Hello! We are looking at revamping our fosphenytoin dosing guidelines/restrictions.
We currently have restrictions based on patient location and monitoring capabilities. For example, we do not allow loading doses to be given on a general floor due to the lack of bedside telemetry monitoring. We do allow maintenance dosing on a general floor.

We have recently found that our neurology practice is changing a bit, and we are seeing bigger maintenance doses that are causing confusion for pharmacy and nursing staff who are trying to figure out who can give what dose in which location.

Does anyone else have a similar guideline in place for fosphenytoin? If so, would you be willing to share the details?

Thanks so much in advance!

Karin Terry
Medication Safety Officer
OSF Healthcare System