Fosphenytoin Administration Guidelines

Dosing and Administration

• The correct way to load Cerebyx (fosphenytoin) is to administer 18 PE/kg IV at a maximum rate of 150 PE/min for adults, as recommended by the American College of Emergency Physicians 1
• Fosphenytoin can be administered faster than phenytoin (150 PE/min vs. 50 mg/min) and is associated with fewer adverse events compared to IV phenytoin loading, according to the American College of Emergency Physicians 1

Monitoring and Safety

• Careful cardiac monitoring is required during and after IV administration due to risk of hypotension and cardiac arrhythmias, and vital signs should be monitored closely, especially blood pressure and heart rate via ECG, as suggested by the American Academy of Pediatrics 2
• Reduce the rate of infusion if heart rate decreases by 10 beats per minute, as recommended by the American Academy of Pediatrics 2

Pharmacokinetics

• After IV administration, therapeutic phenytoin levels (>10 mcg/mL) are typically achieved within minutes after completion of the infusion, according to the American College of Emergency Physicians 3

Compatibility and Storage

• Do not administer fosphenytoin with solutions containing glucose as this may cause precipitation, as noted by Praxis Medical Insights 4