Drug interactions
Phenytoin + Zuranolone
Severity: Major
Phenytoin and Zuranolone: major 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 can markedly lower zuranolone exposure and may cause loss of antidepressant effect. Labeling recommends avoiding strong CYP3A4 inducers.
What this interaction means in plain words
Phenytoin and Zuranolone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Phenytoin belongs to Central Nervous System; Zuranolone belongs to Central Nervous System.
Why it happens
Phenytoin induces CYP3A4, increasing zuranolone metabolism.
What to do
Avoid the combination; if a strong inducer is essential, consider an alternative treatment for postpartum depression.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Phenytoin
- Artemether / lumefantrine + Phenytoin Contraindicated
- Bictegravir + Phenytoin Contraindicated
- Cabotegravir + Phenytoin Contraindicated
- Doravirine + Phenytoin Contraindicated
- Elbasvir / grazoprevir + Phenytoin Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Phenytoin Contraindicated
Other interactions of Zuranolone
- Alprazolam + Zuranolone Major
- Amobarbital + Zuranolone Major
- Apalutamide + Zuranolone Major
- Asenapine + Zuranolone Major
- Brexpiprazole + Zuranolone Major
- Butorphanol + Zuranolone Major
Frequently asked questions
Can I take Phenytoin with Zuranolone?
MediHelp rates the interaction as major. Phenytoin and Zuranolone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Phenytoin can markedly lower zuranolone exposure and may cause loss of antidepressant effect. Labeling recommends avoiding strong CYP3A4 inducers.
How serious is the interaction between Phenytoin and Zuranolone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; if a strong inducer is essential, consider an alternative treatment for postpartum depression.
What other medicines interact with Phenytoin?
MediHelp also lists interactions of Phenytoin with, for example, Artemether / lumefantrine, Bictegravir, Cabotegravir. The full list is on the Phenytoin page.
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