This medication is an anticonvulsant, prescribed for seizures during neurosurgery and status epilepticus. It works in the brain to block the spread of seizure activity.
Contraindicated in patients with history of allergic reaction to similar drugs, abnormalities in heart rhythm and Adams-Stokes syndrome.
IV/IM- Tonic-clonic status epilepticus- As phenytoin Na equivalents (PSE)- Loading dose: 15 mg PSE /kg via IV infusion.
Maintenance: Initial: 4-5 mg PSE/kg/day, subsequent doses depend on patient's response and trough-plasma phenytoin levels.
Seizures except status epilepticus- As PSE: Loading dose: 10-15 mg/kg. Maintenance: Initial: 4-5 mg/kg/day; subsequent doses depend on patient's response and trough-plasma phenytoin levels.
It comes as a solution for injection, to be administered by a healthcare provider into the vein or muscle.
• It may cause dizziness or drowsiness, do not drive a car or operate machinery while taking this medication.
• Caution should be exercised in patients with history of heart problem, liver or kidney disease, low blood albumin levels, diabetes, alcoholism, elderly, patients requiring phosphate restriction.
• Resuscitation facilities must be available.
• Monitor ECG, BP, blood sugar, and respiratory function during infusion; observe patients for at least 30 minutes after infusion.
• IV infusion rate should not exceed 150 mg PSE/minute in adults or 3 mg PSE/kg/minute in children â‰¥5 yr.
• Heart: Low blood pressure, dilatation of blood vessels and fast heart beat.
• Central Nervous System: Involuntary eye movement, dizziness, drowsiness, unsteadiness, tremor, headache, incoordination, stupor, weakness, increase in muscle tone, abnormal movements, tingling, agitation, decreased reflexes, brain edema, speech disorder, sensory loss, vertigo, abnormal thinking, increased reflexes, intracranial hypertension and nervousness.
• Skin: Itching, face edema, rash.
• Eye and ENT: perception of sound within the human ear in the absence of corresponding external sound. Double vision, taste perversion, blurred vision and deafness.
• Gastrointestinal: Nausea, dry mouth, tongue disorder, vomiting and constipation.
• Blood: Easy bruising.
• Skin: Injection-site pain.
• Metabolic: Low potassium in blood.
• Musculoskeletal: Back pain and muscle weakness.
• Respiratory: Pneumonia.
• Miscellaneous: Pelvic pain, chills, fever, infection and fetal defects during pregnancy.
Do not change the dosage, and avoid abrupt withdrawal.
Some drugs could change the level of fosphenytoin in the blood and result in the patient having no effect of the drug or experiencing side effects. Inform your doctor of all medications you are taking before starting fosphenytoin.
Injection: Store at (2-8Â°C). Do not keep at room temperature for more than 48 hours.
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