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Vol. 29, Issue 4, 427-434, April 2001
Faculty of Pharmaceutical Sciences, Kanazawa University, Kanazawa,
Japan (H.Y., T.K., K.T., M.N., T.Y.); Taiho Pharmaceutical Company,
Tokushima, Japan (M.S., Y.M., Y.K.); and Daiichi Pure Chemicals,
Ibaraki, Japan (N.S.)
Phenytoin, 5,5-diphenylhydantoin, is a widely used anticonvulsant
agent with a variety of toxicities, including drug interactions. The
formation of four oxidative metabolites, 4'-hydroxylated
(4'-HPPH), 3'-hydroxylated (3'-HPPH), a catechol (3',4'-diHPPH),
and the 3',4'-dihydrodiol form of phenytoin was examined in rat liver microsomes. In 11 cDNA-expressed rat P450 enzymes tested, CYP2C6 had
the highest activities in 4'- and 3'-HPPH formation from phenytoin, followed only by CYP2C11. In contrast, CYP2C11 had high activity for
3',4'-diHPPH formation from 4'-HPPH, followed by CYP2C6. The rates of
4'-HPPH and 3',4'-diHPPH formation from phenytoin in liver microsomes
in the presence of NADPH were significantly decreased by oral
administration of phenytoin (300 mg/kg for 20 days) to rats, despite
the increase in P450 contents. However, the cumene hydroperoxide-supported formation of 3',4'-dihydrodiol and 4'-HPPH from
phenytoin was induced by phenytoin administration. Hydrogen peroxide
formation in reaction mixtures with NADPH was induced by the
administration of phenytoin; however, the coupling ratio of phenytoin
oxidation was decreased in phenytoin-induced liver microsomal P450
systems. These results suggested that phenytoin could not stimulate its
own apparent oxidative metabolism by liver P450s induced with phenytoin
administration. The increase of unmetabolized phenytoin and byproducts
of oxygen generated in the phenytoin-induced liver microsomal P450
system may be involved in phenytoin-related drug toxicity.
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