Testmiljö
Observera att detta är en testmiljö för utveckling som inte ska användas som underlag för klinisk bedömning. Besök Janusmed här: https://janusmed.se

4/8/2025

Janusmed kön och genus

Janusmed kön och genus – fenytoin

Janusmed kön och genus är ett kunskapsstöd som tillhandahåller information om köns- och genusaspekter på läkemedelsbehandling. Kunskapsstödet är avsedd främst för hälso- och sjukvårdspersonal. Texterna är generella och ska inte ses som behandlingsriktlinjer. Det är alltid behandlande läkare som ansvarar för patientens medicinering.

För att komma till startsidan för Janusmed kön och genus och för att göra sökningar klicka här.

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C C
C C

Fenytoin Testmiljö

Fenytoin

Klass : C

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Produkter

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Epanutin, Fenantoin RPH Pharma, Lehydan, Phenhydan, Phenytoin, Phenyto......

Epanutin, Fenantoin RPH Pharma, Lehydan, Phenhydan, Phenytoin, Phenytoin AWD, Phenytoin Sodium Flynn
ATC-koder

N03AB02

N03AB02
Substanser

fenytoin, fenytoinnatrium

fenytoin, fenytoinnatrium
Sammanfattning

Det saknas kontrollerade studier om skillnader mellan könen avseende effekt, säkerhet eller farmakokinetik för fenytoin förutom i samband med graviditet. Fysiologiska förändringar vid graviditet kan förändra plasmakoncentrationen av fenytoin och därmed kan anfallsfrekvensen hos kvinnan öka. Tätare koncentrationsmätning av fenytoin under graviditet är därför rekommenderat. Fenytoin kan påverka metabolismen av p-piller och kompletterande antikonceptiv metod bör användas.

Det saknas kontrollerade studier om skillnader mellan könen avseende effekt, säkerhet eller farmakokinetik för fenytoin förutom i samband med graviditet. Fysiologiska förändringar vid graviditet kan förändra plasmakoncentrationen av fenytoin och därmed kan anfallsfrekvensen hos kvinnan öka. Tätare koncentrationsmätning av fenytoin under graviditet är därför rekommenderat. Fenytoin kan påverka metabolismen av p-piller och kompletterande antikonceptiv metod bör användas.
Background

Pharmacokinetics and dosing
A study (39 men, 24 women) found no difference between men and women in phenytoin clearance, distribution volume or half-life. Men and women received the same daily dose (4.8 mg/kg/day) of phenytoin or fosphenytoin and trough phenytoin concentrations were similar between men and women [4]. Also, a randomized controlled trial in healthy subjects (12 men, 12 women) showed that the mean AUC, normalized for the mg/kg phenytoin dose, was about 30% lower in women than men. This might be explained by a more rapid elimination in women. This counterbalance the generally lower body weight in women that results in higher phenytoin concentration levels [5]. Dose regimens for phenytoin do not need to be adjusted based on patient’s sex, since the more rapid elimination in women counterbalance the generally lower weight that result in higher phenytoin concentration levels [5].
A study examining binding characteristics of phenytoin to serum proteins in healthy adults (40 men, 40 women) on monotherapy found no sex differences. The affinity of phenytoin to serum proteins......

Visa hela bakgrundstexten

# Pharmacokinetics and dosing A study (39 men, 24 women) found no difference between men and women in phenytoin clearance, distribution volume or half-life. Men and women received the same daily dose (4.8 mg/kg/day) of phenytoin or fosphenytoin and trough phenytoin concentrations were similar between men and women [4]. Also, a randomized controlled trial in healthy subjects (12 men, 12 women) showed that the mean AUC, normalized for the mg/kg phenytoin dose, was about 30% lower in women than men. This might be explained by a more rapid elimination in women. This counterbalance the generally lower body weight in women that results in higher phenytoin concentration levels [5]. Dose regimens for phenytoin do not need to be adjusted based on patient’s sex, since the more rapid elimination in women counterbalance the generally lower weight that result in higher phenytoin concentration levels [5]. A study examining binding characteristics of phenytoin to serum proteins in healthy adults (40 men, 40 women) on monotherapy found no sex differences. The affinity of phenytoin to serum proteins was similar in men and women, and patient’s sex does not have a significant effect on binding characteristics of phenytoin to serum proteins in adult patients [6]. # Effects No studies with a clinically relevant sex analysis regarding effects of phenytoin have been found. # Adverse effects A retrospective analysis (320 men, 343 women) of patients on antiepileptic drug treatment showed fertile women to have a higher risk for skin reactions than men when treated with phenytoin [7]. # Reproductive health issues Enzyme-inducing antiepileptic drugs, such as carbamazepine, phenytoin and phenobarbital, may have potentially negative effects on reproductive endocrine function in men and women. These antiepileptic drugs increase concentrations of sex hormone-binding globulin (SHBG) and thereby reducing the concentrations of unbound biologically active androgens [1-3]. This may result in sexual dysfunction.   Phenytoin pharmacokinetics is altered during pregnancy resulting in lower plasma concentrations and thus, an increased risk of seizures. For appropriate dose adjustment in pregnant women, monitoring of plasma phenytoin concentrations is recommended [8]. Regarding teratogenic aspects, please consult Janusmed Drugs and Birth Defects (in Swedish, Janusmed fosterpåverkan). Phenytoin may affect the metabolism of estrogens and progestogens. Thus, the effect of these can be reduced. Additional contraceptive method should be used [9]. Regarding drug-drug interactions aspects, please consult Janusmed Interactions (in Swedish, Janusmed interaktioner).
Försäljning på recept

Visa hela försäljning på recept

Fler män än kvinnor hämtade ut läkemedel innehållande fenytoin (ATC-kod N03AB02) på recept i Sverige år 2019, totalt 2 071 män och 1 724 kvinnor. Det motsvarar 0,4 respektive 0,3 personer per tusen invånare. Andelen som hämtat ut läkemedel var högst i åldersgruppen 60 år och äldre hos båda könen. I genomsnitt var läkemedel innehållande fenytoin 1,4 gånger vanligare hos män [10].
Referenser

Visa referenser

  1. Duncan S, Blacklaw J, Beastall GH, Brodie MJ. Antiepileptic drug therapy and sexual function in men with epilepsy. Epilepsia. 1999;40:197-204.

  2. Svalheim S, Sveberg L, Mochol M, Taubøll E. Interactions between antiepileptic drugs and hormones. Seizure. 2015;28:12-7.

  3. Yogarajah M, Mula M. Sexual Dysfunction in Epilepsy and the Role of Anti-Epileptic Drugs. Curr Pharm Des. 2017;23(37):5649-5661.

  4. Meyer MC, Straughn AB, Mhatre RM, Shah VP, Chen ML, Williams RL et al. Variability in the bioavailability of phenytoin capsules in males and females. Pharm Res. 2001;18:394-7.

  5. Kodama H, Kodama Y, Shinozawa S, Kanemaru R, Todaka K, Mitsuyama Y. No gender effect on binding characteristics of phenytoin to serum proteins in monotherapy for adult patients with epilepsy. Am J Ther. 2000;7:285-9.

  6. Alvestad S, Lydersen S, Brodtkorb E. Rash from antiepileptic drugs: influence by gender, age, and learning disability. Epilepsia. 2007;48:1360-5.

  7. Phenytek (phenytoin). DailyMed [www]. U.S. National Library of Medicine [updated 2018-02-15, cited 2019-10-14].

  8. Patsalos PN, Perucca E. Clinically important drug interactions in epilepsy: general features and interactions between antiepileptic drugs. Lancet Neurol. 2003;2:347-56.

  9. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2019 [cited 2020-03-10.]

  1. Duncan S, Blacklaw J, Beastall GH, Brodie MJ. Antiepileptic drug therapy and sexual function in men with epilepsy. Epilepsia. 1999;40:197-204.
  2. Svalheim S, Sveberg L, Mochol M, Taubøll E. Interactions between antiepileptic drugs and hormones. Seizure. 2015;28:12-7.
  3. Yogarajah M, Mula M. Sexual Dysfunction in Epilepsy and the Role of Anti-Epileptic Drugs. Curr Pharm Des. 2017;23(37):5649-5661.
  4. Meyer MC, Straughn AB, Mhatre RM, Shah VP, Chen ML, Williams RL et al. Variability in the bioavailability of phenytoin capsules in males and females. Pharm Res. 2001;18:394-7.
  5. Kodama H, Kodama Y, Shinozawa S, Kanemaru R, Todaka K, Mitsuyama Y. No gender effect on binding characteristics of phenytoin to serum proteins in monotherapy for adult patients with epilepsy. Am J Ther. 2000;7:285-9.
  6. Alvestad S, Lydersen S, Brodtkorb E. Rash from antiepileptic drugs: influence by gender, age, and learning disability. Epilepsia. 2007;48:1360-5.
  7. Phenytek (phenytoin). DailyMed [www]. U.S. National Library of Medicine [updated 2018-02-15, cited 2019-10-14].
  8. Patsalos PN, Perucca E. Clinically important drug interactions in epilepsy: general features and interactions between antiepileptic drugs. Lancet Neurol. 2003;2:347-56.
  9. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2019 [cited 2020-03-10.]
Uppdaterat

Litteratursökningsdatum: 10/11/2019

Litteratursökningsdatum: 10/11/2019
Fasstexter

Visa fasstexter

Se även

Fosfenytoin

Karbamazepin

Fenobarbital

C C
C C

Fenytoin Testmiljö

Fenytoin

Klass : C

Visa all info

Skriv ut

Kontakta oss

Produkter

Visa alla produkter

Epanutin, Fenantoin RPH Pharma, Lehydan, Phenhydan, Phenytoin, Phenyto......

Epanutin, Fenantoin RPH Pharma, Lehydan, Phenhydan, Phenytoin, Phenytoin AWD, Phenytoin Sodium Flynn
ATC-koder

N03AB02

N03AB02
Substanser

fenytoin, fenytoinnatrium

fenytoin, fenytoinnatrium
Sammanfattning

Det saknas kontrollerade studier om skillnader mellan könen avseende effekt, säkerhet eller farmakokinetik för fenytoin förutom i samband med graviditet. Fysiologiska förändringar vid graviditet kan förändra plasmakoncentrationen av fenytoin och därmed kan anfallsfrekvensen hos kvinnan öka. Tätare koncentrationsmätning av fenytoin under graviditet är därför rekommenderat. Fenytoin kan påverka metabolismen av p-piller och kompletterande antikonceptiv metod bör användas.

Det saknas kontrollerade studier om skillnader mellan könen avseende effekt, säkerhet eller farmakokinetik för fenytoin förutom i samband med graviditet. Fysiologiska förändringar vid graviditet kan förändra plasmakoncentrationen av fenytoin och därmed kan anfallsfrekvensen hos kvinnan öka. Tätare koncentrationsmätning av fenytoin under graviditet är därför rekommenderat. Fenytoin kan påverka metabolismen av p-piller och kompletterande antikonceptiv metod bör användas.
Background

Pharmacokinetics and dosing
A study (39 men, 24 women) found no difference between men and women in phenytoin clearance, distribution volume or half-life. Men and women received the same daily dose (4.8 mg/kg/day) of phenytoin or fosphenytoin and trough phenytoin concentrations were similar between men and women [4]. Also, a randomized controlled trial in healthy subjects (12 men, 12 women) showed that the mean AUC, normalized for the mg/kg phenytoin dose, was about 30% lower in women than men. This might be explained by a more rapid elimination in women. This counterbalance the generally lower body weight in women that results in higher phenytoin concentration levels [5]. Dose regimens for phenytoin do not need to be adjusted based on patient’s sex, since the more rapid elimination in women counterbalance the generally lower weight that result in higher phenytoin concentration levels [5].
A study examining binding characteristics of phenytoin to serum proteins in healthy adults (40 men, 40 women) on monotherapy found no sex differences. The affinity of phenytoin to serum proteins......

Visa hela bakgrundstexten

# Pharmacokinetics and dosing A study (39 men, 24 women) found no difference between men and women in phenytoin clearance, distribution volume or half-life. Men and women received the same daily dose (4.8 mg/kg/day) of phenytoin or fosphenytoin and trough phenytoin concentrations were similar between men and women [4]. Also, a randomized controlled trial in healthy subjects (12 men, 12 women) showed that the mean AUC, normalized for the mg/kg phenytoin dose, was about 30% lower in women than men. This might be explained by a more rapid elimination in women. This counterbalance the generally lower body weight in women that results in higher phenytoin concentration levels [5]. Dose regimens for phenytoin do not need to be adjusted based on patient’s sex, since the more rapid elimination in women counterbalance the generally lower weight that result in higher phenytoin concentration levels [5]. A study examining binding characteristics of phenytoin to serum proteins in healthy adults (40 men, 40 women) on monotherapy found no sex differences. The affinity of phenytoin to serum proteins was similar in men and women, and patient’s sex does not have a significant effect on binding characteristics of phenytoin to serum proteins in adult patients [6]. # Effects No studies with a clinically relevant sex analysis regarding effects of phenytoin have been found. # Adverse effects A retrospective analysis (320 men, 343 women) of patients on antiepileptic drug treatment showed fertile women to have a higher risk for skin reactions than men when treated with phenytoin [7]. # Reproductive health issues Enzyme-inducing antiepileptic drugs, such as carbamazepine, phenytoin and phenobarbital, may have potentially negative effects on reproductive endocrine function in men and women. These antiepileptic drugs increase concentrations of sex hormone-binding globulin (SHBG) and thereby reducing the concentrations of unbound biologically active androgens [1-3]. This may result in sexual dysfunction.   Phenytoin pharmacokinetics is altered during pregnancy resulting in lower plasma concentrations and thus, an increased risk of seizures. For appropriate dose adjustment in pregnant women, monitoring of plasma phenytoin concentrations is recommended [8]. Regarding teratogenic aspects, please consult Janusmed Drugs and Birth Defects (in Swedish, Janusmed fosterpåverkan). Phenytoin may affect the metabolism of estrogens and progestogens. Thus, the effect of these can be reduced. Additional contraceptive method should be used [9]. Regarding drug-drug interactions aspects, please consult Janusmed Interactions (in Swedish, Janusmed interaktioner).
Försäljning på recept

Visa hela försäljning på recept

Fler män än kvinnor hämtade ut läkemedel innehållande fenytoin (ATC-kod N03AB02) på recept i Sverige år 2019, totalt 2 071 män och 1 724 kvinnor. Det motsvarar 0,4 respektive 0,3 personer per tusen invånare. Andelen som hämtat ut läkemedel var högst i åldersgruppen 60 år och äldre hos båda könen. I genomsnitt var läkemedel innehållande fenytoin 1,4 gånger vanligare hos män [10].
Referenser

Visa referenser

  1. Duncan S, Blacklaw J, Beastall GH, Brodie MJ. Antiepileptic drug therapy and sexual function in men with epilepsy. Epilepsia. 1999;40:197-204.

  2. Svalheim S, Sveberg L, Mochol M, Taubøll E. Interactions between antiepileptic drugs and hormones. Seizure. 2015;28:12-7.

  3. Yogarajah M, Mula M. Sexual Dysfunction in Epilepsy and the Role of Anti-Epileptic Drugs. Curr Pharm Des. 2017;23(37):5649-5661.

  4. Meyer MC, Straughn AB, Mhatre RM, Shah VP, Chen ML, Williams RL et al. Variability in the bioavailability of phenytoin capsules in males and females. Pharm Res. 2001;18:394-7.

  5. Kodama H, Kodama Y, Shinozawa S, Kanemaru R, Todaka K, Mitsuyama Y. No gender effect on binding characteristics of phenytoin to serum proteins in monotherapy for adult patients with epilepsy. Am J Ther. 2000;7:285-9.

  6. Alvestad S, Lydersen S, Brodtkorb E. Rash from antiepileptic drugs: influence by gender, age, and learning disability. Epilepsia. 2007;48:1360-5.

  7. Phenytek (phenytoin). DailyMed [www]. U.S. National Library of Medicine [updated 2018-02-15, cited 2019-10-14].

  8. Patsalos PN, Perucca E. Clinically important drug interactions in epilepsy: general features and interactions between antiepileptic drugs. Lancet Neurol. 2003;2:347-56.

  9. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2019 [cited 2020-03-10.]

  1. Duncan S, Blacklaw J, Beastall GH, Brodie MJ. Antiepileptic drug therapy and sexual function in men with epilepsy. Epilepsia. 1999;40:197-204.
  2. Svalheim S, Sveberg L, Mochol M, Taubøll E. Interactions between antiepileptic drugs and hormones. Seizure. 2015;28:12-7.
  3. Yogarajah M, Mula M. Sexual Dysfunction in Epilepsy and the Role of Anti-Epileptic Drugs. Curr Pharm Des. 2017;23(37):5649-5661.
  4. Meyer MC, Straughn AB, Mhatre RM, Shah VP, Chen ML, Williams RL et al. Variability in the bioavailability of phenytoin capsules in males and females. Pharm Res. 2001;18:394-7.
  5. Kodama H, Kodama Y, Shinozawa S, Kanemaru R, Todaka K, Mitsuyama Y. No gender effect on binding characteristics of phenytoin to serum proteins in monotherapy for adult patients with epilepsy. Am J Ther. 2000;7:285-9.
  6. Alvestad S, Lydersen S, Brodtkorb E. Rash from antiepileptic drugs: influence by gender, age, and learning disability. Epilepsia. 2007;48:1360-5.
  7. Phenytek (phenytoin). DailyMed [www]. U.S. National Library of Medicine [updated 2018-02-15, cited 2019-10-14].
  8. Patsalos PN, Perucca E. Clinically important drug interactions in epilepsy: general features and interactions between antiepileptic drugs. Lancet Neurol. 2003;2:347-56.
  9. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2019 [cited 2020-03-10.]
Uppdaterat

Litteratursökningsdatum: 10/11/2019

Litteratursökningsdatum: 10/11/2019
Fasstexter

Visa fasstexter

Se även

Fosfenytoin

Karbamazepin

Fenobarbital