Clinical Experience With Fosphenytoin in Children

Abstract

Fosphenytoin, a phenytoin prodrug, can be administered in a variety of intravenous diluents and has a more neutral pH value than phenytoin. The pharmacokinetics, safety, and tolerability of fosphenytoin in children from 1 day to 16 years old have been evaluated in two multicenter studies. Data are available from 78 patients who received loading doses (62 with intravenous administration and 16 with intramuscular administration). In these studies, fosphenytoin was converted to phenytoin within 8.3 minutes (range, 2.5-18.5 minutes). In addition, no significant difference in conversion rates was noted from the youngest to the oldest patient. No deaths or serious, alarming, or unexpected adverse events occurred; most adverse events were consistent with those seen with phenytoin therapy in adults. Both intravenous and intramuscular administration were well tolerated, with mild bruising, tenderness, swelling, and/or erythema seen at infusion and injection sites in a small number of patients. (J Child Neurol 1998;13(Suppl 1):S19-S22).