| Indication | Route | Fosphenytoin Dosage* | IV Rate (mg/min) |
|
Loading Dose Administration Status Epilepticus Nonemergent Treatment or Prevention of Seizures Maintenance Dose Administration Maintenance Dose After Loading Dose Temporary Substitution for Oral Phenytoin |
IV IM or IV‡
IM or IV‡ IM or IV‡ |
15 to 20 mg PE/kg 10 to 20 mg PE/kg
4 to 8 mg PE/kg Equivalent to the current oral dose of phenytoin (mg) |
100 to 150 <100
<100 <100 |
* Dosage expressed in phenytoin equivalents (1.5 mg fosphenytoin = 1 mg phenytoin sodium equivalent)
‡ IM or IV fosphenytoin to be used only as outlined above, otherwise, standard IV phenytoin will be used
Monitor:
1. Presence/absence of seizure activity
2. Serum phenytoin concentration
3. Toxicity
a. Transient pruritus (infusion related)
b. Hypotension (infusion related)
Outcome:
Clinical control of seizure activity
