Fosphenytoin

Fosphenytoin is a prodrug of phenytoin can be given more rapidly and causes fewer injection site reactions, when given intravenously (IV) than phenytoin. It can also be given intramuscularly (IM). Fosphenytoin is used in the treatment of status epilepticus and seizures associated with neurosurgery or head injury; when phenytoin by mouth not possible.

Brands
Adult Dose
Dose: 15 to 20 mg PE/kg
Single Dose: 18 (17.5)
Frequency: As recommended.
Route: IV
Instructions: Status Epilepticus: Initial/Loading dose
Neonatal
Paedriatic
Characteristics
. It is of Synthetic origin. . The Molecular Weight of Fosphenytoin is 406.20.
Contraindications
Fosphenytoin
Effects
The symptomatic adverse reactions produced by Fosphenytoin are more or less tolerable and if they become severe, they can be treated symptomatically, these include Itching, Burning, Hypotension, Paresthesias.
Indications
Fosphenytoin is primarily indicated in conditions like Epilepsy, Head injury, Seizures, Status epilepticus, Trauma.
Interactions
Fosphenytoin is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAcetazolamide (Na)AllopurinolAmiodarone (HCl)AzapropazoneBleomycinCarbamazepineChloramphenicolChlorpheniramine (Maleate)ChlorphenpyridaminChlorpromazine (HCl)Cimetidine (HCl)CisplatinCo-TrimoxazoleCyclosporin ADexamethasoneDextropropoxypheneDiazoxideDigoxinDiltiazem (HCl)DisulfiramDoxycyclineFelbamateFluconazoleFluoxetine (HCl)Folic AcidGabapentinImipramine (HCl)IsoniazidLamotrigineLevamisoleLignocaineMebendazoleMethadoneMethoxsalenMianserinMiconazole (Nitrate)NifedipineNitrofurantoinOxacillinPethidine (HCl)PhenobarbitonePhenylbutazone Praziquantel PyridoxineRifampicinSodium ValproateSucralfateSulphinpyrazoneTheophyllineThioridazine (HCl)Ticlopidine (HCl)TizanidineTopiramateTrazodone (HCl)VigabatrinVinblastine (Sulphate)VORICONAZOLEThe hydantoin decreases the effect of voriconazoleZidovudine These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Increased Alkaline Phosphatase LevelsIncreased blood glucose level
Risks
Drug should not be given to patients suffering from Kidney dysfunction.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Inj Store in refrigerator. Do not Freeze.
Warnings
It should be used with care in patients with liver , lungs, heart diseases, blood disorders, severe renal impairment and others in whom phosphate restriction is necessary. Perform blood counts before initiating the therapy. Administer cautiously in the presence of advanced atrioventricular (AV) block. Donot exceed an I/V infusion rate of 150mg/min. Discontinue use if skin rashes appear. Withdrawl of therapy or transition to or from another type of antiepileptic therapy should be made gradually to avoid precipitating an increase in the frequency of seizures.
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