4.2 Article

Effect of therapeutic plasma exchange on phenytoin plasma concentration in patients receiving intravenous fosphenytoin therapy

Journal

PHARMAZIE
Volume 75, Issue 10, Pages 488-490

Publisher

AVOXA-MEDIENGRUPPE DEUTSCHER APOTHEKER GMBH
DOI: 10.1691/ph.2020.0525

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We report for patients with encephalitis treated with plasma exchange (PE) and fosphenytoin. In patient 1, phenytoin levels decreased on the maintenance dose, and the phenytoin concentration was <10 mu g/mL on day 12 of administration. In patient 2, the phenytoin levels was <10 mu g/mL on day 4. Increasing the fosphenytoin dose pushed the phenytoin level into therapeutic range. There were no differences between the areas under the concentration-time curve of phenytoin with and without PE. We previously reported a decline in phenytoin levels after prolonged use of fosphenytoin. Therefore, dose adjustment of fosphenytoin in patients undergoing PE may be unnecessary.

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