Phenytoin dose for convulsions
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phenytoin injection prescribing information status epilepticus dose adults children
For an ongoing convulsion/status epilepticus, phenytoin is a second-line antiseizure drug after an IV benzodiazepine. This requires monitored emergency care.
- Adults: Phenytoin 20 mg/kg IV loading dose (many product labels specify 10-15 mg/kg), at no faster than 50 mg/min.
- Children: 15-20 mg/kg IV loading dose, at 1-3 mg/kg/min, or 50 mg/min, whichever is slower.
- Maintenance after loading: commonly 100 mg IV/oral every 6-8 hours in adults, then individualized with drug levels and clinical review.
Use cardiac rhythm, blood-pressure, and respiratory monitoring during IV administration. Give through a well-running line with normal saline only. Avoid IM phenytoin for acute seizures because absorption is unreliable. Rapid IV dosing can cause severe hypotension and arrhythmias. The DailyMed prescribing information specifies an adult IV rate no greater than 50 mg/min and pediatric rate restrictions.
If the person is actively convulsing now, call emergency services immediately. Do not try to give oral phenytoin during a seizure.
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