Medications like phenytoin, an anticonvulsant, uses liver and kidney hydroxylase enzymes for its own metabolism, so especially with long term use, there's not enough vitamin D being generated.
Phenytoin, sold under the brand name Dilantin among others, is an anti-seizure medication. It is useful for the prevention of tonic-clonic seizures, partial seizures, but not absence seizures. The intravenous form is used for status epilepticus that does not improve with benzodiazepines. It may also be used for certain heart arrhythmias or neuropathic pain. It can be taken intravenously or by mouth. The intravenous form generally begins working within 30 minutes and is effective for 24 hours. Blood levels can be measured to determine the proper dose.