Monograph Details
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Central Nervous System
> Seizure disorders
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Phenytoin Injection |
| Manufacturer |
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Baxter |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Hydantoin. |
| Generic Name |
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Phenytoin 50mg/mL; contains alcohol, propylene glycol. |
| Indications |
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Status epilepticus (tonic-clonic). Seizure prophylaxis and treatment in neurosurgery. |
| Children |
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Status epilepticus: IV not to exceed 1–3mg/kg/min. Loading dose: 15–20mg/kg. Neurosurgical procedures: see literature. |
| Adults |
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Status epilepticus: IV not to exceed 50mg/min. Loading dose: 10–15mg/kg followed by maintenance doses of 100mg orally or IV every 6–8 hrs. Do not dilute solution in IV fluids. Neurosurgical procedures: see literature. |
| Contraindications |
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Heart block and sinus bradycardia. Adams-Stokes syndrome. |
| Precautions |
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Hypotension. Severe myocardial insufficiency. Monitor ECG, BP, respiration, phenytoin levels. Diabetes. Impaired liver function. Change dose gradually. Discontinue if rash develops. Maintain proper dental hygiene. Oral contraception. Porphyria. Elderly. Debilitated. Pregnancy (see literature). Nursing mothers: not recommended. |
| Interactions |
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Potentiated by acute alcohol ingestion, amiodarone, benzodiazepines (e.g., chlordiazepoxide, diazepam), chloramphenicol, dicumarol, disulfiram, estrogens, fluoxetine, halothane, H2 blockers (e.g., cimetidine), isoniazid, methylphenidate, phenothiazines, phenylbutazone, salicylates, succinamides (e.g., ethosuximide), sulfonamides, tolbutamide, trazodone, others. Antagonized by chronic alcohol ingestion, carbamazepine, reserpine, others. Antagonizes tricyclic antidepressants, oral anticoagulants, oral contraceptives, estrogens, corticosteroids, doxycycline, digitoxin, furosemide, theophylline, rifampin, quinidine, vitamins D and K, others. Variable effects with phenobarbital, valproic acid, divalproex, others. Absorption decreased by calcium. |
| Adverse Reactions |
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Nystagmus, drowsiness, dizziness, insomnia, dyskinesias, ataxia, GI disturbances, gingival hyperplasia, osteomalacia, blood dyscrasias, atrial and ventricular conduction depression, slurred speech, lymphadenopathy, hepatic disease, rash, hyperglycemia, SLE, hypertrichosis, immunoglobulin abnormalities. |
| How Supplied |
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Vials (2mL, 5mL), amps (2mL)—25 |
| Additional Resources |
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• Related Prescribing Note |
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