Phenytoin IV
Phenytoin IV is an antiepileptic drug that works by stabilizing neuronal membranes and decreasing seizure activity through the blockade of voltage-gated sodium channels. Because of the risk of severe cardiovascular reactions and local tissue damage, it must be administered slowly and under continuous monitoring.
Dosage by Body Weight
For intravenous administration only. In pediatric patients, the typical loading dose is 15 to 20 mg/kg. Must be administered slowly, not exceeding an infusion rate of 1 to 3 mg/kg/min (or 50 mg/min in adults). Continuous ECG, blood pressure, and respiratory function monitoring are mandatory. Dilute only in 0.9% Normal Saline and use an in-line filter.
- Body Weight
- Below 5 kg
- Dose
- Loading: 15-20 mg/kg; Maintenance: 5 mg/kg/day
- Frequency
- Loading dose once; Maintenance divided every 12 hours
- Tracking Notes
- Infuse very slowly (not exceeding 1 mg/kg/min). Neonates exhibit highly variable clearance; close therapeutic drug monitoring is required.
- Body Weight
- 5-7 kg
- Dose
- Loading: 75-140 mg; Maintenance: 15-20 mg
- Frequency
- Loading dose once; Maintenance every 12 hours
- Tracking Notes
- Based on 15-20 mg/kg loading and 5-8 mg/kg/day maintenance. Monitor heart rate continuously for bradycardia during infusion.
- Body Weight
- 8-10 kg
- Dose
- Loading: 120-200 mg; Maintenance: 20-30 mg
- Frequency
- Loading dose once; Maintenance every 12 hours
- Tracking Notes
- Ensure patent IV access in a large vein. Flush the line with sterile saline before and after administration to prevent precipitation.
- Body Weight
- 11-15 kg
- Dose
- Loading: 165-300 mg; Maintenance: 30-45 mg
- Frequency
- Loading dose once; Maintenance every 12 hours
- Tracking Notes
- Monitor infusion site closely. Avoid extravasation due to risk of chemical pneumonitis and 'purple glove syndrome'.
- Body Weight
- 16-20 kg
- Dose
- Loading: 240-400 mg; Maintenance: 45-60 mg
- Frequency
- Loading dose once; Maintenance every 12 hours
- Tracking Notes
- Do not exceed maximum infusion rate of 1-3 mg/kg/min. Therapeutic range is 10-20 mcg/mL (total phenytoin).
| Body Weight | Dose | Frequency | Tracking Notes |
|---|---|---|---|
| Below 5 kg | Loading: 15-20 mg/kg; Maintenance: 5 mg/kg/day | Loading dose once; Maintenance divided every 12 hours | Infuse very slowly (not exceeding 1 mg/kg/min). Neonates exhibit highly variable clearance; close therapeutic drug monitoring is required. |
| 5-7 kg | Loading: 75-140 mg; Maintenance: 15-20 mg | Loading dose once; Maintenance every 12 hours | Based on 15-20 mg/kg loading and 5-8 mg/kg/day maintenance. Monitor heart rate continuously for bradycardia during infusion. |
| 8-10 kg | Loading: 120-200 mg; Maintenance: 20-30 mg | Loading dose once; Maintenance every 12 hours | Ensure patent IV access in a large vein. Flush the line with sterile saline before and after administration to prevent precipitation. |
| 11-15 kg | Loading: 165-300 mg; Maintenance: 30-45 mg | Loading dose once; Maintenance every 12 hours | Monitor infusion site closely. Avoid extravasation due to risk of chemical pneumonitis and 'purple glove syndrome'. |
| 16-20 kg | Loading: 240-400 mg; Maintenance: 45-60 mg | Loading dose once; Maintenance every 12 hours | Do not exceed maximum infusion rate of 1-3 mg/kg/min. Therapeutic range is 10-20 mcg/mL (total phenytoin). |
Formulation
Purpose
Control of status epilepticus of the tonic-clonic (grand mal) type, and prevention and treatment of seizures occurring during or following neurosurgery.
Generic Name
Phenytoin SodiumBranded Drug Names
Phenytoin IV is listed as a generic drug name. Common branded medicines that may contain the same active ingredient include:
Scheduled Drug
Yes. This medicine should be supplied or used only according to applicable prescription and regulatory requirements.