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Phenytoin 
Dilantin ® 
Usual Diluents
NS
Standard Dilutions   [Amount of drug]  [Infusion volume]  [Infusion rate]
May be given IVPush -See comments.

[100 mg] [50 ml] [5-15 min]
[200-500 mg] [100ml] [15-30 min]
[501-1500 mg] [250 ml] [See comments]
Stability / Miscellaneous
Label: Do not Refrigerate / Use an inline 0.22u filter. 
EXP: 2 HOURS (RT) 

Another source:  Concentrations up to 6.7 mg/ml are stable up to 24 hours (insignificant loss).  Ideally, the solution should be infused within 1 hour of mixing. Constantly monitor for precipitate formation. 

Infusion rates
Maximum: 50 mg/min 
Recommended rate for 
most adults: 40 mg/min. 

Elderly (rate): 20 mg/min. 
Usual IV loading dose: 15 mg/kg TBW 

Maintenance dose (started 18-24h after load): 6 mg/kg ibw IV/PO in divided doses q8 to 12h. (The IV maintenance dose should never be given qd in a single dose). 

Oral loading: 16 mg/kg TBW (use adjBW if obese) given in 3 to 4 divided doses at q2h intervals (divided doses increase bio-availability as well as decrease potential for gastrointestinal side effects such as N&V).  The maximum single oral dose should not exceed 400mg in order to minimize gastrointestinal side effects and increase absorption. 

Sampling: 18 to 24h after loading dose, then q5 to 7 days to assess trend. Average time to steady state: 10 to 14days. 
Half-life: 7-42hrs (average=24h). 

Capsules/injection= 92% phenytoin. Elixir/tabs=100% phenytoin. 

Equation used to estimate the dose req'd to increase current level to normal range if subtherapeutic: = [0.7 x IBW x (15 - current level) ] / 0.92* * (if capsules/injection used) 

Adjusted phenytoin concentration if low serum albumin= measured total concentration / [ (0.2 x albumin) + 0.1] 
 


 

 

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