Fosphenytoin:
Intravenous antiseizure agent
ECMO Dose Adjustment:
YES—an increased dose may be warranted in some patients. Perform therapeutic drug monitoring when available to guide dosing.
Renal Impairment Dose Adjustment:
NONE
CRRT Dose Adjustment:
NONE
Hepatic Impairment Dose Adjustment*:
YES—a decreased dose may be warranted in some patients. Perform therapeutic drug monitoring when available to guide dosing.
Adult Dose^:
Loading Dose: 20 mg phenytoin equivalents (PE)/kg IV x 1 (maximum 2000 mg PE) for status epilepticus
Maintenance Dose: 7 mg phenytoin equivalents (PE)/kg/day IV in 2–3 divided doses
Pediatric Dose:
Loading Dose: 15–20 mg phenytoin equivalents (PE)/kg (maximum 1,500 mg PE) IV x 1 for status epilepticus
Maintenance Dose: 2–4 mg phenytoin equivalents (PE)/kg/dose, twice daily
Neonatal Dose:
Loading Dose: 20 mg phenytoin equivalents (PE)/kg IV x 1 for status epilepticus
Maintenance Dose: 2–4 mg phenytoin equivalents (PE)/kg/dose, twice daily