HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Correspondence: Submit a response Correspondence: View responses Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Burkhardt, R. T. Articles by Cloyd, J. C. Search for Related Content PubMed PubMed Citation Articles by Burkhardt, R. T. Articles by Cloyd, J. C. Related Collections Status epilepticus All Epilepsy/Seizures Antiepileptic drugs Related Article

Lower phenytoin serum levels in persons switched from brand to generic phenytoin

From MINCEP Epilepsy Care (Drs. Leppik and Gapany, K. Blesi, and S. Scott), Minneapolis, MN; and the College of Pharmacy, (Drs. Leppik, Cloyd, and Burkhardt), University of Minnesota, Minneapolis, MN.

Address correspondence and reprint request to Dr. Ilo E. Leppik, Director of Research, MINCEP Epilepsy Care, Suite 200, 5775 Wayzata Boulevard, Minneapolis, MN 55416; e-mail: mincepmail{at}mincep.com

After generic phenytoin (PHT) was marketed, the authors identified eight adult patients (ages 34 to 49) whose seizures increased enough to require intervention after switching to generic PHT. The mean total PHT concentration on brand (before generic) was 17.7 ± 5.3 mg/L, decreased to 12.5 ± 2.7 mg/L with generic, and increased to 17.8 ± 3.9 mg/L after brand was re-introduced. Brand and generic PHT do not yield equivalent concentrations in some patients and substitution should not be permitted without physician notification.

Received January 21, 2004. Accepted in final form June 17, 2004.

Dr. Leppik has received honoraria from Abbott Laboratories, Pfizer, and UCB Pharma. Dr. Cloyd has received honoraria from Elan Pharmaceuticals and GlaxoSmithKline, honoraria in excess of $10,000 from Abbott Laboratories and Ovation Pharmaceuticals, and a grant in excess of $10,000 from Novartis.

Related Article

October 26 Highlights
Neurology 2004 63: 1346-1347. [Full Text] [PDF]

This article has been cited by other articles:

				M. J. Berg, R. A. Gross, K. J. Tomaszewski, W. M. Zingaro, and L. S. Haskins Generic substitution in the treatment of epilepsy: Case evidence of breakthrough seizures Neurology, August 12, 2008; 71(7): 525 - 530. [Abstract] [Full Text] [PDF]

				T. E Welty Author's Reply Ann. Pharmacother., September 1, 2007; 41(9): 1551 - 1552. [Full Text] [PDF]

				T. E Welty Pharmacy and Generic Substitution of Antiepileptic Drugs: Missing in Action? Ann. Pharmacother., June 1, 2007; 41(6): 1065 - 1068. [Abstract] [Full Text] [PDF]

				R. J. Jefferys, J. H. Sherry, R. J. Rackley, S. A. Stetz, T. Bechtel, and I. Leppik Lower phenytoin serum levels in persons switched from brand to generic phenytoin Neurology, August 23, 2005; 65(4): 657 - 658. [Full Text] [PDF]

				C. C. Wiberg, I. E. Leppik, R. Perron, I. E. Leppik, J. C. Cloyd III, S. R. Schwid, R. A. Gross, J. W. Mink, and R. C. Griggs Lower phenytoin serum levels in persons switched from brand to generic phenytoin Neurology, April 26, 2005; 64(8): 1485 - 1486. [Full Text] [PDF]

Correspondence: