Treatment with lipid emulsion decreases high levels of phenytoin in rats

Objective: Phenytoin is a widely used, lipophilic antiepileptic agent. As a result of its narrow therapeutic index, toxicity is not rare. Currently, there is no specific antidote for phenytoin. Therefore, we need a low-cost supportive therapeutic agent that can easily be applied in emergency conditions. The rationale for conducting our study was to evaluate the efficacy of the lipid emulsion to the high levels of phenytoin in an animal model. Methods: We randomly divided 28 rats into 4 groups: Control group (received no treatment); phenytoin group (received 75 mg/kg phenytoin intraperitoneally); lipid emulsion group (received 4 ml/kg 20% lipid emulsion intravenously); phenytoin+lipid emulsion group (received 75 mg/kg phenytoin intraperitoneally and 4 ml/kg 20% lipid emulsion intravenously). We performed blood analysis twice in each group. Results: Lipid emulsion significantly decreased the phenytoin level in the treatment group in comparison with the control group (p=0.035 and p=0.026, respectively). Conclusion: We demonstrated the efficacy of lipid emulsion in reducing serum phenytoin levels in our animal model. Lipid emulsion is a promising method for treatment of phenytoin intoxication.