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Fosphenytoin

Fosphenytoin (Cerebyx®, Parke-Davis; Prodilantin®, Pfizer Holding France) is a water-soluble phenytoin prodrug used only in hospitals for the treatment of epileptic seizures. more...

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On 18 November 2004, Sicor Pharms received a tentative approval letter from the United States Food and Drug Administration for a generic version of fosphenytoin.

Uses

Approved

Fosphenytoin is approved in the United States for the short term (five days or less) treatment of epilepsy when more widely used means of phenytoin administration are not possible or are ill-advised, such as endotracheal intubation, status epilepticus or some other type of repeated seizures; vomiting, and/or the patient is unalert or not awake or both.

Unapproved/Off-label/Investigational

In April of 2003, Applebaum and colleagues at the Ben Gurion University of the Negev in Beersheva reported that even though anticonvulsants are often very effective in mania, and acute mania requires rapid treatment, fosphenytoin had no antimanic effect even 60 minutes after administration of doses used in status epilepticus.

Fosphenytoin was more successfully used to relieve pain refractory to opiates in a 37-year-old woman with neuroma, according to Dr. Gary J. McCleane of the Rampark Pain Center in Lurgan, Northern Ireland. She was given 1,500 phenytoin equivalent units of fosphenytoin over a 24 hour period, producing pain relief that last three to fourteen weeks after each infusion, allowing her to use less opiates.

Metabolism

One mmol (millimole) of phenytoin is produced for every mmol of fosphenytoin administered; the hydrolysis of fosphenytoin also yields phosphate and formaldehyde, the latter of which is subsequently metabolized to formate, which is in turn metabolized by a folate dependent mechanism.

Side effects

Side effects are similar to phenytoin, except that fosphenytoin causes less hypotension and more paresthesia. Fosphenytoin can cause hyperphosphatemia in end-stage renal failure patients.

Read more at Wikipedia.org


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Hypocalcemia-like electrocardiographic changes after administration of intravenous fosphenytoin : An article from: Mayo Clinic Proceedings $20.00 Fosphenytoin sodium: new drug to replace intravenous phenytoin sodium. : An article from: Pediatric Nursing $5.95

Nonemergency Use of Parenteral Phenytoin Products - phenytoin sodium; fosphenytoin sodium
An expert panel developed guidelines for the nonemergency use of parenteral phenytoin products (phenytoin sodium or fosphenytoin sodium). The panel included recognized clinical experts in the area
Randomized evaluation of adverse events and length-of-stay with routine emergency department use of phenytoin or fosphenytoin
Intravenous phenytoin has come under increased scrutiny with the introduction of the prodrug, fosphenytoin. We evaluated adverse events and length-of-stay ...
Focus on...fosphenytoin
THIS ANTICONVULSANT IS BETTER TOLERATED THAN PHENYTOIN. Fosphenytoin (Cerebyx) was developed to reduce some of the problems associated with phenytoin ...
Newer antiepileptic drugs: gabapentin, lamotrigine, felbamate, topiramate and fosphenytoin
Twenty-five to 40 percent of patients with epilepsy continue to have
More news about fosphenytoin
In the February Medication Errors column, we told you about a confusing dosing requirement for I.V. Dilantin's replacement-fosphenytoin (Cerebyx). Fosphenytoin's ...
Management of status epilepticus
Status epilepticus is an increasingly recognized public health problem in the United States. Status epilepticus is associated with a high mortality rate ...
Teva Announces Tentative Approval of Fosphenytoin Sodium Injection
JERUSALEM -- Teva Pharmaceutical Industries Ltd. (Nasdaq:TEVA) announced today that the U.S. Food and Drug Administration has granted tentative approval ...
Eisai
Supplier News--Eisai last month closed the deal on acquiring the epilepsy treatment Zonegran (zonisamide) from Elan Pharma. As part of the agreement, ...

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