Cerebyx

Generic Name: fosphenytoin (fos FEN i toyn)Brand Names: Cerebyx

What is Cerebyx (fosphenytoin)?

Fosphenytoin is an anti-epileptic drug, also called an anticonvulsant. It works by slowing down impulses in the brain that cause seizures.

Fosphenytoin is used to prevent or control seizures. Fosphenytoin is used only for a short time, such as 5 days, when other forms of phenytoin cannot be given.

Fosphenytoin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Cerebyx (fosphenytoin)?You should not use this medication if you are allergic to fosphenytoin or phenytoin (Dilantin) or if you have certain heart conditions such as slow heartbeats, heart block, AV block, or Adams-Stokes syndrome (a heart rhythm disorder).

Before receiving fosphenytoin, tell your doctor if you are allergic to any drugs, or if you have heart, kidney, or liver disease, low blood pressure, alcoholism, porphyria, or diabetes.

Fosphenytoin may cause harm to an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby. Do not receive fosphenytoin without telling your doctor if you are pregnant. Seizure control is very important during pregnancy and the benefits of preventing seizures may outweigh any risks posed by using fosphenytoin.

If you have received fosphenytoin during pregnancy, be sure to tell the doctor who delivers your baby about your fosphenytoin use. Both you and the baby may need to receive medications to prevent excessive bleeding during delivery and just after birth.

Avoid drinking alcohol while you are receiving fosphenytoin. There are many other medicines that can interact with fosphenytoin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without your doctor's advice.What should I discuss with my healthcare provider before I receive Cerebyx (fosphenytoin)?You should not receive this medication if you are allergic to fosphenytoin or phenytoin (Dilantin) or if you have certain heart conditions:

• slow heartbeats;

• heart block;

• AV block; or

• Adams-Stokes syndrome (a heart rhythm disorder).

Before you receive fosphenytoin, tell your doctor if you are allergic to any drugs, or if you have:

• heart disease;

• kidney disease;

• liver disease;

• low blood pressure;

• alcoholism;

• porphyria; or

• diabetes.

If you have any of these conditions, you may need a dose adjustment or special tests to safely receive this medication.

Patients of Asian ancestry may have a higher risk of developing a rare but serious skin reaction to fosphenytoin. Your doctor may recommend a blood test before you start the medication to determine your risk of this skin reaction.

Fosphenytoin can lower your blood sugar. If you are a diabetic, check your blood sugar regularly while you are using this medication.

FDA pregnancy category D. Fosphenytoin may cause harm to an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby. Do not receive fosphenytoin without telling your doctor if you are pregnant. Seizure control is very important during pregnancy and the benefits of preventing seizures may outweigh any risks posed by using fosphenytoin.

If you have received fosphenytoin during pregnancy, be sure to tell the doctor who delivers your baby about your fosphenytoin use. Both you and the baby may need to receive medications to prevent excessive bleeding during delivery and just after birth.

Fosphenytoin can make birth control pills less effective. Avoid pregnancy while receiving fosphenytoin.

It is not known whether fosphenytoin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How is fosphenytoin given?

Fosphenytoin is given as an injection into a muscle or through a needle placed into a vein. You will receive this injection in a clinic or hospital setting. Your doctor, nurse, or other healthcare provider will give you this injection.

Your heart rate will be monitored through electrocardiograph or ECG (sometimes called an EKG) when you are given your first dose of fosphenytoin. This machine measures electrical activity of the heart. This will help your doctor determine whether fosphenytoin is causing any harmful effects on your heart.

To be sure this medication is not causing other harmful effects, your blood may need to be tested at regular intervals.

What happens if I miss a dose?

Since fosphenytoin is given as needed by a healthcare professional, it is not likely that you will miss a dose.

What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine. An overdose of fosphenytoin can be fatal.

Overdose symptoms may include weakness, nausea, vomiting, feeling light-headed, chest pain, fast or slow heart rate, weak pulse, slow breathing (breathing may stop).

What should I avoid while using Cerebyx (fosphenytoin)?

Avoid drinking alcohol while you are receiving fosphenytoin. Alcohol use can increase your blood levels of fosphenytoin and may increase side effects. Daily alcohol use can decrease your blood levels of fosphenytoin, which can increase your risk of seizures.

Cerebyx (fosphenytoin) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Tell your caregivers at once if you have any of these serious side effects:

• severe itching, burning, numbness, or tingly feeling in your groin or other body areas;

• the first sign of any skin rash, no matter how mild;

• severe blistering, peeling, and red skin rash;

• feeling like you might pass out;

• easy bruising or bleeding, unusual weakness;

• fever, chills, swollen glands, body aches, flu symptoms;

• stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);

• confusion, unusual thoughts or behavior;

• extreme thirst or hunger, urinating more than usual;

• tremors, or restless muscle movements in your eyes, tongue, jaw, or neck;

• slurred speech, loss of balance or coordination; or

• ringing in your ears.

Less serious side effects may be more likely to occur, such as:

• dizziness, drowsiness, headache;

• nausea, dry mouth; or

• warmth, redness, or tingly feeling under your skin.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Cerebyx (fosphenytoin)?

Drugs that can increase fosphenytoin levels in your blood include:

• disulfiram (Antabuse);

• birth control pills or hormone replacement therapy;

• chlorpromazine (Thorazine), prochlorperazine (Compazine), thioridazine (Mellaril) and other phenothiazines;

• methylphenidate (Ritalin, Concerta, Daytrana);

• a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal, Solfoton);

• stomach acid reducers such as cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid), or nizatidine (Axid);

• certain sedatives (such as Librium or Valium) or antidepressants (such as Prozac); or

• sulfa drugs such as Septra or Bactrim.

Drugs that can make fosphenytoin less effective in controlling seizures include:

• reserpine; or

• carbamazepine (Tegretol, Epitol, Carbatrol).

Other drugs that can interact with fosphenytoin include:

• a blood thinner such as warfarin (Coumadin);

• digoxin (digitalis, Lanoxin);

• furosemide (Lasix);

• steroid medications (prednisolone and others);

• theophylline (Elixophyllin, Theo-Dur, Theo-Bid, Theolair, Uniphyl);

• valproic acid (Depakene) or divalproex sodium (Depakote);

• an antibiotic such as rifampin (Rimactane, Rifadin, Rifamate) or doxycycline (Doryx, Vibramycin, Adoxa, and others); or

• an antidepressant such as amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Janimine, Tofranil), fluoxetine (Prozac), trazodone (Desyrel), and others.

This list is not complete and there are many other medicines that can interact with fosphenytoin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without your doctor's advice.

Where can I get more information?

• Your pharmacist can provide more information about fosphenytoin.

• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 1.04. Revision Date: 11/17/2009 3:24:31 PM.