BENZODIAZEPINES AND PHENYTOIN - MIDAZOLAM

Phenytoin reduced the AUC of midazolam by about 95%, and the peak serum levels by about 90% when compared with control subjects not taking anticonvulsants. The effects of midazolam were also reduced.
Expect to need to use a much larger dose of midazolam in the presence of phenytoin. An alternative hypnotic may be needed.