Phenytoin Toxicity from Cocaine Adulteration

The use of phenytoin (PHT) as a cocaine adulterant was reported decades ago;that practice is still current. Ironically PHT has also been used for the treatment of cocaine dependence. A drug smuggler developed PHT toxicity after swallowing several rocks of crack. We investigated the current trends of PHT as a cocaine adulterant and its toxicological implications. We also reviewed the clinical use of PTH in relation to cocaine. The use of PHT as cocaine cut is a current practice. This may affect the clinical manifestations and the management of the cocaine-related visits to the emergency department. [West J Emerg Med. 2014;15(2):127–130.]

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