Ketogenic Diet - Mephenytoin Interaction

Interaction Details

Mephenytoin is classified as belonging to the following category: Anticonvulsants

Following the ketogenic diet may reduce the levels of certain anticonvulsants, although the clinical significance of this effect is unclear.
Pharmacokinetic research in patients chronically taking up to 4 antiepileptic drugs shows that following a modified Atkins diet for 4-12 weeks reduces the average anticonvulsant serum concentrations by 10.5% to 13.5% (range 7% to 19%) without affecting overall seizure control. Antiepileptic agents taken by these patients included carbamazepine, oxcarbazepine, topiramate, valproate, clobazam, nitrazepam, lamotrigine, zonisamide, and others. Levels of oxcarbazepine and levetiracetam did not seem to be significantly affected after the initiation of the ketogenic diet. Additionally, a small clinical study in children with drug-refractory epilepsy taking a variety of anticonvulsant medications shows that following a ketogenic diet for 12 weeks reduces serum concentrations of clobazam and its active metabolite desmethylclobazam, both by 38%, and lamotrigine by 15% without affecting overall seizure control. Levels of levetiracetam, topiramate, and valproic acid were not significantly reduced. Serum levels of anticonvulsants should be monitored in patients following a ketogenic diet.

Interaction Rating

Likelihood of Occurrence

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists

References

• Kverneland M, Taubøll E, Selmer KK, Iversen PO, Nakken KO. Modified Atkins diet may reduce serum concentrations of antiepileptic drugs. Acta Neurol Scand. 2015;131(3):187-90.
• Kverneland M, Taubøll E, Molteberg E, Veierød MB, Selmer KK, Nakken KO, Iversen PO. Pharmacokinetic interaction between modified Atkins diet and antiepileptic drugs in adults with drug-resistant epilepsy. Epilepsia. 2019;60(11):2235-2244.
• Pedersen S, Kverneland M, Rudi K, et al. Decreased serum concentrations of antiseizure medications in children with drug resistant epilepsy following treatment with ketogenic diet. Epilepsia Open. 2023;8(3):858-866.

Ketogenic Diet - More Interactions

Ketogenic Diet interacts with 256 drugs

Interaction Rating Key

These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.