Should we do early and frequent charcoal hemoperfusion in phenytoin toxicity?

Phenytoin toxicity or adverse drug reaction is common due to its narrow therapeutic window. Mild and moderate toxicity require supportive care and enteral activated charcoal. In severe toxicity, charcoal hemoperfusion (CHP) have been shown to decrease serum phenytoin half-life and early recovery. Here, we report two cases with phenytoin toxicity who showed marked clinical improvement after early and frequent CHP treatment.