Editing Phenytoin (section)

===Blood===
Folate is present in food in a polyglutamate form, which is then converted into monoglutamates by [[Gamma-glutamyl hydrolase|intestinal conjugase]] to be absorbed by the jejunum. Phenytoin acts by inhibiting this enzyme, thereby causing [[folate deficiency]], and thus [[megaloblastic anemia]].<ref>{{cite journal | vauthors = Carl GF, Smith ML | title = Phenytoin-folate interactions: differing effects of the sodium salt and the free acid of phenytoin | journal = Epilepsia | volume = 33 | issue = 2 | pages = 372–375 | year = 1992 | pmid = 1547769 | doi = 10.1111/j.1528-1157.1992.tb02330.x | s2cid = 40927589 }}</ref>
Other side effects may include: [[agranulocytosis]],<ref>{{cite journal | vauthors = Sharafuddin MJ, Spanheimer RG, McClune GL | title = Phenytoin-induced agranulocytosis: a nonimmunologic idiosyncratic reaction? | journal = Acta Haematologica | volume = 86 | issue = 4 | pages = 212–213 | year = 1991 | pmid = 1805490 | doi = 10.1159/000204838 }}</ref> [[aplastic anemia]],<ref>{{cite journal | vauthors = Handoko KB, Souverein PC, van Staa TP, Meyboom RH, Leufkens HG, Egberts TC, van den Bemt PM | title = Risk of aplastic anemia in patients using antiepileptic drugs | journal = Epilepsia | volume = 47 | issue = 7 | pages = 1232–1236 | date = July 2006 | pmid = 16886988 | doi = 10.1111/j.1528-1167.2006.00596.x | hdl-access = free | s2cid = 25327883 | hdl = 1874/27341 }}</ref> [[leukopenia|decreased white blood cell count]],<ref>{{cite book | vauthors = Workman ML, Lacharity LA |title=Understanding Pharmacology: Essentials for Medication Safety |date=2016 |location=St. Louis, Missouri | publisher = Elsevier Health Sciences |isbn=978-1-4557-3976-9 |edition=2nd | url = https://books.google.com/books?id=AiHmCgAAQBAJ&pg=PA302 }}</ref> and [[thrombocytopenia|a low platelet count]].<ref>{{cite web | vauthors = Hamblin TJ |title=Aplastic anaemia |date=August 2005 | work = NetDoctor |url= http://www.netdoctor.co.uk/diseases/facts/aplasticanaemia.htm |access-date=8 July 2013 |url-status=live |archive-url=https://web.archive.org/web/20130212114642/http://www.netdoctor.co.uk/diseases/facts/aplasticanaemia.htm |archive-date=12 February 2013 }}</ref>