Long-Term Use of Phenytoin: Effects on Whole Blood and Red Cell Folate and Haematological Parameters

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Abstract
Patients treated with phenytoin for periods of several months or years had slightly, but significantly, lower whole blood and red cell folate values than comparable controls, whether folate was determined microbiologically with Lactobacillus casei or by a radioligand method using the bovine milk binder. Hematological parameters including Hb, MCH [mean corpuscular Hb], MCV [mean corpuscular volume] and red blood cell counts did not show any alterations, and no patient developed any signs of anemia. Long-term use of phenytoin appeared not to cause a clinically significant state of folate deficiency, unless some other contributing factors were present.