Interaction of Dietary Pudding With Phenytoin

Abstract

To the Editor.— Patient compliance with use of anticonvulsant medication is necessary to achieve seizure control. In nonambulatory, mentally retarded epileptic patients, phenytoin tablets (Dilantin Infatabs, Parke Davis) are often crushed and mixed with various semisolid foods to mask their taste and to enhance compliance. At our facility, phenytoin tablets were customarily mixed with vanilla pudding prior to patient administration. From our routine therapeutic drug-monitoring program, several patients were observed to have low therapeutic serum concentrations despite seemingly adequate phenytoin dosages.