A 58-year-old man developed neurological toxicity duringconcomitant administration of phenytoin, atorvastatin,enalapril and metformin [routes not stated].The man, who had been receiving phenytoin100 mg/12 hours capsule for last two months for epilepsy,presented for confusion, double vision, in-coordination anddifficulty articulating words. A total phenytoin plasmaconcentration was high 49 mg/L. He was also receivingenalapril 20mg twice daily for arterial hypertension, metformin850mg twice daily for diabetes mellitus and atorvastatin 20mgonce daily and aspirin for prevention of heart attack.Phenytoin-induced neurotoxicity was suspected.
