Implementation

Do not confuse fosphenytoin (Cerebyx) with celocoxib (Celebrex) or citalopram (Celexa)

» Implement seizure precautions

» When substituting fosphenytoin for oral phenytoin therapy, the same total daily dose may be given as a single dose. Unlike parenteral phenytoin, fosphenytoin may be given safely by the IM route

» The anticonvulsant effect of fosphenytoin is not immediate. Additional measures (including parenteral benzodiazepines) are usually required in the immediate management of status epilepticus. Loading dosage of fosphenytoin should be followed with the institution of maintenance anticonvulsant therapy

• Direct IV:

Diluent: D5W or 0.9% NaCl
Concentration: 1.5–25 mg PE/mL May be refrigerated for up to 48 hr

• Rate:
Administer at a rate of <150 mg PE/min in adults and <3 mg/kg/min in children to minimize risk of hypotension

• Y-Site Compatibility:

» amphotericin B liposome

» bivalirudin

» carboplatin

» caspofungin

» cisplatin

» cyclophosphamide

» cytarabine

» dactinomycin

» daptomycin

» dexmedetomidine

» diltiazem

» docetaxel

» doxacurium

» ertapenem

» etoposide

» etoposide phosphate

» fludarabine

» fluorouracil

» gemcitabine

» granisetron

» ifosfamide

» levofloxacin

» linezolid

» lorazepam

» mechlorethamine

» meperidine

» methotrexate

» metronidazole

» nesiritide

» octreotide

» oxaliplatin

» oxytocin

» paclitaxel

» palonosetron

» pantoprazole

» pemetrexed

» phenobarbital

» piperacillin/tazobactam

» rocuronium

» sodium acetate

» tacrolimus

» teniposide

» thiotepa

» tigecycline

» tirofiban

» vincristine

» vinorelbine

» voriconazole

• Y-Site Incompatibility:

» caspofungin

» doxorubicin hydrochloride

» epirubicin

» fenoldopam

» midazolam

» mitoxantrone

» quinapristin/dalfopristin

• Additive Incompatibility:
Information unavailable. Do not admix with other solutions or medications

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