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Oral phenytoin loading in adults: Rapid achievement of therapeutic plasma levels
Author(s) -
Record Kenneth E.,
Rapp Robert P.,
Young A. Byron,
Kostenbauder Harry B.
Publication year - 1979
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410050309
Subject(s) - phenytoin , liter , loading dose , pharmacokinetics , medicine , therapeutic index , oral dose , plasma concentration , plasma levels , regimen , anticonvulsant , anesthesia , pharmacology , epilepsy , drug , psychiatry
Oral loading doses of phenytoin were estimated from a simplified pharmacokinetic model. Twenty patients were administered a calculated average dose of 19.1 mg per kilogram of phenytoin divided into two to four increments given over 3 to 21 hours (10.55 ± 4.74, mean ± SD). Plasma samples drawn 2 to 22 hours (10.75 ± 4.32, mean ± SD) after completion of the loading dose resulted in therapeutic levels ranging from 8.1 to 18.0 μg per milliliter (11.42–11.37 ± 2.41, mean ± SD). Thus, this regimen in which no increment of the loading dose exceeds 600 mg is sufficient to achieve and maintain therapeutic plasma concentrations 18 to 24 hours after initiation of the loading dose.