Fosphenytoin use in children.

Abstract

Phenytoin is widely used for the prevention and treatment of acute seizures in children. Although it has the advantage of being available in parenteral form, it cannot be given through the i.m. route. Furthermore, problems with venous accessibility and maintenance may complicate i.v. administration of phenytoin in newborns and very sick infants. Fosphenytoin, a new phenytoin prodrug, can be safely administered through the i.m. route, and, because of the physical characteristics of its formulation, it offers advantages over phenytoin for i.v. administration. Clinical studies with i.v. and i.m. fosphenytoin demonstrate that the efficacy, safety, and pharmacokinetics of this drug are similar in 5- to 18-year-old children and in young adults. The safety and pharmacokinetic profile of i.v. and i.m. fosphenytoin in younger children and infants is currently being investigated.