CLINICAL-EXPERIENCE WITH FOSPHENYTOIN IN CHILDREN

Fosphenytoin, a phenytoin prodrug, can be administered in a variety of intravenous diluents and has a more neutral pH value than phenytoin. The pharmacokinetics, safety, and tolerability of fosphenytoin in chil dren from I day to 16 years old have been evaluated in two multicenter studies. Data are available from 78 patients who received loading dos es (62 with intravenous administration and 16 with intramuscular admin istration). In these studies, fosphenytoin was converted to phenytoin within 8.3 minutes (range, 2.5-18.5 minutes). In addition, no signific ant difference in conversion rates was noted from the youngest to the oldest patient. No deaths or serious, alarming, or unexpected adverse events occurred; most adverse events were consistent with those seen w ith phenytoin therapy in adults. Both intravenous and intramuscular ad ministration were well tolerated, with mild bruising, tenderness, swel ling, and/or erythema seen at infusion and injection sites in a small number of patients.