Fosphenytoin

Details About Generic Salt ::  Fosphenytoin 

Main Medicine Class:: #N/A   Sub Medicine Class ::  #N/A

1C. ANTI-EPILEPTICS in 1. NERVOUS SYSTEM
FOSPHENYTOIN
HYDANTOIN | ANTI-EPILEPTIC
PK: D: 4.3-10.8L/kg (Vd) M: Hepatic E: Urine

Indications & Dose: SEIZURES ASSOCIATED WITH NEUROSURGERY/HEAD INJURY Prophylactic therapy/Short-term therapy IV/IM Adult 10–15mg (PE)/kg [rate: 50– 100mg (PE)/min] then 4–5mg (PE)/kg/day [rate: 50–100mg (PE)/min] in 1–2 divided doses Child >5 yr: 10–15mg (PE)/kg [rate 1–2mg (PE)/kg/min], then 4–5mg (PE)/kg/day in 1–4 divided doses | STATUS EPILEPTICUS IV Adult 20mg/kg [rate: 100–150mg(PE)/min], then 4–5mg/kg(PE)/day [rate: 50–100mg(PE)/min] in 1–2 divided doses Child >5yr: 20mg/kg [rate: 2–3mg(PE)/kg/min], then 4–5mg(PE)/kg/day [rate: 1–2mg(PE)/kg/min] in 1–4 divided dosesfosphenytoin sodium dose is expressed in terms of phenytoin sodium equivalent (PE); fosphenytoin sodium 1.5mg = phenytoin sodium 1mg | TEMPORARY SUBSTITUTION FOR ORAL PHENYTOIN IV/IM Adult 20mg (PE)/kg (rate: 100–150mg (PE)/min), then 4–5mg (PE)/kg/day (rate: 50– 100mg (PE)/min), in 1–2 divided doses Child >5yr: 20mg (PE)/kg (rate 2–3mg (PE)/kg/min), then 4–5mg (PE)/kg/day (rate: 1–2mg (PE)/kg/min), in 1–4divided doses

Contra: Hypersensitivity to phenytoin, porphyria, avoid parenteral use in sinus bradycardia, sino-atrial block, second- and third-degree heart block and stokes-adams syndrome

Precautions: Abrupt drug withdrawal, hypotension, HF

ADR: Serious: Hypersensitivity reactions, SJS, TEN, hepatotoxicity, CNS depression, arrhythmias, hypotension, CV collapse, cerebellar vestibular symptoms, neurological changes, lymphnode enlargement, gingival hyperplasia, hepatitis, Others: acne, leukopenia, hyperglycaemia, thrombocytopenia, headache, sleeplessness, agitation, confusion, ataxia, nystagmus, diplopia, slurred speech

DDI: Serious Rifampicin/Diazoxide decreases drug level, Carbamazepine efficacy decreases, Chloramphenicol/Allopurinol/Dextromethorphan/Diltiazem/Fluconazole/Isoniazid/Miconazole/Nifedipine/Voriconazole increases drug level, Amiodarone level reduces & drug level increases, Bupropion levels are significantly decreased, Ketoconazole/Itraconazole levels decreases Others Fluvoxamine/Fluoxetine/Ticlopidine increases drug level, Nimodipine/Felodipine/Verapamil levels reduces

Diet: with sufficient fluids

Monitor: BP, ECG, CBC, LFT, respiratory function

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