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Fosphenytoin - Indications, Dosage, Side Effects and Precautions

Written & Compiled by Anushta Chandrapalan, M.Sc  | Medically Reviewed by The Medindia Medical Review Team
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General Information on Fosphenytoin

Generic Name : Fosphenytoin
Pronunciation : fos-FEN-i-toin
Latest prescription information about Fosphenytoin. Learn how to pronounce the drug's name, its indications, dosage, how to take, when to take, when not to take, side effects, special precautions, warnings and its storage instructions . Also listed are the International and Indian trade name(s) of the drug and its price list.
ICD Code : Y46.2 | Therapeutic Classification : Anticonvulsants

Trade Names/Brand Names of Fosphenytoin

India : 

International : 


Why is Fosphenytoin Prescribed? (Indications)

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.

When should Fosphenytoin not be taken? (Contraindications)

Contraindicated in patients with history of allergic reaction to similar drugs, abnormalities in heart rhythm and Adams-Stokes syndrome.

What is the dosage of Fosphenytoin?

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.

How should Fosphenytoin be taken?

It comes as a solution for injection, to be administered by a healthcare provider into the vein or muscle.

What are the warnings and precautions for Fosphenytoin?

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 ≥5 yr.

What are the side effects of Fosphenytoin?

  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.

What are the other precautions for Fosphenytoin?

Do not change the dosage, and avoid abrupt withdrawal.

What are the Drug Interactions of Fosphenytoin?

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.

What are the storage conditions for Fosphenytoin?

Injection: Store at (2-8°C). Do not keep at room temperature for more than 48 hours.

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itorian, India

Please I need your help. There is no any Doctor in my city who prescribes the Generic Medicines. My Doctor prescribed me to take 'Phenytoin Tablets IP 100 mg', product name is 'Eptoin' medicine. I'm taking this medicine since my childhood (3 tablets each day) and the cost of this medicine is now Rs. 220+. I'm wishing to buy the generic medicine of the same because of cost issues. When I searched I came to know the generic name of 'Eptoin' is 'Fosphenytoin' but I'm not sure reason I'm not a doctor. Please help if you can.

dr2kvivek, India



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