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Cerebyx

Cerebyx (fosphenytoin sodium) is an anticonvulsant medication used to control seizures, particularly during or after surgery and in status epilepticus (a prolonged or recurrent seizure). It is a prodrug of phenytoin, meaning it is converted to phenytoin in the body, allowing for intravenous or intramuscular administration when oral administration is not possible.



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Frequently Asked Questions

How quickly does Cerebyx work?
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Cerebyx starts working within 30 to 60 minutes after administration, as it is rapidly converted into phenytoin in the body.

Can Cerebyx be used long-term?
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Cerebyx is typically used for short-term management of seizures or during surgery. For long-term seizure control, oral phenytoin or another anticonvulsant is usually preferred.

What should I do if I miss a dose of Cerebyx?
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Cerebyx is typically administered by a healthcare provider, so missed doses are unlikely. If a dose is missed, contact your healthcare provider immediately for instructions.

Can Cerebyx cause heart problems?
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Yes, when administered too quickly, Cerebyx can cause serious heart issues such as arrhythmias and hypotension. Close monitoring during administration is essential.

Is Cerebyx safe during pregnancy?
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No, Cerebyx (due to its conversion to phenytoin) is not recommended during pregnancy, as it can cause birth defects.

Comprehensive Drug Guide

How Does Cerebyx Work?

Cerebyx is converted into phenytoin in the body, which stabilizes neuronal membranes and reduces the spread of seizure activity. It works by decreasing the electrical conductance between brain cells, reducing the likelihood of seizures.



Common Dosages

  • Injectable solution: 50 mg/mL (phenytoin sodium equivalents)

Typical Dosing

  • For status epilepticus: The usual loading dose is 15 to 20 mg of phenytoin sodium equivalents (PE)/kg, given intravenously at a rate not exceeding 150 mg PE/min.
  • For seizure prevention during surgery: The dose and rate depend on the clinical situation and patient needs, typically given intramuscularly or intravenously.


Typical Dosing

FDA Approved Indications

  • Status epilepticus
  • Seizure prevention during or after surgery


Who Shouldn't Take Cerebyx?

  • Known hypersensitivity to fosphenytoin, phenytoin, or any component of the formulation.
  • Bradycardia or heart block without a pacemaker.
  • Pregnancy, as phenytoin can cause fetal harm.


Advice From The Pharmacist

  • Cerebyx is typically administered in a hospital setting by a healthcare provider. If you are receiving this medication outside of a hospital, follow your healthcare provider’s instructions closely.
  • Regular monitoring of phenytoin levels is important to ensure the medication is working properly and to avoid toxicity.
  • Notify your healthcare provider if you experience symptoms of overdose, such as dizziness, unsteady movements, or blurred vision.


Side Effects of Cerebyx

Common Side Effects

  • Dizziness
  • Headache
  • Nausea
  • Tingling sensations


Uncommon/Severe Side Effects

  • Cardiac arrhythmias
  • Hypotension
  • Severe allergic reactions
  • Phenytoin toxicity (confusion, unsteady movements, slurred speech)


Risks and Warnings of Cerebyx

  • Cardiovascular Risk: Cerebyx can cause cardiac arrhythmias and hypotension, particularly when administered too rapidly. Continuous monitoring of heart rate and blood pressure is recommended during administration.
  • Phenytoin Toxicity: Since Cerebyx is converted to phenytoin, patients may develop phenytoin toxicity, characterized by unsteady movements, confusion, and slurred speech. Monitoring of phenytoin levels is crucial.
  • Teratogenicity: Phenytoin is known to cause birth defects. Women of childbearing age should use effective contraception while taking Cerebyx.


Interactions with Cerebyx

Common Drug Interactions

  • Anticoagulants (e.g., warfarin): Phenytoin can reduce the effectiveness of warfarin, increasing the risk of clot formation.
  • Oral Contraceptives: Phenytoin may reduce the effectiveness of hormonal contraceptives, increasing the risk of unintended pregnancy.
  • Alcohol: Chronic alcohol use can decrease phenytoin levels, while acute alcohol use can increase phenytoin toxicity.


Alternatives to Cerebyx

  • Dilantin (phenytoin): The oral form of phenytoin, used for long-term seizure management.
  • Keppra (levetiracetam): Another anticonvulsant used for seizure control, available in oral and intravenous forms.
  • Valproic Acid (Depakote): Another medication used to treat seizures, available in oral and intravenous forms.