Phenytoin--allopurinol interaction: Michaelis--Menten kinetic parameters of phenytoin with and without allopurinol in a child with Lesch--Nyhan syndrome.

We analyzed Michaelis--Menten pharmacokinetic parameters of phenytoin with and without the coadministration of allopurinol (150 and 200 mg/day) in a child with Lesch--Nyhan syndrome. The Vmax and Km were estimated from at least two different sets of serum concentration--dosage data of phenytoin. The Vmax values (mg/kg/day) were 16.1 without allopurinol, and 12.4 and 10.9 with allopurinol (150 and 200 mg/day), respectively, whereas those for Km remained relatively constant (3.9 to 4.9 microgram/ml). Our results suggest that allopurinol is a drug that inhibits the hepatic metabolism of phenytoin.