Warfarin, phenytoin and thyroid hormones - a binding combination?

As all pharmacists would know, a change in phenytoin dose of this magnitude is inappropriate and may result in an excessive increase in levels. as later occurs in this patient. This problem would need to be addressed with some explanation. especially, as when the level was later elevated, the doctor reduced the dose by lOOmg to 300mg. Advice on this aspect of this case can be found in a previous medication review article addressing this issue.'