Fosphenytoin

Historical note and nomenclature
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By K K Jain MD

Fosphenytoin sodium is a water-soluble prodrug intended for parenteral administration. Its active metabolite is phenytoin. Unlike phenytoin, fosphenytoin does not require propylene glycol and high alkalinity to bring it into solution. Fosphenytoin is rapidly and completely absorbed after intramuscular or intravenous administration. Intravenous fosphenytoin produces fewer local side effects than intravenous phenytoin and has not been associated with serious cardiovascular adverse events. Therefore, it is a useful replacement for parenteral phenytoin. Fosphenytoin was approved by the United States Food and Drug Administration in 1996. It is not available in some countries, such as Japan (Sugai 2007).