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Fosphenytoin

M S Luer1

  • 1University of Arkansas for Medical Sciences, College of Pharmacy, Department of Pharmacy Practice, Little Rock 72205, USA.

Neurological Research
|April 2, 1998
PubMed
Summary

Fosphenytoin, a prodrug of phenytoin, offers advantages like better tolerability and faster administration compared to parenteral phenytoin sodium. However, potential side effects and higher costs require careful consideration for patient selection.

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Area of Science:

  • Pharmacology
  • Drug Development
  • Clinical Pharmacy

Background:

  • Parenteral phenytoin sodium administration presents challenges.
  • Fosphenytoin was developed as an alternative prodrug.
  • Understanding fosphenytoin's profile is crucial for clinical use.

Purpose of the Study:

  • To compare fosphenytoin with parenteral phenytoin sodium.
  • To outline the advantages and disadvantages of fosphenytoin.
  • To guide the selection of fosphenytoin in clinical practice.

Main Methods:

  • Literature review of fosphenytoin and phenytoin properties.
  • Analysis of clinical data regarding safety and efficacy.
  • Cost-benefit analysis of fosphenytoin versus phenytoin.

Main Results:

  • Fosphenytoin offers improved tolerability, safety, stability, intramuscular administration, and faster infusion rates.
  • Disadvantages include dose/rate-related paresthesias, pruritus, delayed hypotension, potential for monitoring errors, and higher acquisition costs.
  • Fosphenytoin is converted to phenytoin in vivo by esterases.

Conclusions:

  • Fosphenytoin presents a viable alternative to parenteral phenytoin sodium for select patients.
  • Careful consideration of fosphenytoin's pros and cons is necessary.
  • Individual patient factors should guide the choice between fosphenytoin and phenytoin.

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