Abstract

To the Editor: We read with great interest the article by Naidech et al1 on the association of phenytoin exposure and cognitive disability after subarachnoid hemorrhage. The authors speculate on a number of reasons for this association, to which we would like to add the possibility of a pharmacokinetic interaction compromising the protective effects of nimodipine. Phenytoin induces the hepatic microsomal enzyme system (cytochrome p-450 isozymes). Induction of the CYP isozyme system may …

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