FOSPHENYTOIN SODIUM

Anticonvulsant

Brand names: Fosphenytoin sodium

Intramuscular, Intravenous

Mechanism of Action

12.1 Mechanism of Action Fosphenytoin is a prodrug of phenytoin and accordingly, its anticonvulsant effects are attributable to phenytoin. The precise mechanism by which phenytoin exerts its therapeutic effect has not been established but is thought to involve the voltage-dependent blockade of membrane sodium channels resulting in a reduction in sustained high-frequency neuronal discharges.

Indications

short-term

as short-term use

for oral phenytoin. Fosphenytoin sodium injection should be used only when oral phenytoin administration is not possible.

Contraindications

• 4 CONTRAINDICATIONS Fosphenytoin sodium is contraindicated in patients with: A history of hypersensitivity to fosphenytoin sodium injection or its inactive ingredients
• or to phenytoin or other hydantoins [see Warnings and Precautions (5.6) ] . Reactions have included angioedema. Sinus bradycardia
• sino-atrial block
• second and third degree A-V block
• its ingredients

FDA Warnings

5 WARNINGS AND PRECAUTIONS • Dosing Errors: Do not confuse the amount of drug to be given in PE with the concentration of the drug in the vial
3 ) • Serious Dermatologic Reactions: Discontinue at the first sign of a rash, unless clearly not drug-related
In some cases, ten-fold overdoses were associated with fatal outcomes
2 Cardiovascular Risk Associated with Rapid Infusion Rapid intravenous administration of fosphenytoin sodium increases the risk of adverse cardiovascular reactions, including severe hypotension and cardiac arrhythmias

Known Side Effects

4 documented side effects by frequency

Drug Not Working

>10%

Low Blood Pressure

1-10%

Fever

0.1-1%

Rash

0.1-1%

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Formulations

Dosage Forms

Tablet

Route

Intramuscular, Intravenous