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Phenytoin Dosage: Usual Adult Dose For Seizures
Phenytoin Dosage: Usual Adult Dose For Seizures
This dosage information may not include all the information needed to use Phenytoin safely and effectively. See additional information for Phenytoin. The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.
Seizures Arrhythmias
Renal Dose Adjustments Liver Dose Adjustments Dose Adjustments Precautions Dialysis Other Comments
IV: Do not exceed the infusion rate of 50 mg/min. Loading dose: 10 to 15 mg/kg IV slowly. Maintenance dose: 100 mg IV every 6 to 8 hours. IM: Avoid the IM route due to erratic absorption.
requirements.) Less than or equal to 4 weeks: Initial: 5 mg/kg/day in 2 divided doses Usual: 5 to 8 mg/kg/day IV in 2 divided doses (may require dosing every 8 hours). Greater than or equal to 4 weeks: Initial: 5 mg/kg/day in 2 to 3 divided doses Usual: (may require up to every 8 hour dosing) 6 months to 3 years: 8 to 10 mg/kg/day 4 to 6 years: 7.5 to 9 mg/kg/day 7 to 9 years: 7 to 8 mg/kg/day 10 to 16 years: 6 to 7 mg/kg/day
Dose Adjustments
Changes in dosage should not be carried out at intervals shorter than 7 to 10 days. If seizure control is established with 100 mg 3 times a day, 300 mg extended release once a day may be considered.
Precautions
Serum levels should be monitored in changing from extended release to prompt release, and from the sodium salt to the free acid suspension and chewable tablets forms. Hypotension usually occurs when the drug is administered rapidly by the IV route. IV administration should not exceed 50 mg/minute in adults. In neonates, the drug should be administered at a rate not exceeding 1 to 3 mg/kg/minute. The intramuscular route is not recommended for the treatment of status epilepticus since blood levels of phenytoin in the therapeutic range cannot be readily achieved with doses and methods of administration ordinarily employed. Acute alcoholic intake may increase phenytoin serum levels while chronic alcoholic use may decrease serum levels.
Dialysis
Data not available
Other Comments
In some cases, serum blood level determinations may be necessary for optimal dosage adjustments. The clinically effective serum level is usually 10 to 20 mcg/mL. When intramuscular administration is required for a patient previously stabilized orally, compensating dosage adjustments are necessary to maintain therapeutic plasma levels. An intramuscular dose 50% greater than the oral dose is necessary to maintain these levels. When returned to oral administration, the dose should be reduced by 50% of the original oral dose for one week to prevent excessive plasma levels due to sustained release from intramuscular tissue sites. If the patient requires more than a week of IM phenytoin, alternative routes should be explored, such as gastric intubation. For time periods less than one week, the patient shifted back from IM administration should receive one-half the original oral dose for the same period of time the patient received IM phenytoin. Monitoring plasma levels help prevent a fall into the subtherapeutic range. Serum blood level determinations are especially helpful when possible drug interactions are suspected.