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Interference of oral phenytoin absorption by continuous nasogastric feedings

Schools of Pharmacy and Medicine, University of Washington. Seattle, WA.

Inhibition of phenytoin absorption by continuous nasogastric tube feeding was studied in 20 neurosurgery patients and 5 normal subjects. Ten patients receiving phenytoin suspension 300 mg per day coadministered with continuous nasogastric feedings had a mean phenytoin serum concentration of 2.59 µg per milliliter. When the feedings were discontinued, the average concentration rose to 10.22 µg per milliliter in 7 days. In 10 other patients stabilized on phenytoin suspension 300 mg per day, the average serum concentration decreased from 9.80 µg per milliliter to 2.72 µg per milliliter in 7 days when continuous tube feedings were started. Five normal subjects received a single oral dose of phenytoin suspension alone and while drinking a nasogastric tube feeding preparation orally at a rate of 100 ml per hour; phenytoin serum levels decreased an average of 71.6% when the tube feeding was taken concurrently.

Address correspondence and reprint requests to Dr. Bauer, School of Pharmacy SC-69, University of Washington, Seattle, WA 98195.

Accepted for publication September 28, 1981.

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