancy-associated safety profiles as Lower-risk (lamotrigine, levetiracetam, oxcarbazepine, clonazepam, diazepam), Intermediate-High risk (carbamazepine, phenytoin, phenobarbital, topiramate), and Highest-risk (valproic acid). These prescribing patterns likely reflect medication availability rather than clinical preference and highlight the challenges of implementing guideline-recommended epilepsy care in resource-constrained settings. Given the substantial burden of NCC-related epilepsy in this population, improving access to safer and more diverse ASM options may represent an important strategy for reducing treatment inequities among people with epilepsy of childbearing potential."

Journal • CNS Disorders • Epilepsy

Model-based clinical utility of pharmacogenetic testing and its potential population impact on the use of essential medicines in Zimbabwe. (PubMed, Front Pharmacol) - "Lower NNG values were observed for UGT1A1-atazanavir (5), UGT1A1-irinotecan (9), CYP2B6-efavirenz (26), and CYP2C9-phenytoin (25), whereas 61% of gene-drug pairs had NNG values > 1,000 compared with 47% in the Dutch population. Many essential medicines in Zimbabwe have actionable pharmacogenomic biomarkers, but gaps in local genomic guidance remain. Strengthening local evidence generation and PGx implementation is essential."

Biomarker • Journal • CYP2C9 • UGT1A1

When Surgical Intervention Becomes a Risk: Severe Drug-Induced Gingival Overgrowth and Clinical Decision-Making in Alpers-Huttenlocher Syndrome. (PubMed, Spec Care Dentist) - "This case underscores the necessity of integrating dental care into the multidisciplinary management of rare mitochondrial disorders and represents, to our knowledge, the first reported association between AHS and severe DIGO."

Journal • Anesthesia • CNS Disorders • Critical care • Epilepsy • Fibrosis • Hepatology • Liver Failure • Metabolic Disorders • Transplantation