Summary
Administration of phenytoin for 5 days significantly reduces oral absorption and bone uptake of radiolabelled calcium in mice. Acute treatment with phenytoin had no effect on calcium disposition. Pretreatment (1–5 days) with phenobarbital also had no effect of calcium disposition. Methotrexate pretreatment for 5 days increased the bone uptake of radiolabelled calcium presumably by decreasing calcium renal clearance. It is concluded that phenytoin induced reduction in calcium metabolism is unrelated to a state of functional folate deficiency.
Similar content being viewed by others
Abbreviations
- 25(OH)D:
-
25-Hydroxyvitamin D
- 1,25(OH)2D:
-
1,25-dihydroxyvitamin D
- PB:
-
Phenobarbital sodium
- MTX:
-
Methotrexate
- DPH:
-
Phenytoin
- Ca-45:
-
Calcium-45
References
Anast CS (1975) Anticonvulsant drugs and calcium metabolism. N Engl J Med 292:587–588
Blanusa M (1975) Liquid scintillation counting of calcium-45 in biological material. Anal Biochem 69:120–130
Caspary WF (1972) Inhibition of intestinal calcium transport by diphenylhydantoin in rat duodenum. Naunyn Schmiedebergs Arch Pharmacol 274:146–153
Christiansen C, Kristensen M, Rodbro P (1972) Latent osteomalacia in epileptic patients on anticonvulsants. Br Med J 3:738–739
Carradino RA (1976) Diphenylhydantoin: direct inhibition of the vitamin D3-mediated calcium absorption mechanism in organcultured duodenum. Biochem Pharmacol 25:863–864
DeLuca HF (1974) Vitamin D — 1973. Am J Med 57:1–12
Hahn TJ, Hendin BA, Scharp CR, Boisseau VC, Haddad JG (1972) Effect of chronic anticonvulsant therapy on serum 25-hydroxycalciferal levels in adults. N Engl J Med 287:900–904
Hahn TJ, Hendin BA, Sharp CR, Boisseau VC, Haddad JG (1975) Serum 25-hydroxycalciferal levels and bone mass in children on chronic anticonvulsant therapy. N Engl J Med 292:550–554
Harrison HC, Harrison HE (1976) Inhibition of vitamin D-stimulated active transport of calcium of rat intestine by diphenylhydantoinphenobarbital treatment. Proc Soc Exp Biol Med 153:220–224
Haussler MR, McCain TA (1977) Basic and clinical concepts related to vitamin D metabolism and action. N Engl J Med 297:974–983; 297:1041–1050
Hawkins CF, Meynell MJ (1954) Megaloblastic anemia due to phenytoin sodium. Lancet II:737–738
Hoffbrand AV, Necheles TF (1968) Mechanism of folate deficiency in patients receiving phenytoin. Lancet II:528–530
Jubiz W, Haussler MR, McCain TA (1977) Plasma 1,25-dihydroxy vitamin D levels in patients receiving anticonvulsant drugs. J Clin Endocrinol Metab 44:617–621
Lifshitz F, Maclaren NK (1973) Vitamin D-dependent rickets in institutionalized mentally retarded children receiving long-term anticonvulsant therapy. I. A survey of 288 patients. J Pediatr 83:612–620
Livingston S, Berman W, Pauli LL (1973) Anticonvulsant drugs and vitamin D metabolism. JAMA 224:1634–1635
Maclaren N, Lifshitz F (1973) Vitamin D-dependency rickets in institutionalized, mentally retarded children on long-term anticonvulsant therapy. II. The response to 25-hydroxyholecalciferal and to vitamin D. Pediatr Res 7:914–922
Maxwell JD, Hunter J, Stewart DA, Williams R (1972) Folate deficiency after anticonvulsant drugs; an effect of hepatic enzyme induction. Br Med J 1:297–299
Meynell MJ (1966) Megaloblastic anemia in anticonvulsant therapy. Lancet I:487
Myrtle JF, Norman AW (1971) Vitamin D: A cholecaciferal metabolite highly active in promoting intestinal calcium transport. Science 171:79–81
Nichols G, Wasserman RH (eds) (1971) Cellular mechanisms for calcium transfer and homeostasis. Academic Press, New York
Paul L, Evans MA (1978) Effects of methotrexate and phenytoin on nucleotide metabolism in the adult and fetal mouse. Pharmacologist 20:201
Reynolds EH (1972) Diphenylhydantoin: Hematologic aspects of toxicity. In: Woodbury DM, Penry JK, Schmidt RP (eds) Antiepileptic drugs. Raven Press, New York, pp 247–262
Villareale M, Gould CV, Wasserman RH, Bar A, Chiroff RT, Bergstrom WH (1974) Diphenylhydantoin: Effects on calcium metabolism in the chick. Science 183:671–673
Wong RG, Norman AW, Reddy CR, Coburn JW (1972) Biologic effects of 1,25-dihydroxycholecalciferal (a highly active vitamin D metabolite) in acutely uremic rats. J Clin Invest 51:1287–1296
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Evans, M.A. Effects of anticonvulsants and methotrexate on calcium disposition. Naunyn-Schmiedeberg's Arch. Pharmacol. 315, 63–67 (1980). https://doi.org/10.1007/BF00504231
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00504231