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Fosphenytoin

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Fosphenytoin

Pro-drug: phenytoin ester

IV/IM administration

Clinical uses

Adverse effects

Less common than with phenytoin. Many of the side effects of the latter are thought to be related to the carrier substance.

  • severe cardiovascular adverse effects have been reported in patients receiving IV preparation
    • asystole, VF
    • hypotension
    • bradycardia
    • heart block
  • majority of side effects occur within 30 minutes of infusion

Committee on Safety of Medicines recommendations:
Monitor heart rate, blood pressure and respiratory function for the duration of the infusion.

Continue to observe the patient for at least 30 minutes after the end of the infusion

Hypotension may occur with recommended doses and rates of infusion. A reduction in infusion rate of discontinuation of therapy may be necessary

A lower loading dose and/or infusion rate, and a lower or less frequent maintenance dose may be required in the elderly and those with renal or hepatic impairment. A 10-25% reduction in dose or rate is advised

 

©Charles Gomersall, April, 2014 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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