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Phenytoin capsules are available in the following strengths- 25mg, 50mg, 100mg 5.4 Correction of phenytoin levels in hypoalbuminaemia and renal failure Phenytoin is highly protein bound and where protein binding is reduced, as in uraemia and hypoalbuminaemia, free phenytoin concentration levels will be increased accordingly. ;�5.z_"��l>�q�F#`Q����O��l�+!Ԧ������AJ��6v#������ The rate of administration for IV phenytoin should be no greater than 50 mg per minute in adults and 1-3 mg/kg/min (or 50 mg per minute, whichever is slower) in pediatric patients.Serum concentrations should be monitored and care should be taken when switching a patient from the sodium salt to the free acid form. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.The diluted infusion mixture (Phenytoin Sodium Injection plus normal saline) should not be refrigerated. �ܮ�����+zu\ɫ��uyu�yP��o��S���Ճ����:���D�7B�$2� � �e��ϴ*c)��`eR�I>6ϒ8)G–�h�B�j\z��� 0�p����t0>��u�`���Z�"��H&e����ee\��0wy���:�3LI$3��Wj�D��Ҵ腒��o�3߽�����J���!޿_]Ru��? Phenytoin sodium capsules are approximately 90% bioavailable by the oral route. Neither GlobalRPh Inc. nor any other party involved in the preparation of this document shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material. 2 0 obj <> x��=k�7��]���_�j���4���m]�c'��v�N���Uv?Ȳf�Z�h"i����# �_ࣻ�{w���FI �����v�9G��͋�y�����r�������_�7��w���ywx������z�]���ߣo_���}�����""N�����g"J���7e'i�g2���������2�;=�Dw��ϟ�r������ϾS�~}����� �AR*R�9��G���et��Ʒ���p�����ùד�l��8K3'i����m�q��eeڽXW�W���g�!z�>����~��?�D?�?�����v�� (The IV maintenance dose should never be given qd in a single dose).As non-emergency therapy, Phenytoin Sodium Injection should be administered more slowly as either a loading dose or by intermittent infusion.

Adminstration should commence immediately after the mixture has been prepared and completed within 1 hour. Give phenytoin over 30-40 minutes (rate <50mg/minute). Serum blood level determinations are especially helpful when possible drug interactions are suspected.When treatment with oral phenytoin is not possible, IV phenytoin can be substituted for oral phenytoin at the same total daily dose. v�����,��*�3e��--C�LIV)?
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Considerations for PO to IV Dose Conversions. Fosphenytoin is a water soluble prodrug of phenytoin which is rapidly converted to phenytoin after intravenous (IV) or intramuscular (IM) administration. Prior to the administration, the patency of the IV catheter should be tested with a flush of sterile saline. A faint yellow coloration may develop, however this has no effect on the potency of the solution.The loading dose should be followed by maintenance doses of 100 mg orally or intravenously every 6-8 hours.In the pediatric population, a loading dose of 15-20 mg/kg of phenytoin sodium intravenously will usually produce plasma concentrations of phenytoin within the generally accepted therapeutic range (10-20 mcg/mL). For this reason, plasma phenytoin concentrations may increase modestly when IM or IV fosphenytoin sodium injection is substituted for oral phenytoin sodium therapy. endobj
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