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Fosphenytoin use in children

From the Division of Child Neurology, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA.
Address correspondence and reprint requests to Dr. John M. Pellock, Division of Child Neurology, Medical College of Virginia, MCV Station Box 211, Richmond, VA 23298.

Abstract.

Phenytoin is widely used for the prevention and treatment of acute seizures in children.Although it has the advantage of being available in parenteral form, it cannot be given through the IM route. Furthermore, problems with venous accessibility and maintenance may complicate IV administration of phenytoin in newborns and very sick infants. Fosphenytoin, a new phenytoin prodrug, can be safely administered through the IM route, and, because of the physical characteristics of its formulation, it offers advantages over phenytoin for IV administration. Clinical studies with IV and IM fosphenytoin demonstrate that the efficacy, safety, and pharmacokinetics of this drug are similar in 5- to 18-year-old children and in young adults. The safety and pharmacokinetic profile of IV and IM fosphenytoin in younger children and infants is currently being investigated.

NEUROLOGY 1996;46(Suppl 1): S14-S16