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July 1982

Phenytoin and Lactation

Author Affiliations

Department of Medicine Richland Memorial Hospital University of South Carolina School of Medicine Columbia, SC 29203

Arch Neurol. 1982;39(7):457-458. doi:10.1001/archneur.1982.00510190075035

To the Editor.—  The metabolism of phenytoin in pregnancy has been carefully studied1,2; however, comparatively little has been written about phenytoin and lactation. We recently studied a patient who received phenytoin throughout an 11-month period of lactation.

Report of a Case.—  A 30-year-old primigravida was delivered of a normal infant by cesarean section. On the sixth postpartum day, she had a grand mal seizure; she was found to have a cortical venous occlusion with hemorrhage on the convexity of the left frontal lobe of the brain. Her seizures were well controlled by phenytoin, 300 mg orally alternating with 400 mg orally every other day. She continued throughout to nurse her baby. Phenytoin levels were therapeutic at 14, 17, and 16 μg/mL in the third to fifth postpartum months. Gradual weaning of the infant began in the sixth month, and the patient's phenytoin levels rose to 18 μg/mL. As the

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