Pro-Epanutin

What is it?

An anticonvulsant and hydantoin available as a solution in vials for infusion containing 750mg of fosphenytoin sodium per 10ml.

Medical Uses

Fits associated with head injury or neurosurgery, control of status epilepticus of tonic-clonic type, as a substitute for phenytoin taken by mouth when this route is not possible for the patient.

Dosage

Adults and children aged over 5 years, status epilepticus, 15mg per kg of body weight at first at rate of 100 to 150mg per minute, by intravenous infusion. Treatment and prevention of fits, 10 to 15mg per kg of bodyweight at first at a rate of 50 to 100mg per minute by intramuscular injection or infusion. Maintenance dose is 4 to 5mg per kg of body weight by intravenous infusion or intramuscular injection. Children should be treated by intravenous infusion.

Special Care

Pregnancy, elderly persons, liver or kidney disease, serious heart muscle deficiency, diabetes, low blood pressure (reduce rate of infusion or may be necessary to withdraw treatment), low blood albumin, restricted phosphate intake. Respiration, ECG and blood pressure during infusion and for a minimum of 30 minutes afterwards.

Avoid Use

Children aged under 5 years, breastfeeding, various types of heart block, porphyria (inherited metabolic disorder involving porphyrins), sinus brabycardia (slow heart beat), Adams- Stokes syndrome.

Possible Drug and Food Interactions

Corticosteroids, antacids, anticonvulsants, vitamin D, drugs to treat ulcers, amiodarone, analgesics, frusemide, tolbutamide, antineoplastics, antipsychotics, antifungals, quinidine, folic acid, antidepressants, coumarin anticoagulants, disulfram, benzodiazepines, theophylline, oral contraceptives, disulfrcm, antibacterials.

Known Side Effects

Blood changes, gastrointestinal upset, itching, liver damage, hepatitis, headache, increased growth of hair, low blood pressure, heart and circulatory disorders, slow heartbeat, ventricular fibrillation, heart attack, asytole, effects on central nervous system, allergic reactions. Any adverse side effects should be reported to the Committee on the Safety of Medicines (CSM).