Drug interactions
Escitalopram + Fosphenytoin
Severity: Moderate
Escitalopram and Fosphenytoin: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Phenytoin induces CYP2C19 and CYP3A4, which may lower escitalopram concentrations and reduce antidepressant effect. Escitalopram may also rarely raise phenytoin levels.
What this interaction means in plain words
Escitalopram and Fosphenytoin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Escitalopram belongs to Central Nervous System; Fosphenytoin belongs to Central Nervous System.
Why it happens
Enzyme induction of CYP2C19 and CYP3A4 by phenytoin increasing escitalopram clearance.
What to do
Monitor depressive symptoms and consider escitalopram dose titration. Check phenytoin levels if toxicity signs appear.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Other interactions of Fosphenytoin
- Dronedarone + Fosphenytoin Contraindicated
- Fosphenytoin + Ledipasvir-sofosbuvir Contraindicated
- Fosphenytoin + Lorlatinib Contraindicated
- Fosphenytoin + Lurasidone Contraindicated
- Fosphenytoin + Ranolazine Contraindicated
- Fosphenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
Frequently asked questions
Can I take Escitalopram with Fosphenytoin?
MediHelp rates the interaction as moderate. Escitalopram and Fosphenytoin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Phenytoin induces CYP2C19 and CYP3A4, which may lower escitalopram concentrations and reduce antidepressant effect. Escitalopram may also rarely raise phenytoin levels.
How serious is the interaction between Escitalopram and Fosphenytoin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor depressive symptoms and consider escitalopram dose titration. Check phenytoin levels if toxicity signs appear.
What other medicines interact with Escitalopram?
MediHelp also lists interactions of Escitalopram with, for example, Cisapride, Citalopram, Isocarboxazid. The full list is on the Escitalopram page.
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