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Oral: Epilepsy:

• Adult: Initially, 3 mg/kg daily as single dose or in divided doses. Alternatively, 15000 mg daily increased gradually to 600 mg daily if necessary. Maintenance: 20000 mg daily.
• Child: Initially, 5 mg/kg daily in 2 divided doses. Maintenance: 4 mg/kg daily in divided doses. Max dose: 300 mg daily.

Intravenous: Tonic-clonic status epilepticus:

• Adult: Adjunctive therapy with a benzodiazepine (e.g. diazepam): 105 mg/kg by slow inj or intermittent infusion at a max rate of 50 mg/min. Maintenance: 100 mg IV (or orally) given every 6 hr.
• Child: Neonates: 20 mg/kg as a loading dose, then 2.5 mg/kg bid; 1 mth2 yr: 18 mg/kg as a loading dose, then 2.5 mg/kg bid; >12 yr: 18 mg/kg as a loading dose, then up to 100 mg 3 times daily.

Should be taken with food. When administering to patients on nasogastric or other enteral feeds, do not administer feeds 2 hr before or after a dose. Be consistent throughout therapy in relation to feed times. Do not switch dosage forms/brands w/o prior consideration.

Pediatric Use: A loading dose of 15 to 20 mg/kg of Phenytoin intravenously will usually produce serum concentrations of phenytoin within the generally accepted serum total concentrations between 10 and 20 mcg/mL (unbound phenytoin concentrations of 1 to 2 mcg/mL). Because of the increased risk of adverse cardiovascular reactions associated with rapid administration Phenytoin should be injected slowly intravenously at a rate not exceeding 1 to 3 mg/kg/min or 50 mg per minute, whichever is slower

Geriatric Use: Phenytoin clearance tends to decrease with increasing age. Lower or less frequent dosing may be required 

Renal and Hepatic Impairment Or Hypoalbuminemia: The liver is the site of biotransformation. Patients with impaired liver function, elderly patients, or those who are gravely ill may show early toxicity. Because the fraction of unbound phenytoin is increased in patients with renal or hepatic disease, or in those with hypoalbuminemia, the monitoring of phenytoin serum levels should be based on the unbound fraction in those patients.

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