Fosphenytoin Sodium and Alcoholism

• Generic Name: fosphenytoin
• Dosage Forms: n.a.
• Other Brand Names: Cerebyx

Treatment of generalized tonic-clonic status epilepticus.

Benzodiazepines (e.g., diazepam, lorazepam, midazolam) are considered drugs of choice for initial treatment of status epilepticus; IV fosphenytoin (or phenytoin) may be used as a second-line agent if seizures continue.

IV fosphenytoin appears to be better tolerated than IV phenytoin (e.g., fewer adverse cardiovascular effects), and some experts state that fosphenytoin is preferred when both agents are available.

Compared with IV phenytoin, IV fosphenytoin sodium is associated with fewer infusion site reactions (e.g., erythema, pain, burning, swelling, pruritus, soft tissue damage, phlebitis, necrosis) and less frequent need for infusion rate reduction, infusion interruption, and/or changes of infusion sites, but is associated with a higher incidence of systemic sensory disturbances (e.g., burning, paresthesia, pruritus).

Prevention and treatment of seizures occurring during neurosurgery.

May be used as a short-term parenteral replacement for oral phenytoin; because of risks associated with parenteral administration, manufacturer states fosphenytoin should only be used when oral phenytoin not possible.