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fosphenytoin

Brand Name :

Sesquient, Cerebyx

Synonyms :

fosphenytoin

Class :

Anticonvulsants, Hydantoins





No data available for drug.

Actions and Spectrum: 

fosphenytoin is a prodrug of the anticonvulsant medication phenytoin. When administered, fosphenytoin is converted into phenytoin, which then acts on the brain to prevent seizures. 

The spectrum of action of fosphenytoin is quite broad, as it can be used to prevent and treat seizures of various types, including generalized tonic-clonic seizures, partial seizures, and status epilepticus.

Phenytoin works by stabilizing neuronal membranes and decreasing the activity of voltage-gated sodium channels in the brain, thereby reducing the abnormal electrical activity that leads to seizures. 

DRUG INTERACTION

fosphenytoin

&

  • Nordazepam
  • Glechoma hederacea
  • Alternanthera sessilis
  • nicofetamide
  • napthol asol
  • cocamidopropyl betaine
  • musa x paradisiaca
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  • Sorghum
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  • tovorafenib
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  • eschscholzia californica
  • canna indica root
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  • dexverapamil
  • sitogluside
  • secalciferol
  • cefatrizine
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  • aminacrine undecylate
  • ethylenediamine mandelate
  • pelubiprofen
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  • epitiostanol
  • androstenediol
  • Nitroxoline
  • Iocarmic acid
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  • dordaviprone (investigational drug)
  • Vitexin
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  • scorias spongiosa
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  • citric acid/ sodium bicarbonate/ sodium carbonate anhydrous
  • vadadustat
  • permethrin medical grade cis/trans isomers 25/75
  • lutetium, isotope of mass 177
  • human normal immunoglobulin
  • sacrosidase
  • apadamtase alfa, recombinant
  • acetyl hexapeptide-8 amide
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  • argipressin
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  • biotin/colecalciferol/copper (ii)sulfate dried/ cyanocobalamine/ dl-alpha tocopherol acetate/dibasic calcium phosphate anhydrous/folic acid/iron (ii)sulfate dried/ lecithin/ magnesium sulfate dried/ nicotinamide/ pyridoxine hydrochloride/ riboflavin
  • ampicillin sodium / cloxacillin sodium
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  • furosemide/potassium chloride
  • amylamine
  • jaborandi
  • patritumab deruxtecan
  • jackfruit
  • sterculia
  • ascorbigen
  • ashitaba
  • androstenetrione
  • andrachne
  • cosibelimab
  • racecadotril
  • neomycin/chlorhexidine
  • octocog alfa
  • cetrimide
  • ispaghula husk
  • polyhexanide
  • octenidine
  • polygeline
  • heparinoid
  • jewelweed
  • boldo
  • anizatrectinib
  • alpinia
  • henbane
  • cynanchum vincetoxicum root and sulfur
  • boditrectinib
  • izumerogant
  • zavondemstat
  • abuta
  • fadogia agrestis
  • fly agaric mushroom
  • meptazinol
  • methoxyflurane
  • tramadol/dexketoprofen
  • betaine/polyhexanide
  • filgotinib
  • inosine acedoben dimepranol
  • alverine citrate
  • hyoscine butylbromide
  • senna+ ispaghula
  • cabbage palm
  • cajeput oil
  • calanus oil
  • calamint
  • canada balsam
  • carnosine
  • alverine citrate/simeticone
  • dihydroartemisinin/piperaquine
  • mebeverine/ispaghula
  • calcipotriol
  • tacalcitol
  • triethyl citrate/ethyl linoleate
  • sodium dilauramidoglutamide lysine
  • fazamorexant
  • avibactam tomilopil and ceftibuten
  • drostanolone
  • tigilanol tiglate
  • isorhynchophylline
  • rhynchophylline
  • crisugabalin
  • epigallocatechin gallate
  • clomocycline
  • corynoxeine
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  • Culmerciclib
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  • phensuximide
  • resencatinib (investigational)
  • rolusafine
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  • benzquinamide
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  • fulzerasib (Investigational Drug)
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  • Upleganan (Investigational Drug)
  • menthyl ethylamido oxalate
  • quaternium-90 montmorillonite
  • unecritinib (investigational drug)
  • etohexadiol
  • guaiol
  • proximadiol
  • verdinexor
  • sofnobrutinib
  • talbutal
  • ethoxzolamide
  • propiomazine
  • enprofylline
  • phenmetrazine
  • merigolix
  • pralurbactam
  • neracorvir
  • vonifimod
  • apaziquone hydroquinone
  • darizmetinib
  • zandelisib
  • xininurad
  • ritivixibat
  • amiselimod phosphate (investigational drug)
  • emzeltrectinib (investigational drug)
  • ficonalkib
  • cinalukast
  • ulobetasol
  • candoxatril
  • nitrofural
  • acetyldigitoxin
  • bentiromide
  • dextrothyroxine
  • chlorotrianisene
  • remikiren
  • pipobroman
  • vidarabine
  • immune globulin intravenous, human-stwk
  • spermine
  • serine
  • N-acetyl glucosamine
  • valine
  • adenine
  • asparagine
  • citrulline
  • adinazolam
  • interferon alfacon-1
  • interferon alfa-n1
  • felypressin
  • birch triterpenes
  • pyridoxal phosphate
  • technetium Tc-99m arcitumomab
  • beta-alanine
  • dihomo-gamma-linolenic acid
  • urea/hydrocortisone
  • R21/Matrix-M vaccine
  • povidone-iodine (ophthalmic)
  • pheniramine
  • hydrocortisone rectal
  • chloroxylenol/pramoxine/zinc acetate
  • chloroxylenol/pramoxine
  • dextrose/sucrose/vitamin C/zinc sulphate
  • furazolidone/metronidazole/dicyclomine
  • ergocalciferol (vitamin D2)
  • benoxaprofen (discontinued)
  • teicoplanin
  • carbomer
  • chromic chloride / iron (ii) chloride tetrahydrate / potassium iodide / manganese chloride / sodium fluoride / sodium selenite pentahydrate / sodium molybdate dihydrate / zinc chloride/ cupric chloride
  • bufylline
  • lidocaine/prilocaine
  • opium tincture, squill oxymel
  • dibrompropamidine
  • metronidazole/tetracycline/bismuth subsalicylate
  • agnus- castus
  • velaglucerase alfa
  • alendronic acid / colecalciferol
  • bimatoprost / timolol
  • efbemalenograstim alfa
  • dried ferrous sulfate/folic acid
  • dried ferrous sulfate / sodium ascorbate
  • nirogacestat
  • soya-bean oil, medium-chain triglycerides
  • demeclocycline hydrochloride and triamcinolone acetonide
  • fusidic acid / hydrocortisone acetate
  • macrogol
  • storax, benzoin
  • nomegestrol acetate/estradiol
  • flumetasone pivalate/ clioquinol
  • berdazimer topical (Pending FDA Approval)
  • buflomedil
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  • cromolyn sodium, inhaled
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  • chloroprocaine ophthalmic
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  • typhoid polysaccharide vaccine
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  • cromolyn sodium, intranasal
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  • methionine
  • amino acids and electrolytes in dextrose with calcium
  • slippery elm
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  • brilaroxazine
  • palopegteriparatide
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  • zoliflodacin (pending FDA approval)
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  • fluorine F18 DCFPyL
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  • sabizabulin(Pending FDA approval)
  • fexapotide(Phase 3 Clinical trial)
  • diatrizoic acid
  • drotaverine
  • diethyl phthalate
  • enclomiphene
  • epalrestat
  • ethamsylate
  • flupirtine
  • imidurea
  • sodium glycolate
  • feracrylum
  • ethacridine
  • furazolidone/metronidazole
  • ozagrel hydrochloride
  • leptazol
  • l-glutamic acid /vitamin B complex
  • etizolam
  • etizolam/propranolol
  • ethoheptazine citrate
  • etophylline and theophylline
  • etophylline
  • finger millet
  • drotaverine/mefenamic acid
  • dichloroxylenol
  • pneumococcal 7-valent vaccine
  • diclofenac and metaxalone
  • dipivefrin ophthalmic
  • enbucrilate
  • potassium citrate and citric acid
  • potassium gluconate
  • aclarubicin
  • alfuzosin/dutasteride
  • adrenochrome monosemicarbazone
  • selenium sulfide topical
  • sertaconazole
  • amorolfine cream
  • amsacrine
  • amylmetacresol
  • sulfonated phenolics in aqueous solution
  • technetium Tc-99m sulfur colloid
  • raltitrexed
  • romiplostim
  • acediasulfone
  • azulene
  • acebrophylline
  • clonazepam/escitalopram oxalate
  • allylestrenol
  • andrographolide
  • artemotil
  • technetium Tc-99m sestamibi
  • rubidium Rb-82
  • somapacitan
  • sodium sulfate, magnesium sulfate and potassium sulfate
  • almitrine
  • gramicidin
  • nikethamide
  • technetium Tc-99m sodium pertechnetate
  • betiatide
  • prilocaine/epinephrine
  • amlexanox
  • acetaminophen/salicylamide/phenyltoloxamine
  • neomycin topical
  • zilucoplan
  • antazoline and xylometazoline
  • toripalimab
  • iron isomaltoside
  • meningococcal A C Y and W polysaccharide tetanus toxoid conjugate vaccine
  • meningococcal A C Y and W-135 diphtheria conjugate vaccine
  • tetradecyl Sulfuric Acid
  • benzoyl peroxide, clindamycin phosphate, adapalene
  • ethylephedrine
  • actarit
  • pyrantel tartrate
  • tenofovir disoproxil fumarate or tenofovir DF
  • melitracen
  • amitriptylinoxide(Phase 4 Clinical Trials)
  • threonine
  • ditiocarb zinc
  • epicriptine
  • levallorphan
  • kinetin
  • laurocapram
  • pentagastrin
  • parthenolide
  • nicoboxil
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  • prulifloxacin
  • proscillaridin
  • tizanidine and rofecoxib
  • tolnaftate, gentamicin, chinoform and betamethasone valerate
  • pine bark extract
  • pipenzolate methylbromide
  • bephenium hydroxynaphthoate
  • niclosamide
  • pyrvinium
  • pipenzolate methylbromide/phenobarbitone
  • piracetam/ginkgo biloba/vinpocetine
  • benzyl benzoate/disulfiram
  • benzyl benzoate
  • loperamide/simethicone
  • piroctone olamine
  • sodium fusidate
  • piroxicam topical/capsaicin/menthol/methyl salicylate
  • sodium metabisulfite
  • sodium lauryl sulfate
  • taspoglutide
  • glyclopyramide
  • tolnaftate, gentamicin, iodochlorohydroxyquinoline, chlorocresol, betamethasone valerate
  • serratiopeptidase
  • sodium antimony gluconate
  • triamterene / benzthiazide
  • tribenoside / lidocaine
  • triclocarban
  • triprolidine/dextromethorphan  
  • vitamins/minerals/omega-3 Fatty acids
  • soyabean oil
  • sucralfate/oxethazaine
  • sucralfate/tinidazole/povidone iodine
  • sodium cromoglycate
  • aloe vera/liquid paraffin/white soft paraffin
  • aloe vera/jojoba oil/vitamin E
  • allantoin/triclosan/vitamin e/zinc oxide
  • alpha-Lipoic acid/minerals/multivitamins
  • alprazolam/paracetamol
  • alprazolam/melatonin
  • azithromycin/ambroxol
  • atorvastatin/clopidogrel/aspirin
  • aceclofenac, paracetamol and serratiopeptidase
  • alfacalcidol, vitamin B-complex, minerals and antioxidants
  • alpha- lipoic acid, vitamin b complex and vitamin c
  • alpha-galactosidase and simethicone
  • alpha-galactosidase, amylase, proteases, lipase and lactase
  • amikacin and cefepime
  • aminophylline, ephedrine and phenobarbitone
  • artesunate, sulphadoxine and pyrimethamine
  • finasteride/tamsulosin
  • flavoxate/ofloxacin
  • fenofibrate/metformin
  • lignocaine, hydrocortisone topical and allantoin
  • linoleic acid and sodium lactate
  • troxerutin
  • meclizine/nicotinic acid
  • mecobalamin/ginkgo Biloba
  • spirulina
  • loperamide and furazolidone
  • ketoconazole/cetrimide
  • ketoconazole/zinc pyrithione
  • lercanidipine/atenolol
  • levocetirizine/montelukast/ambroxol
  • levarterenol
  • levocetirizine/phenylpropanolamine 
  • indapamide/amlodipine
  • itopride/methyl polysiloxane
  • mebendazole/levamisole
  • eberconazole/mometasone
  • gliclazide/metformin/pioglitazone
  • fluconazole/tinidazole
  • haemocoagulase
  • halometasone
  • hesperidin
  • imipramine/chlordiazepoxide
  • idebenone / l-arginine / zinc sulphate/selenium/proanthocyanidin
  • mecobalamin and piracetam
  • mesterolone
  • mosapride and pantoprazole
  • atorvastatin, co enzyme q10, vitamin e, zinc, and selenium
  • azithromycin and benzalkonium chloride
  • beta carotene, vitamin c, vitamin e, minerals, lutein, eicosapentaenoic acid, docosahexenoic acid and vit b12
  • alpha-galactosidase
  • aloe vera gel/vitamin e/lactic acid
  • aloe vera gel/jojoba/vitamin e/glycerine
  • famotidine and domperidone
  • faropenem medoxomil
  • nedosiran
  • fluconazole/ornidazole/azithromycin
  • ebastine/montelukast
  • eberconazole
  • dienogest/estradiol valerate
  • ambroxol/salbutamol
  • benzoic acid/salicylic acid/ichthammol/ triamcinolone acetonide
  • desloratadine/ambroxol
  • dexibuprofen/paracetamol
  • atorvastatin/ramipril
  • diastase
  • diastase and simethicone
  • diazepam and propranolol
  • dexrabeprazole / domperidone
  • dexrabeprazole
  • dexketoprofen /paracetamol
  • beta carotene/vitamin C/minerals
  • aloe vera gel/urea
  • aloe vera gel/glycerine
  • alpha-lipoic acid/benfotiamine/chromium/folic acid/mecobalamin / vit b6
  • alprazolam/propranolol
  • alprazolam /sertraline
  • ibuprofen/dextropropoxyphene
  • ambroxol/cetirizine/phenylephrine/ guaiphenesin/menthol
  • dextropropoxyphene/dexchlorpheniramine maleate/bromhexine
  • promegestone
  • batroxobin
  • bencyclane
  • benfluorex
  • acetylpheneturide
  • abarelix
  • abetimus
  • naftidrofuryl
  • nalorphine
  • oxiracetam
  • letosteine
  • lafutidine
  • leuprorelin
  • levodropropizine
  • glutaral
  • losartan/ramipril
  • gallopamil
  • lanatoside c
  • lauromacrogol
  • gestodene
  • aceclofenac/methyl salicylate/menthol/linseed oil/capsaicin
  • aceclofenac/paracetamol/tizanidine
  • alginic acid/magaldrate/simethicone
  • aceclofenac/paracetamol
  • aceclofenac/rabeprazole
  • alginic acid
  • pantoprazole and domperidone
  • urokinase
  • rimiterol
  • olanzapine/fluoxetine
  • normethadone/hydroxyephedrine
  • myrtol
  • moxonidine
  • propylhexedrine
  • sodium hypochlorite solution
  • sodium chloride/sodium citrate
  • Hepatitis B Vaccine (Recombinant [Adjuvanted])
  • Hepatitis B Vaccine (Recombinant)
  • aceclofenac and serratiopeptidase
  • levosulpiride
  • niaprazine
  • tromantadine
  • trimetazidine
  • vinburnine
  • mizoribine
  • molgramostim
  • mosapride
  • eugenol
  • tolperisone
  • etamsylate
  • etynodiol
  • mizolastine
  • metenolone
  • reproterol
  • rebamipide
  • mephenoxalone
  • metandienone
  • furosemide/spironolactone
  • hydroxycarbamide
  • tenonitrozole
  • fenoverine
  • fenquizone
  • tiapride
  • tibolone
  • furazolidone
  • furosemide & amiloride
  • fosfestrol
  • fluclorolone
  • flubendazole
  • tertatolol
  • tetracosactide
  • tetryzoline
  • tolciclate
  • trapidil
  • troxipide
  • temoporfin
  • telbivudine
  • teprenone
  • hexamidine
  • mebhydrolin
  • mepartricin
  • fencamfamin
  • medazepam
  • theodrenaline
  • thiamazole
  • thiocolchicoside
  • psilocybin
  • veralipride
  • pyritinol
  • opipramol
  • oprelvekin
  • betamethasone + gentamicin
  • betamethasone + neomycin
  • betamethasone + salicylic acid
  • oxedrine
  • bopindolol
  • orgotein (investigational)
  • oxaceprol
  • ormeloxifene
  • bevantolol
  • bifemelane
  • clebopride
  • demoxytocin
  • cicletanine
  • cefsulodin
  • chlortalidon
  • sisomicin
  • somatrem
  • carbazochrome
  • caroverine
  • cathine
  • ipriflavone
  • isepamicin
  • silymarin
  • simethicone
  • sermorelin
  • diloxanide
  • dimethindene
  • diosmin/hesperidin
  • calamine
  • canrenone
  • captodiame
  • imidapril
  • cefetamet
  • cefodizime
  • cefoperazone + sulbactam
  • ivermectin + albendazole
  • serrapeptase
  • bromisoval
  • beraprost
  • pridinol
  • proglumide
  • bamipine
  • barnidipine
  • bamifylline
  • benzbromarone
  • betamethasone/fusidic acid
  • para-chlorophenol
  • pantethine
  • nomifensine
  • pemoline
  • parnaparin
  • pentolinium
  • nialamide
  • novobiocin
  • nicergoline
  • octocrylene
  • octisalate
  • oftasceine
  • oxolamine
  • oxyphencyclimine
  • penfluridol
  • pentoxyverine
  • phenoxymethylpenicillin
  • picloxydine
  • pilsicainide hydrochloride
  • piperazine
  • pirarubicin
  • policresulen
  • prifinium bromide
  • prethcamide
  • pristinamycin
  • pirenzepine
  • piribedil
  • pimethixene
  • pargyline
  • phosphatidyl choline
  • phthalylsulfathiazole
  • phytomenadione
  • pranlukast
  • pinazepam
  • oxyphenonium
  • noxytiolin
  • periciazine
  • pethidine
  • phenindamine
  • histidine
  • isoleucine
  • proline
  • lauric acid
  • lymecycline
  • hypromellose
  • abiraterone acetate and niraparib
  • ichthammol
  • levamisole
  • naftazone
  • nefopam
  • oxprenolol
  • oxybuprocaine
  • elranatamab-bcmm
  • lapyrium
  • isoaminile
  • iotrolan
  • mazindol
  • masoprocol
  • lypressin
  • meradimate
  • molsidomine
  • monobenzone
  • mequinol/gluconolactone/ lactobionic acid/ arbutin
  • medifoxamine
  • mebutamate
  • metergoline
  • methantheline
  • methdilazine
  • metocurine
  • micronomicin
  • metaraminol
  • mephenesin
  • menadione
  • medrysone
  • metixene
  • levobetaxolol
  • guaiacol glycerol ether
  • eucalyptol
  • sodium tetradecyl sulfate
  • sugammadex
  • carbetocin
  • certoparin
  • chlorcyclizine/pseudoephedrine
  • cephapirin
  • indecainide
  • iobitridol
  • iomeprol
  • chlorphenesin
  • msud analog
  • msud maxamum
  • iceland moss
  • glutethimide
  • hexachlorophene
  • haloprogin
  • deferoxamine
  • ethchlorvynol
  • dexpanthenol topical
  • etilefrine
  • deslanoside
  • carbocromen
  • diazolidinylurea
  • dibenzepin
  • etofamide
  • guanoxan
  • halazepam
  • guanadrel sulfate
  • dapiprazole
  • soapwort
  • debrisoquine
  • l-tryptophan
  • chlormerodrin
  • chlorquinaldol
  • cetrimonium
  • carbocisteine
  • chlorcyclizine/codeine
  • technetium Tc-99m tetrofosmin
  • technetium Tc-99m disofenin
  • technetium Tc-99m gluceptate
  • technetium Tc-99m labeled red blood cells
  • amylmetacresol/dextromethorphan hydrobromide
  • anileridine phosphate
  • pyrethrins
  • pyrantel pamoate
  • quinagolide
  • spiramycin
  • standard hyperkalemic cardioplegia solution
  • technetium tc-99m mertiatide
  • technetium tc-99m medronate
  • bemotrizinol / bisoctrizole
  • benfotiamine
  • bemotrizinol + titanium dioxide + zinc oxide
  • technetium Tc-99m oxidronate
  • technetium Tc-99m pentetate
  • technetium Tc-99m pyrophosphate
  • benziodarone
  • octinoxate/bisoctrizole
  • bicisate dihydrochloride
  • technetium Tc-99m bicisate
  • norelgestromin/ethinyl estradiol
  • norgestimate/ethinyl estradiol
  • ximelagatran (investigational)
  • xamoterol
  • trioxsalen
  • poly-urea urethane
  • rilmenidine
  • pemirolast
  • oxitriptan
  • beclomethasone, intranasal
  • thimerosal
  • camphor gel
  • camphor
  • mumps virus vaccine, live
  • rubella virus vaccine, live
  • aluminum chloride (dental)
  • alum irrigation
  • framycetin, phenylephrine, and gramicidin
  • ombitasvir, paritaprevir, ritonavir, and dasabuvir
  • olipudase alfa
  • etonogestrel/ethinyl estradiol
  • mycophenolate
  • fluoroestradiol F 18
  • donor organ cardioplegia solution
  • fluciclovine F 18
  • fusidic acid (ophthalmic)
  • fusidic acid and hydrocortisone
  • framycetin, dexamethasone, and gramicidin
  • fludeoxyglucose F-18
  • fluorouracil/salicylic acid
  • indium In-111 oxyquinoline
  • indium In-111 pentetreotide
  • indium In-111 capromab pendetide
  • lusutrombopag
  • mitomycin (ophthalmic)
  • mifepristone and misoprostol
  • minoxidil (systemic)
  • methyl aminolevulinate (topical)
  • methyl folate, methylcobalamin, and acetylcysteine
  • ciclesonide/formoterol/tiotropium
  • nedocromil (Oral Inhalation)
  • batefenterol (Investigational)
  • neostigmine and glycopyrrolate
  • nepafenac ophthalmic
  • netupitant/palonosetron
  • meperidine and promethazine
  • mepivacaine and levonordefrin
  • maltodextrin
  • medical cannabis
  • medium chain triglycerides
  • mometasone/glycopyrrolate (glycopyrronium)/ indacaterol
  • moxifloxacin ophthalmic
  • neomycin/fluocinolone
  • nadroparin
  • iodine I-125 iothalamate
  • amikacin liposome (oral inhalation)
  • bupivacaine liposome
  • natamycin
  • lopinavir and ritonavir
  • lysine
  • macitentan and tadalafil
  • mitomycin pyelocalyceal
  • moclobemide
  • mometasone and indacaterol
  • efinaconazole
  • blue-green algae
  • indocyanine green
  • follitropin beta
  • lumasiran
  • glycerin/lidocaine
  • edrophonium/atropine
  • indigo carmine
  • lutropin alfa
  • instant glucose/intravenous dextrose
  • iobenguane I-123
  • ixekizumab
  • isosulfan blue dye
  • levofloxacin ophthalmic
  • levonorgestrel oral/ferrous bisglycinate/ ethinylestradiol
  • ethinyl estradiol/levonorgestrel transdermal
  • hydroquinone
  • hydroxypropyl methylcellulose
  • icodextrin
  • lipid emulsion (soybean, medium-chain triglyceride, olive, and fish oils; [SMOF])
  • iodinated I 125 albumin
  • iodinated I 131 albumin
  • lipid emulsion (plant oil-based)
  • levonorgestrel intrauterine
  • levonorgestrel/ethinyl estradiol
  • lactic acid and sodium-PCA
  • lactated Ringer solution
  • ketotifen (systemic)
  • lanolin
  • leuprolide and norethindrone
  • levodopa and benserazide
  • gonadorelin acetate
  • hemodialysis solutions
  • nirsevimab
  • gentian violet
  • gallium ga-68 dotatate
  • fusidic acid and betamethasone
  • gallium citrate Ga-67
  • gadopentetate dimeglumine
  • gadofosveset
  • follitropin delta
  • follitropin alfa and lutropin alfa
  • follitropin alfa
  • rocatinlimab
  • grass pollens allergen extract
  • flotufolastat F18
  • fluorescein ophthalmic
  • barium
  • balanced salt solution
  • air polymer type A intrauterine device
  • clodronate
  • bentoquatam
  • clobetasone
  • alfacalcidol
  • citric acid/glucono-delta-lactone/magnesium carbonate
  • benzoin
  • desirudin
  • immune globulin IV (IGIV)
  • dequalinium
  • pseudoephedrine/desloratadine
  • clofedanol
  • cyproterone and ethinyl estradiol
  • dextranomer and hyaluronic acid or derivatives
  • diatrizoate meglumine and diatrizoate sodium
  • glucosamine sulfate, chondroitin sulfate and Msm
  • squill
  • gotu kola
  • blessed thistle
  • bitter melon
  • apraclonidine
  • chlophedianol/dexbrompheniramine/pseudoephedrine
  • wild jujube
  • chitosan
  • cilazapril/hydrochlorothiazide
  • dexbrompheniramine and phenylephrine
  • diethylene triamine penta-acetic acid
  • dexchlorpheniramine and pseudoephedrine
  • lily of the valley
  • diflucortolone
  • corydalis
  • lemon balm
  • MSM
  • calcium polystyrene sulfonate
  • caprylidene
  • peppermint oil
  • efavirenz/lamivudine/tenofovir DF
  • emtricitabine/tenofovir DF /efavirenz
  • dutasteride/tamsulosin
  • milk thistle
  • centaury
  • horseweed
  • lycopus
  • agrimony
  • alfalfa
  • kava
  • cetrorelix
  • cetylpyridinium
  • chlophedianol and dexbrompheniramine
  • betahistine
  • choline C-11
  • boric acid vaginal suppository
  • aluminum acetate
  • aluminum chloride hexahydrate
  • 14-C urea breath test
  • absorbable collagen
  • valoctocogene roxaparvovec-rvox
  • amlodipine and celecoxib
  • aspirin and omeprazole
  • azilsartan and chlorthalidone
  • landiolol (Pending FDA approval)
  • isosorbide dinitrate/hydralazine
  • losartan/hydrochorothiazide
  • udenafil
  • dextromethorphan/quinidine
  • onasemnogene abeparvovec
  • orphenadrine/aspirin/caffeine
  • trace elements
  • sodium phenylbutyrate/ taurursodiol
  • fish oil triglycerides
  • infant formula
  • glutamine
  • chloroquine phosphate
  • afatinib
  • quinidine gluconate
  • methylergonovine
  • prothrombin complex concentrate, human
  • BCG intravesical live
  • capivasertib
  • cedazuridine
  • carbonyl iron
  • iron dextran complex
  • lovotibeglogene autotemcel (FDA Approval Pending)
  • sodium benzoate/sodium phenylacetate
  • mineral oil otic
  • zolmitriptan transdermal
  • midazolam intranasal
  • fosinopril/hydrochlorothiazide
  • caplacizumab
  • arginine
  • sodium phenylbutyrate
  • meloxicam/rizatriptan
  • manganese
  • acetaminophen/pamabrom/pyridoxine
  • varicella zoster immune globulin, human
  • amitriptyline/perphenazine
  • narsoplimab (Pending FDA Approval)
  • amlodipine/perindopril
  • imiglucerase
  • canagliflozin/metformin
  • tafamidis meglumine
  • somatrogon-ghla
  • glimepiride/rosiglitazone
  • becaplermin
  • lithium
  • loxapine inhaled
  • nicotine transdermal
  • tixagevimab and cilgavimab (Investigational)
  • muromonab CD3
  • ansuvimab
  • coal tar bath products
  • fibrin sealant
  • arimoclomol (FDA Approval Pending)
  • varenicline intranasal
  • aducanumab
  • oxycodone/naloxone
  • ritlecitinib
  • sodium polystyrene sulfonate
  • calcipotriene/betamethasone
  • calcium hydroxylapatite
  • cantharidin topical
  • doxepin cream
  • clocortolone
  • formaldehyde topical
  • sodium sulfide topical
  • collagenase
  • selegiline transdermal
  • foscarbidopa/foslevodopa (FDA approval pending)
  • saxagliptin/metformin
  • linagliptin/metformin
  • linzagolix (FDA approval pending)
  • efgartigimod/hyaluronidase SC
  • elamipretide (Pending FDA approval)
  • rozanolixizumab
  • diazoxide
  • glimepiride/pioglitazone
  • cipaglucosidase alfa
  • dihydroergotamine intranasal
  • delandistrogene moxeparvovec
  • beremagene geperpavec
  • hyaluronic acid and derivatives
  • hyaluronic acid, non-animal stabilized
  • eplontersen (FDA Approval Pending)
  • nitric oxide gas
  • sodium phenylbutyrate and taurursodiol
  • treprostinil SC
  • viltolarsen
  • albuterol/ipratropium
  • budesonide inhaled
  • budesonide rectal
  • palovarotene
  • sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol
  • amino acids mixture
  • aminobenzoate potassium
  • elivaldogene autotemcel
  • naproxen and sumatriptan
  • sumatriptan intranasal
  • alglucerase
  • metformin/rosiglitazone
  • ertugliflozin/metformin
  • elosulfase alfa
  • calcium carbonate/magnesium hydroxide
  • starch suppository
  • abicipar pegol (FDA Approval Pending)
  • riboflavin 5′-phosphate ophthalmic
  • povidone ophthalmic
  • glycerin oropharyngeal
  • dimethicone topical
  • menthol topical, dimethicone topical
  • pramoxine topical, menthol topical and dimethicone topical
  • phosphorated carbohydrate
  • brilliant blue G ophthalmic
  • brolucizumab intravitreal
  • purified water, ophthalmic
  • hydroxyethyl cellulose ophthalmic
  • ranibizumab intravitreal implant
  • sodium chloride hypertonic, ophthalmic 
  • cetirizine ophthalmic
  • phentolamine ophthalmic
  • ganciclovir ophthalmic
  • triamcinolone intravitreal
  • ocriplasmin intravitreal
  • atoltivimab/maftivimab/odesivimab
  • pegcetacoplan intravitreal
  • triamcinolone acetonide extended-release injectable suspension
  • tobramycin/loteprednol ophthalmic
  • 2-octyl cyanoacrylate
  • vitamins A & D topical
  • diphenhydramine/allantoin topical
  • pyrethrins/piperonyl butoxide
  • lodoxamide ophthalmic
  • obeticholic acid
  • fluocinolone intravitreal implant
  • sincalide
  • linaclotide
  • nedocromil ophthalmic
  • cysteamine ophthalmic
  • avacincaptad pegol intravitreal
  • azelastine ophthalmic
  • bacitracin ophthalmic
  • propylene glycol ophthalmic
  • rimexolone ophthalmic
  • metoclopramide intranasal
  • mirikizumab
  • netarsudil ophthalmic
  • cenegermin
  • dexamethasone ophthalmic insert
  • prednisolone ophthalmic
  • phenylephrine and cocoa butter rectal
  • phenylephrine and witch hazel topical
  • phenylephrine, pramoxine, glycerin and petrolatum rectal
  • bisacodyl rectal
  • aluminum hydroxide/magnesium carbonate
  • aluminum hydroxide/magnesium hydroxide
  • hyoscyamine spray
  • methenamine/methylene blue/ hyoscyamine/ sodium phosphate monobasic/ phenyl salicylate
  • phenylephrine
  • chlorophyll
  • castor oil
  • cholic acid
  • phenol oropharyngeal
  • articaine/epinephrine
  • antithymocyte globulin equine
  • aluminum hydroxide/magnesium trisilicate
  • methenamine/hyoscyamine
  • hydrocortisone topical/pramoxine topical 
  • sodium fluoride topical
  • mesna
  • C1 esterase inhibitor recombinant
  • menthol and pectin
  • menthol oropharyngeal
  • pectin oropharyngeal
  • gepirone
  • Goldenseal
  • polyethylene glycol and electrolytes
  • polyethylene glycol/electrolytes/sodium ascorbate/ascorbic acid
  • brompheniramine/pseudoephedrine/dextromethorphan
  • brompheniramine phenylephrine
  • acetaminophen/doxylamine/phenylephrine
  • doxylamine/acetaminophen/pseudoephedrine/dextromethorphan
  • acetaminophen/doxylamine/dextromethorphan
  • acetaminophen/doxylamine/dextromethorphan/phenylephrine
  • eslicarbazepine
  • fluticasone and salmeterol
  • codeine, acetaminophen, butalbital and caffeine
  • codeine, chlorpheniramine and phenylephrine
  • iodine
  • povidone iodine
  • butalbital/aspirin/caffeine/codeine
  • polyethylene glycol 400/propylene glycol ophthalmic 
  • pegvaliase
  • amivantamab
  • iopamidol
  • codeine and pseudoephedrine
  • emtricitabine, rilpivirine, tenofovir DF
  • penicillin G aqueous
  • miconazole topical
  • miconazole vaginal
  • ciprofloxacin inhaled (Pending FDA approval)
  • ceftazidime/avibactam
  • ceftolozane/​tazobactam
  • aztreonam inhalation
  • amphotericin B cholesteryl sulfate
  • miconazole oral
  • elvitegravir/cobicistat/emtricitabine/tenofovir DF
  • isavuconazonium sulfate
  • dapivirine intravaginal (FDA Approval Pending)
  • lamivudine/raltegravir
  • codeine/triprolidine/pseudoephedrine
  • cadexomer iodine
  • brompheniramine/pseudoephedrine
  • codeine/acetaminophen
  • codeine/guaifenesin
  • beclomethasone inhaled
  • epoetin beta/methoxy polyethylene glycol
  • voreloxin(Orphan Drug)
  • rociletinib
  • pitcher plant
  • phosphatidylserine
  • telotristat ethyl
  • copper CU 64 dotatate
  • urea topical
  • exenatide subdermal implant
  • asenapine transdermal
  • ethiodized oil
  • urea oral
  • miglustat
  • acalisib(Investigational)
  • acetophenazine
  • guggul
  • aceneuramic acid
  • mestranol/norethindrone
  • reishi
  • lactitol
  • vonoprazan fumarate
  • motherwort
  • silver nitrate
  • salicylic acid/sulfur shampoo
  • salicylic acid topical
  • ketorolac ophthalmic
  • ketoconazole topical
  • Japanese encephalitis virus vaccine
  • dibucaine topical ointment
  • ketorolac intranasal
  • ketorolac/phenylephrine ophthalmic
  • rotavirus oral vaccine, live
  • guarana
  • hops
  • krill oil
  • salicylic acid/coal tar shampoo
  • sufentanil SL
  • pancrelipase
  • passion flower
  • pepdite one plus
  • nivolumab and relatlimab
  • relatlimab (Pending FDA Approval)
  • benzalkonium chloride/benzocaine
  • ketotifen, drug-eluting contact lens
  • calcitriol topical
  • oxymetazoline topical
  • alclometasone topical
  • capsaicin topical
  • diclofenac/misoprostol
  • diclofenac ophthalmic
  • diclofenac topical
  • pramoxine/calamine topical
  • veverimer
  • tolazoline
  • olopatadine ophthalmic
  • lutetium lu 177-dota-tate
  • lutetium lu 177 vipivotide tetraxetan
  • strontium 89 chloride
  • interferon alfa n3
  • lutetium Lu 177- Diethylenetriamine Pentaacetic acid-omburtamab (FDA Approval Pending)
  • samarium sm 153 lexidronam
  • cytomegalovirus immune globulin (CMV IG)
  • antithymocyte globulin rabbit
  • inolimomab (Pending FDA Approval)
  • olopatadine intranasal
  • olopatadine intranasal/​mometasone, intranasal
  • benzocaine/butamben/tetracaine topical
  • antipyrine/benzocaine/phenylephrine
  • dyclonine/menthol
  • surufatinib
  • fruquintinib
  • tepotinib 
  • dostarlimab
  • hepatitis B immune globulin (HBIG)
  • remestemcel-L
  • benzocaine/menthol oropharyngeal
  • interferon beta 1b
  • tetracaine/oxymetazoline intranasal
  • benzocaine oropharyngeal
  • benzalkonium chloride/menthol/petrolatum topical
  • inamrinone
  • alpha 1 proteinase inhibitor
  • potassium bicarbonate/potassium citrate
  • potassium phosphate/sodium acid phosphate
  • asparaginase Erwinia chrysanthemi recombinant
  • motixafortide
  • pegloticase
  • etesevimab
  • Rho(D) immune globulin
  • tetanus immune globulin (TIG)
  • reltecimod (pending FDA approval)
  • avasopasem
  • trimethoprim/polymyxin B ophthalmic
  • naphazoline ophthalmic
  • sulfacetamide topical
  • sirolimus intravitreal (pending FDA approval)
  • sirolimus protein bound
  • sirolimus topical
  • glycopyrronium tosylate topical
  • sofpironium
  • olmesartan, amlodipine and hydrochlorothiazide
  • dovitinib (Pending FDA Approval)
  • epinephrine inhaled
  • quizartinib (Pending FDA Approval)
  • ranibizumab intravitreal injection
  • sodium hyaluronate
  • bacitracin and lidocaine topical
  • brimonidine topical
  • benzoyl peroxide and tretinoin topical
  • talquetamab
  • betrixaban
  • acetaminophen/caffeine/pyrilamine
  • fentanyl transmucosal
  • bacitracin topical
  • buprenorphine,long-acting injection
  • buprenorphine buccal
  • nalmefene intranasal
  • sulbactam/durlobactam
  • metronidazole topical 
  • daratumumab/hyaluronidase
  • glofitamab
  • rituximab-hyaluronidase
  • drospirenone/ethinyl estradiol/levomefolate
  • loncastuximab tesirine
  • ingenol mebutate topical
  • momelotinib
  • trastuzumab/deruxtecan
  • trastuzumab/hyaluronidase
  • trastuzumab duocarmazine
  • lifileucel
  • umbralisib
  • eflornithine/sulindac
  • cytarabine/daunorubicin liposomal
  • doxorubicin liposomal
  • epcoritamab
  • lanadelumab  
  • esomeprazole/naproxen 
  • terbinafine topical
  • ravulizumab
  • clotrimazole topical
  • choline magnesium trisalicylate
  • tacrolimus ointment
  • mechlorethamine topical
  • donislecel
  • pozelimab (Pending FDA Approval)
  • human rabies immune globulin (HRIG)
  • melphalan flufenamide
  • sintilimab (Pending FDA Approval)
  • oportuzumab monatox (Pending FDA Approval)
  • sotorasib
  • irinotecan liposomal
  • sulfur topical
  • silver sulfadiazine
  • capsaicin transdermal
  • sutimlimab
  • tretinoin topical
  • acetaminophen rectal
  • menthol topical
  • naftifine
  • oatmeal, colloidal topical
  • oxiconazole
  • methylsalicylate/menthol topical
  • C1 inhibitor human
  • lifitegrast ophthalmic
  • prednisolone/sulfacetamide ophthalmic
  • mannitol inhalation
  • ofloxacin otic
  • petrolatum & mineral oil topical
  • clascoterone topical
  • gefapixant (Pending FDA Approval)
  • colesevelam
  • technetium Tc 99m succimer
  • nebivolol/valsartan
  • ciprofloxacin/fluocinolone acetonide, otic
  • finafloxacin otic
  • magnesium hydroxide/mineral oil
  • phenylephrine/mineral oil/petrolatum rectal
  • carbamide peroxide oral
  • atropine ophthalmic
  • sodium sulfacetamide/sulfur
  • sulfacetamide ophthalmic
  • lucinactant
  • benzonatate
  • besifloxacin ophthalmic
  • benzhydrocodone/acetaminophen
  • beractant
  • trimagnesium citrate anhydrous
  • vitamin b2
  • carbamide peroxide otic
  • mineral oil topical
  • ethyl alcohol intranasal
  • boric acid/alcohol otic
  • absorbable gelatin compressed sponge, USP
  • absorbable gelatin sponge, USP
  • vincristine liposomal
  • technetium Tc 99m albumin aggregated injection
  • metaproterenol
  • budesonide inhaled/formoterol/glycopyrrolate inhaled
  • epinephrine racemic
  • umeclidinium bromide/vilanterol inhaled
  • indacaterol, inhaled/glycopyrrolate inhaled
  • betaine  
  • laronidase 
  • estrogens esterified/methyltestosterone            
  • cerliponase alfa
  • ertugliflozin/sitagliptin
  • hawthorn
  • shepherd’s purse
  • thiamine
  • naphazoline/glycerin ophthalmic
  • oxymetazoline ophthalmic
  • dorzolamide
  • dexamethasone intraocular
  • dexamethasone/ciprofloxacin
  • dexamethasone ophthalmic
  • metipranolol ophthalmic
  • timolol ophthalmic
  • boron
  • fezolinetant
  • pegunigalsidase alfa-iwxj
  • biotin
  • pantothenic acid
  • silicon
  • sodium acid phosphate
  • hypochlorous acid topical
  • methenamine/sodium acid phosphate
  • aviptadil 
  • bremelanotide
  • glucagon intranasal
  • metformin and repaglinide
  • bai ji
  • pau d’arco
  • juzentaihoto
  • mistletoe
  • quercetin
  • rosemary
  • sheng di huang
  • chasteberry
  • maitake
  • grapefruit
  • lentinan
  • juniper
  • nettle
  • parsley
  • rose hips
  • tongkat ali
  • horny goat weed
  • damiana
  • yohimbe
  • insulin NPH
  • aprocitentan
  • noni Juice
  • sodium iodide I-131
  • green tea
  • sea cucumber
  • wheat germ extract
  • fenofibrate micronized 
  • rogisen
  • danshen
  • lutein
  • witch hazel
  • dextroamphetamine transdermal
  • amphetamine/dextroamphetamine
  • hoodia
  • kolanut
  • boswellia
  • opuntia ficus indica
  • lavender
  • nadh
  • tea tree oil
  • metformin/sitagliptin 
  • dapagliflozin/ metformin/saxagliptin  
  • antihemophilic factor recombinant
  • inclisiran
  • bempedoic acid/ezetimibe
  • volanesorsen  
  • omega 3 carboxylic acids
  • pericyazine
  • levomepromazine (methotrimeprazine)
  • betaxolol ophthalmic
  • respiratory syncytial virus vaccine, adjuvanted
  • phenylephrine hydrochloride and tropicamide ophthalmic
  • alirocumab
  • neomycin/polymyxin B/gramicidin ophthalmic
  • factor IX
  • gentamicin topical
  • ansofaxine (Pending FDA Approval)
  • zuranolone
  • factor IX, recombinant
  • factor IX complex
  • factor XIII A-subunit, recombinant
  • factor X, human
  • mesalamine rectal
  • etrasimod
  • anti-inhibitor coagulant complex
  • factor IX, recombinant/albumin fusion protein
  • fibrinogen, human
  • aminocaproic acid
  • metyrosine
  • nonoxynol-9 vaginal
  • progesterone intravaginal gel
  • ipecac syrup
  • botulinum antitoxin, heptavalent
  • pentetate calcium trisodium
  • crotalidae polyvalent immune FAB (ovine)
  • dehydrated alcohol injection 
  • gold sodium thiomalate (Discontinued)
  • lactic acid/citric acid/potassium bitartrate vaginal
  • von Willebrand factor, recombinant
  • luspatercept
  • digoxin immune FAB (Antidote)
  • crotalidae immune FAB (equine)
  • magnesium (Antidote)
  • pyridoxine (Antidote)
  • edetate calcium disodium
  • albumin IV
  • nitroglycerin sublingual
  • obiltoxaximab
  • anthrax immune globulin
  • nitroglycerin topical
  • dextrose
  • nesiritide
  • estradiol vaginal
  • bazedoxifene/conjugated estrogens
  • botulism immune globulin iv
  • amoxicillin/omeprazole/rifabutin
  • synthetic human angiotensin II
  • nitroglycerin IV
  • nitroglycerin translingual
  • nitroprusside sodium
  • tetrahydrozoline/zinc sulfate/hypromellose ophthalmic
  • sodium citrate/citric acid
  • pemetrexate
  • methicillin
  • plasminogen 
  • acai
  • american ginseng
  • cordyceps
  • tramadol/acetaminophen
  • belladonna alkaloids/phenobarbital
  • erythromycin topical/benzoyl peroxide
  • glucosamine sulfate
  • panax ginseng (suppl/herb)
  • tolnaftate
  • sulopenem etzadroxil/probenecid
  • sulfur hexafluoride
  • sotrovimab
  • arbaclofen
  • rifampin/isoniazid
  • clindamycin /tretinoin topical
  • benzoyl peroxide/clindamycin topical
  • apremilast
  • antivenins, centuroides (scorpion)
  • bamlanivimab and etesevimab
  • vilobelimab
  • gadobenate
  • pentosan polysulfate sodium
  • methylsalicylate/menthol/camphor topical
  • antivenin, black widow spider
  • benzoyl peroxide and hydrocortisone
  • clindamycin topical
  • isometheptene, dichloralphenazone and acetaminophen
  • acetaminophen and phenyltoloxamine
  • erythromycin topical
  • erythromycin ophthalmic
  • alpha hydroxy acids, topical
  • buprenorphine transdermal
  • butalbital/acetaminophen/caffeine
  • buprenorphine/samidorphan
  • buprenorphine subdermal implant
  • celecoxib/tramadol
  • drospirenone/ethinyl estradiol
  • resorcinol/sulfur
  • eflornithine
  • rifampin/isoniazid/pyrazinamide
  • tofersen
  • devil’s claw
  • ticarcillin/clavulanate
  • atropine/pralidoxime
  • aprepitant
  • suramin
  • phenelzine 
  • artichoke
  • american dogwood
  • attapulgite
  • atlantic cedar
  • axalimogene filolisbac
  • sodium thiosulfate & sodium nitrite
  • ataluren
  • omidubicel-onlv
  • capsicum
  • ginger
  • cryoprecipitate
  • bictegravir/emtricitabine/tenofovir DF
  • emtricitabine/tenofovir DF
  • fo-ti
  • siberian ginseng
  • granulocytes
  • zinc substituted heme C
  • zinc trihydroxide
  • ashwagandha 
  • cat’s claw
  • glandular products
  • SAMe
  • shark cartilage
  • altovis
  • feverfew
  • horse chestnut
  • magnesium aspartate
  • octacosanol
  • pleurisy root
  • star anise
  • butterbur
  • elderberry
  • licorice (Suppl/herb)
  • aconite
  • pentetate zinc trisodium
  • menthol topical/zinc oxide topical
  • corn-starch/kaolin/zinc oxide topical
  • 5-hydroxytryptophan (5-htp)
  • butcher’s broom
  • articulin
  • bearberry
  • goldenrod
  • progesterone, natural
  • black cohosh
  • wild yam
  • cranberry
  • dong quai
  • phytoestrogens
  • norethindrone
  • false Unicorn Root
  • raspberry Leaf
  • asafoetida
  • turmeric
  • dehydroepiandrosterone (DHEA)
  • hyaluronan
  • aliskiren/amlodipine
  • octreotide (Antidote)
  • tranexamic acid injection
  • duocal
  • neocate infant formula
  • pediatric Eo28
  • aloe
  • red clover
  • propolis
  • androstenedione
  • heartsease
  • comfrey
  • bilberry
  • chamomile
  • eyebright
  • calendula
  • sage
  • yucca
  • polypody
  • odevixibat
  • vinpocetine
  • olanzapine/samidorphan
  • creatine
  • yerba mate
  • spesolimab
  • azficel-T
  • tiludronate
  • estetrol and drospirenone
  • pseudoephedrine/fexofenadine
  • lincomycin
  • neomycin oral
  • fluocinolone acetonide, otic
  • tretinoin/ hydroquinone/ fluocinolone
  • halobetasol topical
  • hydrocortisone/​iodoquinol
  • penicillin G procaine /penicillin G benzathine
  • hydrocortisone probutate topical
  • colistin/neomycin/hydrocortisone/thonzonium otic
  • ebola zaire vaccine
  • hepatitis a/​b vaccine
  • vibegron
  • lindane
  • nystatin topical
  • respiratory syncytial virus (RSV) vaccine
  • chikungunya vaccine, live
  • tenecteplase
  • reteplase
  • anthrax vaccine adsorbed, adjuvanted
  • meningococcal ABCWY pentavalent vaccine
  • eculizumab
  • cholestyramine
  • tinzaparin
  • taurolidine/​citrate/​heparin
  • protein C concentrate
  • antithrombin alfa
  • antithrombin III
  • multivitamins, vision
  • ibuprofen/​chlorpheniramine/​pseudoephedrine
  • acetaminophen/ibuprofen
  • ibuprofen/pseudoephedrine
  • paclitaxel protein-bound
  • acetic acid vaginal
  • acetic acid otic
  • hydrocodone/ ibuprofen
  • methyl salicylate / isopropanol/ citronellyl acetate/ citric acid
  • ibuprofen and phenylephrine
  • acetylcysteine (Antidote)
  • iron/​folic acid/​vitamin/​mineral
  • iobenguane I-131
  • dolutegravir/rilpivirine
  • chlorhexidine topical
  • chlorhexidine oral
  • thyroid desiccated
  • proparacaine ophthalmic
  • podophyllum resin
  • phendimetrazine
  • phenoxybenzamine
  • polidocanol
  • phentermine and topiramate
  • piflufolastat F18
  • piperacillin/tazobactam
  • prednisolone and gentamicin ophthalmic
  • promethazine and codeine
  • poractant alfa
  • protamine sulfate
  • aflibercept intravitreal
  • prednicarbate
  • promethazine/dextromethorphan
  • codeine, phenylephrine, and promethazine
  • potassium phosphate
  • glatiramer acetate
  • gentamicin (Ophthalmic)
  • leniolisib
  • rezafungin
  • fluorometholone
  • dalfampridine
  • hydrocortisone topical 
  • empagliflozin and linagliptin
  • triamcinolone topical
  • minocycline topical
  • minocycline dental
  • ketotifen ophthalmic
  • darunavir and cobicistat
  • lidocaine topical
  • neomycin/polymyxin B/bacitracin/lidocaine (OTC)
  • lidocaine/ hydrocortisone
  • lidocaine anesthetic
  • lidocaine ophthalmic
  • lidocaine/tetracaine
  • desonide
  • dabigatran
  • fexofenadine
  • fluoride
  • decitabine and cedazuridine
  • dasiglucagon
  • hydroxypropyl cellulose ophthalmic
  • epoetin alfa
  • ibritumomab tiuxetan
  • trimethobenzamide
  • dexamethasone/ tobramycin
  • tafasitamab
  • valacyclovir
  • mebendazole
  • levoleucovorin
  • flaxseed
  • germanium
  • glutathione
  • lycopene
  • pygeum
  • horseradish
  • ziv-aflibercept
  • micafungin
  • trofinetide
  • taliglucerase alfa
  • tildrakizumab
  • sulopenem (Pending FDA Approval)
  • thyrotropin alfa
  • birch
  • thrombin, topical
  • tivozanib
  • tafluprost
  • methohexital
  • urea and hydrocortisone
  • unoprostone ophthalmic
  • trihexyphenidyl
  • ezetimibe
  • evolocumab
  • trifluridine and tipiracil
  • methenamine
  • misoprostol
  • miltefosine
  • rimantadine
  • maralixibat
  • coenzyme Q10
  • chlorella
  • garlic
  • forskolin
  • zavegepant
  • menotropins
  • margetuximab
  • meprobamate
  • melarsoprol
  • evening primrose oil
  • lemongrass
  • molindone
  • fenugreek
  • phytosterols
  • red yeast rice
  • uridine triacetate
  • tropicamide
  • incobotulinumtoxinA
  • Grape Seed Extract
  • carbachol ophthalmic
  • cosyntropin
  • cyclopentolate and phenylephrine
  • carteolol ophthalmic
  • pentazocine/naloxone
  • pentazocine/acetaminophen
  • casimersen
  • carisoprodol, aspirin, and codeine
  • carisoprodol
  • carboprost tromethamine
  • flurandrenolide
  • brinzolamide/brimonidine
  • betamethasone topical
  • omaveloxolone
  • bardoxolone
  • allogeneic processed thymus tissue
  • fluocinolone topical
  • tacrolimus topical
  • ruxolitinib topical
  • pimecrolimus topical
  • sofosbuvir, velpatasvir and voxilaprevir
  • sofosbuvir/velpatasvir
  • mitotane
  • elbasvir/​grazoprevir
  • wheat dextrin
  • vanadium
  • iron/folic acid/vitamin/mineral
  • molybdenum
  • sparsentan
  • velmanase alfa-tycv
  • pegcetacoplan
  • ferrous sulfate
  • cyclosporine ophthalmic
  • ferric pyrophosphate
  • ammonium lactate
  • etelcalcetide
  • iodoquinol
  • sucroferric oxyhydroxide
  • doxercalciferol
  • terconazole vaginal
  • cortisone
  • pyronaridine
  • tetrahydrozoline, ophthalmic
  • tenapanor
  • tesamorelin
  • benazepril/hydrochlorothiazide
  • nadolol and bendroflumethiazide
  • spironolactone and hydrochlorothiazide
  • COVID-19 Vaccine, mRNA
  • atosiban
  • bisoprolol and hydrochlorothiazide
  • ephedrine/guaifenesin
fosphenytoin + 

trimethoprim 

fosphenytoin: they may diminish the serum concentration of trimethoprim

canagliflozin 

fosphenytoin: they may diminish the serum concentration of canagliflozin

rilpivirine 

it decreases the concentration of rilpivirine in the serum

pemigatinib 

It may diminish the effect when combined with pemigatinib by affecting CYP3A4 metabolism

alpelisib

when both drugs are combined, there may be a decreased level of serum concentration of alpelisib   

romidepsin

when both drugs are combined, there may be a reduced level or effect of romidepsin by affecting hepatic or intestinal enzyme cyp3a4 metabolism  

ixazomib

fosphenytoin decreases the effect of ixazomib by altering intestinal/hepatic CYP3A4 enzyme metabolism

fedratinib

fosphenytoin decreases the effect of fedratinib by altering the intestinal/hepatic CYP3A4 enzyme metabolism

floxuridine

CYP2C9 inhibitors enhance the plasma concentration of fosphenytoin

edoxaban 

may increase the level of effectiveness through P-glycoprotein MDR1 efflux transporter

pancuronium

may decrease the neuromuscular-blocking effect when combined with neuromuscular-blocking agents

botulinum toxin

may decrease the neuromuscular-blocking effect when combined with neuromuscular-blocking agents

abobotulinumtoxinA

may decrease the neuromuscular-blocking effect when combined with neuromuscular-blocking agents

rimabotulinumtoxinB

may decrease the neuromuscular-blocking effect when combined with neuromuscular-blocking agents

daxibotulinumtoxinA

may decrease the neuromuscular-blocking effect when combined with neuromuscular-blocking agents

mipomersen 

It may enhance the toxicity when combined with mipomersen

potassium iodide

it decreases the concentration of thyroid products in serum

propylthiouracil

it decreases the concentration of thyroid products in serum

liotrix

it decreases the concentration of thyroid products in serum

potassium perchlorate

it decreases the concentration of thyroid products in serum

miconazole oral 

The miconazole (oral) has the potential to elevate the levels of fosphenytoin in the bloodstream

cannabidiol 

It may enhance the effect when combined with cannabidiol by affecting CYP3A4 metabolism

metformin 

It may diminish the effects when combined with metformin by pharmacodynamic antagonism

vitamin d 

It may diminish the effects when combined with vitamin D

fencamfamin 

The potential for CNS depression may enhanced when fosphenytoin is used together with fencamfamin

niaprazine 

When fosphenytoin is used together with niaprazine, the risk or seriousness of CNS depression is enhanced

levosulpiride 

When fosphenytoin is used together with levosulpiride, the risk or seriousness of CNS depression is enhanced

alprazolam 

When alprazolam and fosphenytoin is used together, this leads to reduction in the alprazolam’s metabolism

dexrabeprazole 

When dexrabeprazole and fosphenytoin is used together, this leads to reduction in the dexrabeprazole’s metabolism

maralixibat

fosphenytoin: they may enhance the serum concentration of CYP3A4 Inhibitors

lenacapavir

fosphenytoin: they may enhance the serum concentration of CYP3A4 Inhibitors

curcumin

fosphenytoin: they may enhance the serum concentration of CYP3A4 Inhibitors

glecaprevir

fosphenytoin: they may enhance the serum concentration of CYP3A4 Inhibitors

caspofungin

fosphenytoin: they may enhance the serum concentration of CYP3A4 Inhibitors

ridaforolimus 

When fosphenytoin is used together with ridaforolimus, this leads to enhanced concentration serum of fosphenytoin

calcipotriol 

the serum concentration of calcipotriol can be diminished when it is combined with fosphenytoin

tacalcitol 

the serum concentration of tacalcitol can be lessened when it is associated with fosphenytoin

carmustine

when both the drugs are combined, the serum concentration of fosphenytoin decreases    

methotrexate

the interaction may decrease the serum concentration of fosphenytoin by increasing the unbound protein metabolites. It also increases the serum concentration of methotrexate

brentuximab

is having an antagonistic impact over brentuximab vedotin, by showing altered intestinal/hepatic CYP3A4 enzyme metabolism.

cabazitaxel

increases serum level of cabazitaxel by affecting the enzyme CYP3A4

fluorouracil

the levels of fosphenytoin are increased by fluorouracil via an unknown mechanism

gefitinib

fosphenytoin decreases the effect of gefitinib by altering the intestinal/ hepatic CYP3A4 enzyme metabolism

lacosamide

may decrease the level by affecting the hepatic enzyme CYP3A4 metabolism

cefazolin 

may increase the serum concentration of cefazolin

albendazole 

It may diminish levels when combined with albendazole by enhancing metabolism

medroxyprogesterone

It may enhance the risk of adverse effects when combined with progesterone derivatives

medrogestone

It may enhance the risk of adverse effects when combined with progesterone derivatives

medroxyprogesterone acetate

It may enhance the risk of adverse effects when combined with progesterone derivatives

mefenamic acid

It may enhance the risk of adverse effects when combined with progesterone derivatives

nomegestrol

It may enhance the risk of adverse effects when combined with progesterone derivatives

lomitapide 

When fosphenytoin is used together with lomitapide, this leads to an enhancement in lomitapide’s metabolism

finasteride

it decreases the effect or level of finasteride by altering the intestinal/hepatic enzyme CYP3A4 metabolism

dutasteride

it decreases the effect or level of dutasteride by altering the intestinal/hepatic enzyme CYP3A4 metabolism

Frequency defined 

>10% 

IV, adults 

Nystagmus (44%) 

Dizziness (31%) 

Pruritus (49%) 

Ataxia (11%) 

Somnolence (20%) 

Adults and children 

General 

Injection-site reaction, Chills, Fever, Face edema, Injection-site pain, Infection 

Musculoskeletal 

Leg cramps, myalgia, arthralgia, myopathy 

Nervous  

Dysarthria, Intracranial hypertension, reflexes increased, thinking abnormal, Speech disorder, Nervousness. 

Skin 

Rash 

Respiratory 

Pneumonia 

Digestive 

Constipation 

Cardiovascular 

Hypertension 

IV, children and adolescents 

Nystagmus (18%) 

Vomiting (21%) 

IM 

Nystagmus (15%) 

1-10% 

IV, adults 

Pelvic pain (4%) 

Extrapyramidal syndrome (4%) 

Incoordination (4%) 

Dry mouth (4%) 

Tongue disorder (4%) 

Paresthesia (4%) 

Vasodilatation (6%) 

Hypotension (8%) 

Stupor (8%) 

Tinnitus (9%) 

Nausea (9%) 

Tremor (3%) 

Diplopia (3%) 

Taste perversion (3%) 

Agitation (3%) 

Dysarthria (2%) 

Hypesthesia (2%) 

Vomiting (2%) 

Brain edema (2%) 

Vertigo (2%) 

Asthenia (2%) 

Deafness (2%) 

Amblyopia (2%) 

Headache (2%) 

Back pain (2%) 

IV, children and adolescents 

Rash (5%) 

Somnolence (6%) 

Ataxia (10%) 

Nervousness (7%) 

Hypotension (5%) 

Pruritus (6%) 

Fever (8%) 

Adults and children 

General 

injection-site hemorrhage, sepsis, injection-site inflammation, photosensitivity reaction 

injection-site edema, malaise, generalized edema, shock, cachexia, flu syndrome, cryptococcosis. 

Nervous 

CNS depression, confusion, twitching, akathisia, positive Babinski sign, circumoral paresthesia, hemiplegia, hypotonia, convulsion, extrapyramidal syndrome, insomnia, meningitis, depersonalization, depression, hypokinesia, hyperkinesia, paralysis, psychosis, aphasia, emotional lability, coma, hyperesthesia, myoclonus, personality disorder, acute brain syndrome, encephalitis, subdural hematoma, encephalopathy, hostility, amnesia, and neurosis. 

Urogenital 

Urinary retention, oliguria, dysuria, genital edema, kidney failure, polyuria, urethral pain, urinary incontinence, albuminuria, vaginitis, and vaginal moniliasis 

Special senses 

Visual field defect, eye pain, conjunctivitis, photophobia, hyperacusis, mydriasis, ear pain, taste loss, and parosmia 

Skin 

Contact dermatitis, pustular rash,urticaria, maculopapular rash, skin discoloration 

skin nodule, sweating.  

IM 

Somnolence (7%) 

Reflexes decreased (3%) 

Ataxia (8%) 

Pruritus (3%) 

Dizziness (5%) 

Incoordination (8%) 

Paresthesia (4%) 

Headache (9%) 

Vomiting (3%) 

Asthenia (9%) 

Nausea (5%) 

Tremor (10%)

Black Box Warning: 

The black box warning for fosphenytoin is related to the risk of cardiovascular adverse reactions, including severe hypotension and arrhythmias, particularly when the drug is administered too rapidly or in excessive doses. 

The black box warning specifically cautions that fosphenytoin should be administered slowly and in a manner that allows for cardiac monitoring, especially in patients with a history of cardiovascular disease. It also warns that the drug should not be used to treat certain types of arrhythmias, such as atrial fibrillation or flutter. 

Contraindication/Caution: 

Contraindication 

  • Hypersensitivity: fosphenytoin should not be used in patients allergic to the drug or to phenytoin. 
  • Bradycardia: fosphenytoin can cause bradycardia, which is a slow heart rate. Therefore, it should not be used in patients with a history of bradycardia or other cardiac conduction abnormalities, unless they have a pacemaker in place. 
  • Heart block: fosphenytoin can worsen heart block, which is a condition where the electrical impulses that regulate the heartbeat are disrupted. Therefore, it should not be used in patients with second- or third-degree heart block. 
  • Porphyria: fosphenytoin can trigger an acute attack of porphyria, which is a rare genetic disorder that affects the production of heme, a component of hemoglobin. Therefore, it should not be used in patients with this condition. 
  • Preexisting hypotension: fosphenytoin can cause a drop in blood pressure, which can be dangerous in patients with preexisting hypotension. 

Caution 

  • Pregnancy and breastfeeding: fosphenytoin may be harmful to a developing fetus, so it should only be used in pregnant women if the potential benefits outweigh the risks. It may also be excreted in breast milk, so breastfeeding should be avoided while taking fosphenytoin. 
  • Liver disease: fosphenytoin is metabolized by the liver, caution in patients with liver disease, as they may be at increased risk of toxicity. 
  • Kidney disease: fosphenytoin is excreted by the kidneys, caution in patients with kidney disease, as they may be at increased risk of toxicity. 
  • Elderly patients: Elderly patients may be more susceptible to the side effects of fosphenytoin, such as dizziness, confusion, and sedation, so they should be monitored closely while taking the medication. 
  • Drug interactions: fosphenytoin may interact with other medications, such as oral contraceptives, warfarin, and corticosteroids, so healthcare professionals should review a patient’s medication history carefully before prescribing fosphenytoin. 
  • Seizure control: fosphenytoin is used to prevent and treat seizures, but it is important to monitor a patient’s seizure control while they are taking the medication, as it may require adjustments in dosing or other medications. 

Pregnancy consideration:  

US FDA pregnancy category: Not assigned. 

Lactation:   

Excreted into human milk is Not known.  

Pregnancy category: 

  • Category A: well-controlled and Satisfactory studies do not show risk to the fetus in the first/later trimester.       
  • Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women       
  • Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.     
  • Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.      
  • Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.      
  • Category N: There is no data available for the drug under this category 

Pharmacology:

fosphenytoin is a prodrug of phenytoin, meaning that it is metabolized in the body to produce phenytoin, which is the active form of the drug. The pharmacology of fosphenytoin and phenytoin is similar, but there are some differences in their pharmacokinetics, which may affect their clinical use. 

Pharmacodynamics: 

Mechanism of Action: Phenytoin works by stabilizing neuronal membranes and reducing the spread of abnormal electrical activity in the brain, which can cause seizures. It appears to work by blocking voltage-dependent sodium channels in the neurons, thereby reducing the influx of sodium ions and stabilizing the neuronal membrane. 

Pharmacokinetics: 

Absorption 

fosphenytoin exhibits complete bioavailability when administered via intramuscular injection. Maximum plasma concentration is achieved at the end of the infusion when given through intravenous route. When administered intramuscularly, the plasma concentration is lower, but the effect is more sustained than intravenous due to the time required for absorption of fosphenytoin from the injection site. Peak plasma concentration is reached approximately 30 minutes after the intramuscular administration. 

Distribution 

The human plasma proteins, primarily albumin, bind protein at a rate of approximately 95-99%, while the volume of distribution is between 4.3-10.8 L. 

Metabolism 

Upon administration, fosphenytoin undergoes rapid hydrolysis, converting it to phenytoin. Phenytoin is metabolized in the liver and gives rise to various metabolites. 

Elimination and Excretion 

The half-life of fosphenytoin, resulting from its conversion to phenytoin, is approximately 15 minutes. fosphenytoin or its metabolites are not excreted in the urine. 

Administration: 

IV/IM administration 

fosphenytoin is usually administered by injection into a vein (intravenously), although it can also be given by intramuscular injection in certain situations. Here are some general guidelines for the administration of fosphenytoin: 

  • fosphenytoin should be given slowly, over a period of at least 30 minutes, to minimize the risk of cardiovascular adverse reactions. Rapid administration can cause severe hypotension and arrhythmias. 
  • The dose of fosphenytoin is based on the patient’s weight and the indication for treatment. The maximum recommended loading dose is 20 mg phenytoin equivalents per kilogram of body weight. 
  • fosphenytoin should be administered with caution in patients with cardiac disease or those who are receiving other medications that can affect cardiac function. 
  • fosphenytoin should not be mixed with other medications or solutions, as this can cause precipitation or inactivation of the drug. 
  • fosphenytoin should be stored at room temperature and protected from light. 
  • When administering fosphenytoin intravenously, it is important to use a large bore needle or catheter to minimize the risk of tissue irritation or necrosis. 
  • During and after administration patients should be monitored closely for signs of adverse reactions, such as hypotension, arrhythmias or hypersensitivity reactions. 

Patient information leaflet 

Generic Name: fosphenytoin 

Pronounced: [ fos-FEN-i-toyn ] 

Why do we use fosphenytoin? 

fosphenytoin is a medication used for the prevention and treatment of seizures in patients with epilepsy or other neurological disorders. Here are some specific uses of fosphenytoin: 

  • Status epilepticus: fosphenytoin can be used in the emergency treatment of status epilepticus, which is a medical emergency characterized by prolonged or repeated seizures. 
  • Prophylaxis of seizures: fosphenytoin can be used to prevent seizures before and after neurosurgery, during diagnostic procedures involving the brain, or in other situations where seizure activity is anticipated. 
  • Substitution for phenytoin: fosphenytoin can be used as a substitute for phenytoin when oral administration is not possible, such as in patients with swallowing difficulties or gastrointestinal dysfunction. 
  • Convulsive status epilepticus in children: fosphenytoin can be used to treat convulsive status epilepticus in children when other treatments have failed or are not feasible. 
  • Acute treatment of seizures: fosphenytoin can be used for the acute treatment of seizures, especially in patients who cannot tolerate phenytoin. 

fosphenytoin

Brand Name :

Sesquient, Cerebyx

Synonyms :

fosphenytoin

Class :

Anticonvulsants, Hydantoins




No data available for drug.

Dosage forms & Strengths 

IM/IV dose 

Sesquient, Cerebyx 

500mg PE/10mL 

100mg PE/2mL 

Dosage forms & Strengths 

IM/IV dose 

Sesquient ,Cerebyx 

500mg PE/10mL 

100mg PE/2mL 

Refer to adult dosing 

DRUG INTERACTION

fosphenytoin

&

  • Nordazepam
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  • barley grass
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  • amylamine
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  • racecadotril
  • neomycin/chlorhexidine
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  • heparinoid
  • jewelweed
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  • cynanchum vincetoxicum root and sulfur
  • boditrectinib
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  • abuta
  • fadogia agrestis
  • fly agaric mushroom
  • meptazinol
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  • tramadol/dexketoprofen
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  • senna+ ispaghula
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  • pine bark extract
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  • niclosamide
  • pyrvinium
  • pipenzolate methylbromide/phenobarbitone
  • piracetam/ginkgo biloba/vinpocetine
  • benzyl benzoate/disulfiram
  • benzyl benzoate
  • loperamide/simethicone
  • piroctone olamine
  • sodium fusidate
  • piroxicam topical/capsaicin/menthol/methyl salicylate
  • sodium metabisulfite
  • sodium lauryl sulfate
  • taspoglutide
  • glyclopyramide
  • tolnaftate, gentamicin, iodochlorohydroxyquinoline, chlorocresol, betamethasone valerate
  • serratiopeptidase
  • sodium antimony gluconate
  • triamterene / benzthiazide
  • tribenoside / lidocaine
  • triclocarban
  • triprolidine/dextromethorphan  
  • vitamins/minerals/omega-3 Fatty acids
  • soyabean oil
  • sucralfate/oxethazaine
  • sucralfate/tinidazole/povidone iodine
  • sodium cromoglycate
  • aloe vera/liquid paraffin/white soft paraffin
  • aloe vera/jojoba oil/vitamin E
  • allantoin/triclosan/vitamin e/zinc oxide
  • alpha-Lipoic acid/minerals/multivitamins
  • alprazolam/paracetamol
  • alprazolam/melatonin
  • azithromycin/ambroxol
  • atorvastatin/clopidogrel/aspirin
  • aceclofenac, paracetamol and serratiopeptidase
  • alfacalcidol, vitamin B-complex, minerals and antioxidants
  • alpha- lipoic acid, vitamin b complex and vitamin c
  • alpha-galactosidase and simethicone
  • alpha-galactosidase, amylase, proteases, lipase and lactase
  • amikacin and cefepime
  • aminophylline, ephedrine and phenobarbitone
  • artesunate, sulphadoxine and pyrimethamine
  • finasteride/tamsulosin
  • flavoxate/ofloxacin
  • fenofibrate/metformin
  • lignocaine, hydrocortisone topical and allantoin
  • linoleic acid and sodium lactate
  • troxerutin
  • meclizine/nicotinic acid
  • mecobalamin/ginkgo Biloba
  • spirulina
  • loperamide and furazolidone
  • ketoconazole/cetrimide
  • ketoconazole/zinc pyrithione
  • lercanidipine/atenolol
  • levocetirizine/montelukast/ambroxol
  • levarterenol
  • levocetirizine/phenylpropanolamine 
  • indapamide/amlodipine
  • itopride/methyl polysiloxane
  • mebendazole/levamisole
  • eberconazole/mometasone
  • gliclazide/metformin/pioglitazone
  • fluconazole/tinidazole
  • haemocoagulase
  • halometasone
  • hesperidin
  • imipramine/chlordiazepoxide
  • idebenone / l-arginine / zinc sulphate/selenium/proanthocyanidin
  • mecobalamin and piracetam
  • mesterolone
  • mosapride and pantoprazole
  • atorvastatin, co enzyme q10, vitamin e, zinc, and selenium
  • azithromycin and benzalkonium chloride
  • beta carotene, vitamin c, vitamin e, minerals, lutein, eicosapentaenoic acid, docosahexenoic acid and vit b12
  • alpha-galactosidase
  • aloe vera gel/vitamin e/lactic acid
  • aloe vera gel/jojoba/vitamin e/glycerine
  • famotidine and domperidone
  • faropenem medoxomil
  • nedosiran
  • fluconazole/ornidazole/azithromycin
  • ebastine/montelukast
  • eberconazole
  • dienogest/estradiol valerate
  • ambroxol/salbutamol
  • benzoic acid/salicylic acid/ichthammol/ triamcinolone acetonide
  • desloratadine/ambroxol
  • dexibuprofen/paracetamol
  • atorvastatin/ramipril
  • diastase
  • diastase and simethicone
  • diazepam and propranolol
  • dexrabeprazole / domperidone
  • dexrabeprazole
  • dexketoprofen /paracetamol
  • beta carotene/vitamin C/minerals
  • aloe vera gel/urea
  • aloe vera gel/glycerine
  • alpha-lipoic acid/benfotiamine/chromium/folic acid/mecobalamin / vit b6
  • alprazolam/propranolol
  • alprazolam /sertraline
  • ibuprofen/dextropropoxyphene
  • ambroxol/cetirizine/phenylephrine/ guaiphenesin/menthol
  • dextropropoxyphene/dexchlorpheniramine maleate/bromhexine
  • promegestone
  • batroxobin
  • bencyclane
  • benfluorex
  • acetylpheneturide
  • abarelix
  • abetimus
  • naftidrofuryl
  • nalorphine
  • oxiracetam
  • letosteine
  • lafutidine
  • leuprorelin
  • levodropropizine
  • glutaral
  • losartan/ramipril
  • gallopamil
  • lanatoside c
  • lauromacrogol
  • gestodene
  • aceclofenac/methyl salicylate/menthol/linseed oil/capsaicin
  • aceclofenac/paracetamol/tizanidine
  • alginic acid/magaldrate/simethicone
  • aceclofenac/paracetamol
  • aceclofenac/rabeprazole
  • alginic acid
  • pantoprazole and domperidone
  • urokinase
  • rimiterol
  • olanzapine/fluoxetine
  • normethadone/hydroxyephedrine
  • myrtol
  • moxonidine
  • propylhexedrine
  • sodium hypochlorite solution
  • sodium chloride/sodium citrate
  • Hepatitis B Vaccine (Recombinant [Adjuvanted])
  • Hepatitis B Vaccine (Recombinant)
  • aceclofenac and serratiopeptidase
  • levosulpiride
  • niaprazine
  • tromantadine
  • trimetazidine
  • vinburnine
  • mizoribine
  • molgramostim
  • mosapride
  • eugenol
  • tolperisone
  • etamsylate
  • etynodiol
  • mizolastine
  • metenolone
  • reproterol
  • rebamipide
  • mephenoxalone
  • metandienone
  • furosemide/spironolactone
  • hydroxycarbamide
  • tenonitrozole
  • fenoverine
  • fenquizone
  • tiapride
  • tibolone
  • furazolidone
  • furosemide & amiloride
  • fosfestrol
  • fluclorolone
  • flubendazole
  • tertatolol
  • tetracosactide
  • tetryzoline
  • tolciclate
  • trapidil
  • troxipide
  • temoporfin
  • telbivudine
  • teprenone
  • hexamidine
  • mebhydrolin
  • mepartricin
  • fencamfamin
  • medazepam
  • theodrenaline
  • thiamazole
  • thiocolchicoside
  • psilocybin
  • veralipride
  • pyritinol
  • opipramol
  • oprelvekin
  • betamethasone + gentamicin
  • betamethasone + neomycin
  • betamethasone + salicylic acid
  • oxedrine
  • bopindolol
  • orgotein (investigational)
  • oxaceprol
  • ormeloxifene
  • bevantolol
  • bifemelane
  • clebopride
  • demoxytocin
  • cicletanine
  • cefsulodin
  • chlortalidon
  • sisomicin
  • somatrem
  • carbazochrome
  • caroverine
  • cathine
  • ipriflavone
  • isepamicin
  • silymarin
  • simethicone
  • sermorelin
  • diloxanide
  • dimethindene
  • diosmin/hesperidin
  • calamine
  • canrenone
  • captodiame
  • imidapril
  • cefetamet
  • cefodizime
  • cefoperazone + sulbactam
  • ivermectin + albendazole
  • serrapeptase
  • bromisoval
  • beraprost
  • pridinol
  • proglumide
  • bamipine
  • barnidipine
  • bamifylline
  • benzbromarone
  • betamethasone/fusidic acid
  • para-chlorophenol
  • pantethine
  • nomifensine
  • pemoline
  • parnaparin
  • pentolinium
  • nialamide
  • novobiocin
  • nicergoline
  • octocrylene
  • octisalate
  • oftasceine
  • oxolamine
  • oxyphencyclimine
  • penfluridol
  • pentoxyverine
  • phenoxymethylpenicillin
  • picloxydine
  • pilsicainide hydrochloride
  • piperazine
  • pirarubicin
  • policresulen
  • prifinium bromide
  • prethcamide
  • pristinamycin
  • pirenzepine
  • piribedil
  • pimethixene
  • pargyline
  • phosphatidyl choline
  • phthalylsulfathiazole
  • phytomenadione
  • pranlukast
  • pinazepam
  • oxyphenonium
  • noxytiolin
  • periciazine
  • pethidine
  • phenindamine
  • histidine
  • isoleucine
  • proline
  • lauric acid
  • lymecycline
  • hypromellose
  • abiraterone acetate and niraparib
  • ichthammol
  • levamisole
  • naftazone
  • nefopam
  • oxprenolol
  • oxybuprocaine
  • elranatamab-bcmm
  • lapyrium
  • isoaminile
  • iotrolan
  • mazindol
  • masoprocol
  • lypressin
  • meradimate
  • molsidomine
  • monobenzone
  • mequinol/gluconolactone/ lactobionic acid/ arbutin
  • medifoxamine
  • mebutamate
  • metergoline
  • methantheline
  • methdilazine
  • metocurine
  • micronomicin
  • metaraminol
  • mephenesin
  • menadione
  • medrysone
  • metixene
  • levobetaxolol
  • guaiacol glycerol ether
  • eucalyptol
  • sodium tetradecyl sulfate
  • sugammadex
  • carbetocin
  • certoparin
  • chlorcyclizine/pseudoephedrine
  • cephapirin
  • indecainide
  • iobitridol
  • iomeprol
  • chlorphenesin
  • msud analog
  • msud maxamum
  • iceland moss
  • glutethimide
  • hexachlorophene
  • haloprogin
  • deferoxamine
  • ethchlorvynol
  • dexpanthenol topical
  • etilefrine
  • deslanoside
  • carbocromen
  • diazolidinylurea
  • dibenzepin
  • etofamide
  • guanoxan
  • halazepam
  • guanadrel sulfate
  • dapiprazole
  • soapwort
  • debrisoquine
  • l-tryptophan
  • chlormerodrin
  • chlorquinaldol
  • cetrimonium
  • carbocisteine
  • chlorcyclizine/codeine
  • technetium Tc-99m tetrofosmin
  • technetium Tc-99m disofenin
  • technetium Tc-99m gluceptate
  • technetium Tc-99m labeled red blood cells
  • amylmetacresol/dextromethorphan hydrobromide
  • anileridine phosphate
  • pyrethrins
  • pyrantel pamoate
  • quinagolide
  • spiramycin
  • standard hyperkalemic cardioplegia solution
  • technetium tc-99m mertiatide
  • technetium tc-99m medronate
  • bemotrizinol / bisoctrizole
  • benfotiamine
  • bemotrizinol + titanium dioxide + zinc oxide
  • technetium Tc-99m oxidronate
  • technetium Tc-99m pentetate
  • technetium Tc-99m pyrophosphate
  • benziodarone
  • octinoxate/bisoctrizole
  • bicisate dihydrochloride
  • technetium Tc-99m bicisate
  • norelgestromin/ethinyl estradiol
  • norgestimate/ethinyl estradiol
  • ximelagatran (investigational)
  • xamoterol
  • trioxsalen
  • poly-urea urethane
  • rilmenidine
  • pemirolast
  • oxitriptan
  • beclomethasone, intranasal
  • thimerosal
  • camphor gel
  • camphor
  • mumps virus vaccine, live
  • rubella virus vaccine, live
  • aluminum chloride (dental)
  • alum irrigation
  • framycetin, phenylephrine, and gramicidin
  • ombitasvir, paritaprevir, ritonavir, and dasabuvir
  • olipudase alfa
  • etonogestrel/ethinyl estradiol
  • mycophenolate
  • fluoroestradiol F 18
  • donor organ cardioplegia solution
  • fluciclovine F 18
  • fusidic acid (ophthalmic)
  • fusidic acid and hydrocortisone
  • framycetin, dexamethasone, and gramicidin
  • fludeoxyglucose F-18
  • fluorouracil/salicylic acid
  • indium In-111 oxyquinoline
  • indium In-111 pentetreotide
  • indium In-111 capromab pendetide
  • lusutrombopag
  • mitomycin (ophthalmic)
  • mifepristone and misoprostol
  • minoxidil (systemic)
  • methyl aminolevulinate (topical)
  • methyl folate, methylcobalamin, and acetylcysteine
  • ciclesonide/formoterol/tiotropium
  • nedocromil (Oral Inhalation)
  • batefenterol (Investigational)
  • neostigmine and glycopyrrolate
  • nepafenac ophthalmic
  • netupitant/palonosetron
  • meperidine and promethazine
  • mepivacaine and levonordefrin
  • maltodextrin
  • medical cannabis
  • medium chain triglycerides
  • mometasone/glycopyrrolate (glycopyrronium)/ indacaterol
  • moxifloxacin ophthalmic
  • neomycin/fluocinolone
  • nadroparin
  • iodine I-125 iothalamate
  • amikacin liposome (oral inhalation)
  • bupivacaine liposome
  • natamycin
  • lopinavir and ritonavir
  • lysine
  • macitentan and tadalafil
  • mitomycin pyelocalyceal
  • moclobemide
  • mometasone and indacaterol
  • efinaconazole
  • blue-green algae
  • indocyanine green
  • follitropin beta
  • lumasiran
  • glycerin/lidocaine
  • edrophonium/atropine
  • indigo carmine
  • lutropin alfa
  • instant glucose/intravenous dextrose
  • iobenguane I-123
  • ixekizumab
  • isosulfan blue dye
  • levofloxacin ophthalmic
  • levonorgestrel oral/ferrous bisglycinate/ ethinylestradiol
  • ethinyl estradiol/levonorgestrel transdermal
  • hydroquinone
  • hydroxypropyl methylcellulose
  • icodextrin
  • lipid emulsion (soybean, medium-chain triglyceride, olive, and fish oils; [SMOF])
  • iodinated I 125 albumin
  • iodinated I 131 albumin
  • lipid emulsion (plant oil-based)
  • levonorgestrel intrauterine
  • levonorgestrel/ethinyl estradiol
  • lactic acid and sodium-PCA
  • lactated Ringer solution
  • ketotifen (systemic)
  • lanolin
  • leuprolide and norethindrone
  • levodopa and benserazide
  • gonadorelin acetate
  • hemodialysis solutions
  • nirsevimab
  • gentian violet
  • gallium ga-68 dotatate
  • fusidic acid and betamethasone
  • gallium citrate Ga-67
  • gadopentetate dimeglumine
  • gadofosveset
  • follitropin delta
  • follitropin alfa and lutropin alfa
  • follitropin alfa
  • rocatinlimab
  • grass pollens allergen extract
  • flotufolastat F18
  • fluorescein ophthalmic
  • barium
  • balanced salt solution
  • air polymer type A intrauterine device
  • clodronate
  • bentoquatam
  • clobetasone
  • alfacalcidol
  • citric acid/glucono-delta-lactone/magnesium carbonate
  • benzoin
  • desirudin
  • immune globulin IV (IGIV)
  • dequalinium
  • pseudoephedrine/desloratadine
  • clofedanol
  • cyproterone and ethinyl estradiol
  • dextranomer and hyaluronic acid or derivatives
  • diatrizoate meglumine and diatrizoate sodium
  • glucosamine sulfate, chondroitin sulfate and Msm
  • squill
  • gotu kola
  • blessed thistle
  • bitter melon
  • apraclonidine
  • chlophedianol/dexbrompheniramine/pseudoephedrine
  • wild jujube
  • chitosan
  • cilazapril/hydrochlorothiazide
  • dexbrompheniramine and phenylephrine
  • diethylene triamine penta-acetic acid
  • dexchlorpheniramine and pseudoephedrine
  • lily of the valley
  • diflucortolone
  • corydalis
  • lemon balm
  • MSM
  • calcium polystyrene sulfonate
  • caprylidene
  • peppermint oil
  • efavirenz/lamivudine/tenofovir DF
  • emtricitabine/tenofovir DF /efavirenz
  • dutasteride/tamsulosin
  • milk thistle
  • centaury
  • horseweed
  • lycopus
  • agrimony
  • alfalfa
  • kava
  • cetrorelix
  • cetylpyridinium
  • chlophedianol and dexbrompheniramine
  • betahistine
  • choline C-11
  • boric acid vaginal suppository
  • aluminum acetate
  • aluminum chloride hexahydrate
  • 14-C urea breath test
  • absorbable collagen
  • valoctocogene roxaparvovec-rvox
  • amlodipine and celecoxib
  • aspirin and omeprazole
  • azilsartan and chlorthalidone
  • landiolol (Pending FDA approval)
  • isosorbide dinitrate/hydralazine
  • losartan/hydrochorothiazide
  • udenafil
  • dextromethorphan/quinidine
  • onasemnogene abeparvovec
  • orphenadrine/aspirin/caffeine
  • trace elements
  • sodium phenylbutyrate/ taurursodiol
  • fish oil triglycerides
  • infant formula
  • glutamine
  • chloroquine phosphate
  • afatinib
  • quinidine gluconate
  • methylergonovine
  • prothrombin complex concentrate, human
  • BCG intravesical live
  • capivasertib
  • cedazuridine
  • carbonyl iron
  • iron dextran complex
  • lovotibeglogene autotemcel (FDA Approval Pending)
  • sodium benzoate/sodium phenylacetate
  • mineral oil otic
  • zolmitriptan transdermal
  • midazolam intranasal
  • fosinopril/hydrochlorothiazide
  • caplacizumab
  • arginine
  • sodium phenylbutyrate
  • meloxicam/rizatriptan
  • manganese
  • acetaminophen/pamabrom/pyridoxine
  • varicella zoster immune globulin, human
  • amitriptyline/perphenazine
  • narsoplimab (Pending FDA Approval)
  • amlodipine/perindopril
  • imiglucerase
  • canagliflozin/metformin
  • tafamidis meglumine
  • somatrogon-ghla
  • glimepiride/rosiglitazone
  • becaplermin
  • lithium
  • loxapine inhaled
  • nicotine transdermal
  • tixagevimab and cilgavimab (Investigational)
  • muromonab CD3
  • ansuvimab
  • coal tar bath products
  • fibrin sealant
  • arimoclomol (FDA Approval Pending)
  • varenicline intranasal
  • aducanumab
  • oxycodone/naloxone
  • ritlecitinib
  • sodium polystyrene sulfonate
  • calcipotriene/betamethasone
  • calcium hydroxylapatite
  • cantharidin topical
  • doxepin cream
  • clocortolone
  • formaldehyde topical
  • sodium sulfide topical
  • collagenase
  • selegiline transdermal
  • foscarbidopa/foslevodopa (FDA approval pending)
  • saxagliptin/metformin
  • linagliptin/metformin
  • linzagolix (FDA approval pending)
  • efgartigimod/hyaluronidase SC
  • elamipretide (Pending FDA approval)
  • rozanolixizumab
  • diazoxide
  • glimepiride/pioglitazone
  • cipaglucosidase alfa
  • dihydroergotamine intranasal
  • delandistrogene moxeparvovec
  • beremagene geperpavec
  • hyaluronic acid and derivatives
  • hyaluronic acid, non-animal stabilized
  • eplontersen (FDA Approval Pending)
  • nitric oxide gas
  • sodium phenylbutyrate and taurursodiol
  • treprostinil SC
  • viltolarsen
  • albuterol/ipratropium
  • budesonide inhaled
  • budesonide rectal
  • palovarotene
  • sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol
  • amino acids mixture
  • aminobenzoate potassium
  • elivaldogene autotemcel
  • naproxen and sumatriptan
  • sumatriptan intranasal
  • alglucerase
  • metformin/rosiglitazone
  • ertugliflozin/metformin
  • elosulfase alfa
  • calcium carbonate/magnesium hydroxide
  • starch suppository
  • abicipar pegol (FDA Approval Pending)
  • riboflavin 5′-phosphate ophthalmic
  • povidone ophthalmic
  • glycerin oropharyngeal
  • dimethicone topical
  • menthol topical, dimethicone topical
  • pramoxine topical, menthol topical and dimethicone topical
  • phosphorated carbohydrate
  • brilliant blue G ophthalmic
  • brolucizumab intravitreal
  • purified water, ophthalmic
  • hydroxyethyl cellulose ophthalmic
  • ranibizumab intravitreal implant
  • sodium chloride hypertonic, ophthalmic 
  • cetirizine ophthalmic
  • phentolamine ophthalmic
  • ganciclovir ophthalmic
  • triamcinolone intravitreal
  • ocriplasmin intravitreal
  • atoltivimab/maftivimab/odesivimab
  • pegcetacoplan intravitreal
  • triamcinolone acetonide extended-release injectable suspension
  • tobramycin/loteprednol ophthalmic
  • 2-octyl cyanoacrylate
  • vitamins A & D topical
  • diphenhydramine/allantoin topical
  • pyrethrins/piperonyl butoxide
  • lodoxamide ophthalmic
  • obeticholic acid
  • fluocinolone intravitreal implant
  • sincalide
  • linaclotide
  • nedocromil ophthalmic
  • cysteamine ophthalmic
  • avacincaptad pegol intravitreal
  • azelastine ophthalmic
  • bacitracin ophthalmic
  • propylene glycol ophthalmic
  • rimexolone ophthalmic
  • metoclopramide intranasal
  • mirikizumab
  • netarsudil ophthalmic
  • cenegermin
  • dexamethasone ophthalmic insert
  • prednisolone ophthalmic
  • phenylephrine and cocoa butter rectal
  • phenylephrine and witch hazel topical
  • phenylephrine, pramoxine, glycerin and petrolatum rectal
  • bisacodyl rectal
  • aluminum hydroxide/magnesium carbonate
  • aluminum hydroxide/magnesium hydroxide
  • hyoscyamine spray
  • methenamine/methylene blue/ hyoscyamine/ sodium phosphate monobasic/ phenyl salicylate
  • phenylephrine
  • chlorophyll
  • castor oil
  • cholic acid
  • phenol oropharyngeal
  • articaine/epinephrine
  • antithymocyte globulin equine
  • aluminum hydroxide/magnesium trisilicate
  • methenamine/hyoscyamine
  • hydrocortisone topical/pramoxine topical 
  • sodium fluoride topical
  • mesna
  • C1 esterase inhibitor recombinant
  • menthol and pectin
  • menthol oropharyngeal
  • pectin oropharyngeal
  • gepirone
  • Goldenseal
  • polyethylene glycol and electrolytes
  • polyethylene glycol/electrolytes/sodium ascorbate/ascorbic acid
  • brompheniramine/pseudoephedrine/dextromethorphan
  • brompheniramine phenylephrine
  • acetaminophen/doxylamine/phenylephrine
  • doxylamine/acetaminophen/pseudoephedrine/dextromethorphan
  • acetaminophen/doxylamine/dextromethorphan
  • acetaminophen/doxylamine/dextromethorphan/phenylephrine
  • eslicarbazepine
  • fluticasone and salmeterol
  • codeine, acetaminophen, butalbital and caffeine
  • codeine, chlorpheniramine and phenylephrine
  • iodine
  • povidone iodine
  • butalbital/aspirin/caffeine/codeine
  • polyethylene glycol 400/propylene glycol ophthalmic 
  • pegvaliase
  • amivantamab
  • iopamidol
  • codeine and pseudoephedrine
  • emtricitabine, rilpivirine, tenofovir DF
  • penicillin G aqueous
  • miconazole topical
  • miconazole vaginal
  • ciprofloxacin inhaled (Pending FDA approval)
  • ceftazidime/avibactam
  • ceftolozane/​tazobactam
  • aztreonam inhalation
  • amphotericin B cholesteryl sulfate
  • miconazole oral
  • elvitegravir/cobicistat/emtricitabine/tenofovir DF
  • isavuconazonium sulfate
  • dapivirine intravaginal (FDA Approval Pending)
  • lamivudine/raltegravir
  • codeine/triprolidine/pseudoephedrine
  • cadexomer iodine
  • brompheniramine/pseudoephedrine
  • codeine/acetaminophen
  • codeine/guaifenesin
  • beclomethasone inhaled
  • epoetin beta/methoxy polyethylene glycol
  • voreloxin(Orphan Drug)
  • rociletinib
  • pitcher plant
  • phosphatidylserine
  • telotristat ethyl
  • copper CU 64 dotatate
  • urea topical
  • exenatide subdermal implant
  • asenapine transdermal
  • ethiodized oil
  • urea oral
  • miglustat
  • acalisib(Investigational)
  • acetophenazine
  • guggul
  • aceneuramic acid
  • mestranol/norethindrone
  • reishi
  • lactitol
  • vonoprazan fumarate
  • motherwort
  • silver nitrate
  • salicylic acid/sulfur shampoo
  • salicylic acid topical
  • ketorolac ophthalmic
  • ketoconazole topical
  • Japanese encephalitis virus vaccine
  • dibucaine topical ointment
  • ketorolac intranasal
  • ketorolac/phenylephrine ophthalmic
  • rotavirus oral vaccine, live
  • guarana
  • hops
  • krill oil
  • salicylic acid/coal tar shampoo
  • sufentanil SL
  • pancrelipase
  • passion flower
  • pepdite one plus
  • nivolumab and relatlimab
  • relatlimab (Pending FDA Approval)
  • benzalkonium chloride/benzocaine
  • ketotifen, drug-eluting contact lens
  • calcitriol topical
  • oxymetazoline topical
  • alclometasone topical
  • capsaicin topical
  • diclofenac/misoprostol
  • diclofenac ophthalmic
  • diclofenac topical
  • pramoxine/calamine topical
  • veverimer
  • tolazoline
  • olopatadine ophthalmic
  • lutetium lu 177-dota-tate
  • lutetium lu 177 vipivotide tetraxetan
  • strontium 89 chloride
  • interferon alfa n3
  • lutetium Lu 177- Diethylenetriamine Pentaacetic acid-omburtamab (FDA Approval Pending)
  • samarium sm 153 lexidronam
  • cytomegalovirus immune globulin (CMV IG)
  • antithymocyte globulin rabbit
  • inolimomab (Pending FDA Approval)
  • olopatadine intranasal
  • olopatadine intranasal/​mometasone, intranasal
  • benzocaine/butamben/tetracaine topical
  • antipyrine/benzocaine/phenylephrine
  • dyclonine/menthol
  • surufatinib
  • fruquintinib
  • tepotinib 
  • dostarlimab
  • hepatitis B immune globulin (HBIG)
  • remestemcel-L
  • benzocaine/menthol oropharyngeal
  • interferon beta 1b
  • tetracaine/oxymetazoline intranasal
  • benzocaine oropharyngeal
  • benzalkonium chloride/menthol/petrolatum topical
  • inamrinone
  • alpha 1 proteinase inhibitor
  • potassium bicarbonate/potassium citrate
  • potassium phosphate/sodium acid phosphate
  • asparaginase Erwinia chrysanthemi recombinant
  • motixafortide
  • pegloticase
  • etesevimab
  • Rho(D) immune globulin
  • tetanus immune globulin (TIG)
  • reltecimod (pending FDA approval)
  • avasopasem
  • trimethoprim/polymyxin B ophthalmic
  • naphazoline ophthalmic
  • sulfacetamide topical
  • sirolimus intravitreal (pending FDA approval)
  • sirolimus protein bound
  • sirolimus topical
  • glycopyrronium tosylate topical
  • sofpironium
  • olmesartan, amlodipine and hydrochlorothiazide
  • dovitinib (Pending FDA Approval)
  • epinephrine inhaled
  • quizartinib (Pending FDA Approval)
  • ranibizumab intravitreal injection
  • sodium hyaluronate
  • bacitracin and lidocaine topical
  • brimonidine topical
  • benzoyl peroxide and tretinoin topical
  • talquetamab
  • betrixaban
  • acetaminophen/caffeine/pyrilamine
  • fentanyl transmucosal
  • bacitracin topical
  • buprenorphine,long-acting injection
  • buprenorphine buccal
  • nalmefene intranasal
  • sulbactam/durlobactam
  • metronidazole topical 
  • daratumumab/hyaluronidase
  • glofitamab
  • rituximab-hyaluronidase
  • drospirenone/ethinyl estradiol/levomefolate
  • loncastuximab tesirine
  • ingenol mebutate topical
  • momelotinib
  • trastuzumab/deruxtecan
  • trastuzumab/hyaluronidase
  • trastuzumab duocarmazine
  • lifileucel
  • umbralisib
  • eflornithine/sulindac
  • cytarabine/daunorubicin liposomal
  • doxorubicin liposomal
  • epcoritamab
  • lanadelumab  
  • esomeprazole/naproxen 
  • terbinafine topical
  • ravulizumab
  • clotrimazole topical
  • choline magnesium trisalicylate
  • tacrolimus ointment
  • mechlorethamine topical
  • donislecel
  • pozelimab (Pending FDA Approval)
  • human rabies immune globulin (HRIG)
  • melphalan flufenamide
  • sintilimab (Pending FDA Approval)
  • oportuzumab monatox (Pending FDA Approval)
  • sotorasib
  • irinotecan liposomal
  • sulfur topical
  • silver sulfadiazine
  • capsaicin transdermal
  • sutimlimab
  • tretinoin topical
  • acetaminophen rectal
  • menthol topical
  • naftifine
  • oatmeal, colloidal topical
  • oxiconazole
  • methylsalicylate/menthol topical
  • C1 inhibitor human
  • lifitegrast ophthalmic
  • prednisolone/sulfacetamide ophthalmic
  • mannitol inhalation
  • ofloxacin otic
  • petrolatum & mineral oil topical
  • clascoterone topical
  • gefapixant (Pending FDA Approval)
  • colesevelam
  • technetium Tc 99m succimer
  • nebivolol/valsartan
  • ciprofloxacin/fluocinolone acetonide, otic
  • finafloxacin otic
  • magnesium hydroxide/mineral oil
  • phenylephrine/mineral oil/petrolatum rectal
  • carbamide peroxide oral
  • atropine ophthalmic
  • sodium sulfacetamide/sulfur
  • sulfacetamide ophthalmic
  • lucinactant
  • benzonatate
  • besifloxacin ophthalmic
  • benzhydrocodone/acetaminophen
  • beractant
  • trimagnesium citrate anhydrous
  • vitamin b2
  • carbamide peroxide otic
  • mineral oil topical
  • ethyl alcohol intranasal
  • boric acid/alcohol otic
  • absorbable gelatin compressed sponge, USP
  • absorbable gelatin sponge, USP
  • vincristine liposomal
  • technetium Tc 99m albumin aggregated injection
  • metaproterenol
  • budesonide inhaled/formoterol/glycopyrrolate inhaled
  • epinephrine racemic
  • umeclidinium bromide/vilanterol inhaled
  • indacaterol, inhaled/glycopyrrolate inhaled
  • betaine  
  • laronidase 
  • estrogens esterified/methyltestosterone            
  • cerliponase alfa
  • ertugliflozin/sitagliptin
  • hawthorn
  • shepherd’s purse
  • thiamine
  • naphazoline/glycerin ophthalmic
  • oxymetazoline ophthalmic
  • dorzolamide
  • dexamethasone intraocular
  • dexamethasone/ciprofloxacin
  • dexamethasone ophthalmic
  • metipranolol ophthalmic
  • timolol ophthalmic
  • boron
  • fezolinetant
  • pegunigalsidase alfa-iwxj
  • biotin
  • pantothenic acid
  • silicon
  • sodium acid phosphate
  • hypochlorous acid topical
  • methenamine/sodium acid phosphate
  • aviptadil 
  • bremelanotide
  • glucagon intranasal
  • metformin and repaglinide
  • bai ji
  • pau d’arco
  • juzentaihoto
  • mistletoe
  • quercetin
  • rosemary
  • sheng di huang
  • chasteberry
  • maitake
  • grapefruit
  • lentinan
  • juniper
  • nettle
  • parsley
  • rose hips
  • tongkat ali
  • horny goat weed
  • damiana
  • yohimbe
  • insulin NPH
  • aprocitentan
  • noni Juice
  • sodium iodide I-131
  • green tea
  • sea cucumber
  • wheat germ extract
  • fenofibrate micronized 
  • rogisen
  • danshen
  • lutein
  • witch hazel
  • dextroamphetamine transdermal
  • amphetamine/dextroamphetamine
  • hoodia
  • kolanut
  • boswellia
  • opuntia ficus indica
  • lavender
  • nadh
  • tea tree oil
  • metformin/sitagliptin 
  • dapagliflozin/ metformin/saxagliptin  
  • antihemophilic factor recombinant
  • inclisiran
  • bempedoic acid/ezetimibe
  • volanesorsen  
  • omega 3 carboxylic acids
  • pericyazine
  • levomepromazine (methotrimeprazine)
  • betaxolol ophthalmic
  • respiratory syncytial virus vaccine, adjuvanted
  • phenylephrine hydrochloride and tropicamide ophthalmic
  • alirocumab
  • neomycin/polymyxin B/gramicidin ophthalmic
  • factor IX
  • gentamicin topical
  • ansofaxine (Pending FDA Approval)
  • zuranolone
  • factor IX, recombinant
  • factor IX complex
  • factor XIII A-subunit, recombinant
  • factor X, human
  • mesalamine rectal
  • etrasimod
  • anti-inhibitor coagulant complex
  • factor IX, recombinant/albumin fusion protein
  • fibrinogen, human
  • aminocaproic acid
  • metyrosine
  • nonoxynol-9 vaginal
  • progesterone intravaginal gel
  • ipecac syrup
  • botulinum antitoxin, heptavalent
  • pentetate calcium trisodium
  • crotalidae polyvalent immune FAB (ovine)
  • dehydrated alcohol injection 
  • gold sodium thiomalate (Discontinued)
  • lactic acid/citric acid/potassium bitartrate vaginal
  • von Willebrand factor, recombinant
  • luspatercept
  • digoxin immune FAB (Antidote)
  • crotalidae immune FAB (equine)
  • magnesium (Antidote)
  • pyridoxine (Antidote)
  • edetate calcium disodium
  • albumin IV
  • nitroglycerin sublingual
  • obiltoxaximab
  • anthrax immune globulin
  • nitroglycerin topical
  • dextrose
  • nesiritide
  • estradiol vaginal
  • bazedoxifene/conjugated estrogens
  • botulism immune globulin iv
  • amoxicillin/omeprazole/rifabutin
  • synthetic human angiotensin II
  • nitroglycerin IV
  • nitroglycerin translingual
  • nitroprusside sodium
  • tetrahydrozoline/zinc sulfate/hypromellose ophthalmic
  • sodium citrate/citric acid
  • pemetrexate
  • methicillin
  • plasminogen 
  • acai
  • american ginseng
  • cordyceps
  • tramadol/acetaminophen
  • belladonna alkaloids/phenobarbital
  • erythromycin topical/benzoyl peroxide
  • glucosamine sulfate
  • panax ginseng (suppl/herb)
  • tolnaftate
  • sulopenem etzadroxil/probenecid
  • sulfur hexafluoride
  • sotrovimab
  • arbaclofen
  • rifampin/isoniazid
  • clindamycin /tretinoin topical
  • benzoyl peroxide/clindamycin topical
  • apremilast
  • antivenins, centuroides (scorpion)
  • bamlanivimab and etesevimab
  • vilobelimab
  • gadobenate
  • pentosan polysulfate sodium
  • methylsalicylate/menthol/camphor topical
  • antivenin, black widow spider
  • benzoyl peroxide and hydrocortisone
  • clindamycin topical
  • isometheptene, dichloralphenazone and acetaminophen
  • acetaminophen and phenyltoloxamine
  • erythromycin topical
  • erythromycin ophthalmic
  • alpha hydroxy acids, topical
  • buprenorphine transdermal
  • butalbital/acetaminophen/caffeine
  • buprenorphine/samidorphan
  • buprenorphine subdermal implant
  • celecoxib/tramadol
  • drospirenone/ethinyl estradiol
  • resorcinol/sulfur
  • eflornithine
  • rifampin/isoniazid/pyrazinamide
  • tofersen
  • devil’s claw
  • ticarcillin/clavulanate
  • atropine/pralidoxime
  • aprepitant
  • suramin
  • phenelzine 
  • artichoke
  • american dogwood
  • attapulgite
  • atlantic cedar
  • axalimogene filolisbac
  • sodium thiosulfate & sodium nitrite
  • ataluren
  • omidubicel-onlv
  • capsicum
  • ginger
  • cryoprecipitate
  • bictegravir/emtricitabine/tenofovir DF
  • emtricitabine/tenofovir DF
  • fo-ti
  • siberian ginseng
  • granulocytes
  • zinc substituted heme C
  • zinc trihydroxide
  • ashwagandha 
  • cat’s claw
  • glandular products
  • SAMe
  • shark cartilage
  • altovis
  • feverfew
  • horse chestnut
  • magnesium aspartate
  • octacosanol
  • pleurisy root
  • star anise
  • butterbur
  • elderberry
  • licorice (Suppl/herb)
  • aconite
  • pentetate zinc trisodium
  • menthol topical/zinc oxide topical
  • corn-starch/kaolin/zinc oxide topical
  • 5-hydroxytryptophan (5-htp)
  • butcher’s broom
  • articulin
  • bearberry
  • goldenrod
  • progesterone, natural
  • black cohosh
  • wild yam
  • cranberry
  • dong quai
  • phytoestrogens
  • norethindrone
  • false Unicorn Root
  • raspberry Leaf
  • asafoetida
  • turmeric
  • dehydroepiandrosterone (DHEA)
  • hyaluronan
  • aliskiren/amlodipine
  • octreotide (Antidote)
  • tranexamic acid injection
  • duocal
  • neocate infant formula
  • pediatric Eo28
  • aloe
  • red clover
  • propolis
  • androstenedione
  • heartsease
  • comfrey
  • bilberry
  • chamomile
  • eyebright
  • calendula
  • sage
  • yucca
  • polypody
  • odevixibat
  • vinpocetine
  • olanzapine/samidorphan
  • creatine
  • yerba mate
  • spesolimab
  • azficel-T
  • tiludronate
  • estetrol and drospirenone
  • pseudoephedrine/fexofenadine
  • lincomycin
  • neomycin oral
  • fluocinolone acetonide, otic
  • tretinoin/ hydroquinone/ fluocinolone
  • halobetasol topical
  • hydrocortisone/​iodoquinol
  • penicillin G procaine /penicillin G benzathine
  • hydrocortisone probutate topical
  • colistin/neomycin/hydrocortisone/thonzonium otic
  • ebola zaire vaccine
  • hepatitis a/​b vaccine
  • vibegron
  • lindane
  • nystatin topical
  • respiratory syncytial virus (RSV) vaccine
  • chikungunya vaccine, live
  • tenecteplase
  • reteplase
  • anthrax vaccine adsorbed, adjuvanted
  • meningococcal ABCWY pentavalent vaccine
  • eculizumab
  • cholestyramine
  • tinzaparin
  • taurolidine/​citrate/​heparin
  • protein C concentrate
  • antithrombin alfa
  • antithrombin III
  • multivitamins, vision
  • ibuprofen/​chlorpheniramine/​pseudoephedrine
  • acetaminophen/ibuprofen
  • ibuprofen/pseudoephedrine
  • paclitaxel protein-bound
  • acetic acid vaginal
  • acetic acid otic
  • hydrocodone/ ibuprofen
  • methyl salicylate / isopropanol/ citronellyl acetate/ citric acid
  • ibuprofen and phenylephrine
  • acetylcysteine (Antidote)
  • iron/​folic acid/​vitamin/​mineral
  • iobenguane I-131
  • dolutegravir/rilpivirine
  • chlorhexidine topical
  • chlorhexidine oral
  • thyroid desiccated
  • proparacaine ophthalmic
  • podophyllum resin
  • phendimetrazine
  • phenoxybenzamine
  • polidocanol
  • phentermine and topiramate
  • piflufolastat F18
  • piperacillin/tazobactam
  • prednisolone and gentamicin ophthalmic
  • promethazine and codeine
  • poractant alfa
  • protamine sulfate
  • aflibercept intravitreal
  • prednicarbate
  • promethazine/dextromethorphan
  • codeine, phenylephrine, and promethazine
  • potassium phosphate
  • glatiramer acetate
  • gentamicin (Ophthalmic)
  • leniolisib
  • rezafungin
  • fluorometholone
  • dalfampridine
  • hydrocortisone topical 
  • empagliflozin and linagliptin
  • triamcinolone topical
  • minocycline topical
  • minocycline dental
  • ketotifen ophthalmic
  • darunavir and cobicistat
  • lidocaine topical
  • neomycin/polymyxin B/bacitracin/lidocaine (OTC)
  • lidocaine/ hydrocortisone
  • lidocaine anesthetic
  • lidocaine ophthalmic
  • lidocaine/tetracaine
  • desonide
  • dabigatran
  • fexofenadine
  • fluoride
  • decitabine and cedazuridine
  • dasiglucagon
  • hydroxypropyl cellulose ophthalmic
  • epoetin alfa
  • ibritumomab tiuxetan
  • trimethobenzamide
  • dexamethasone/ tobramycin
  • tafasitamab
  • valacyclovir
  • mebendazole
  • levoleucovorin
  • flaxseed
  • germanium
  • glutathione
  • lycopene
  • pygeum
  • horseradish
  • ziv-aflibercept
  • micafungin
  • trofinetide
  • taliglucerase alfa
  • tildrakizumab
  • sulopenem (Pending FDA Approval)
  • thyrotropin alfa
  • birch
  • thrombin, topical
  • tivozanib
  • tafluprost
  • methohexital
  • urea and hydrocortisone
  • unoprostone ophthalmic
  • trihexyphenidyl
  • ezetimibe
  • evolocumab
  • trifluridine and tipiracil
  • methenamine
  • misoprostol
  • miltefosine
  • rimantadine
  • maralixibat
  • coenzyme Q10
  • chlorella
  • garlic
  • forskolin
  • zavegepant
  • menotropins
  • margetuximab
  • meprobamate
  • melarsoprol
  • evening primrose oil
  • lemongrass
  • molindone
  • fenugreek
  • phytosterols
  • red yeast rice
  • uridine triacetate
  • tropicamide
  • incobotulinumtoxinA
  • Grape Seed Extract
  • carbachol ophthalmic
  • cosyntropin
  • cyclopentolate and phenylephrine
  • carteolol ophthalmic
  • pentazocine/naloxone
  • pentazocine/acetaminophen
  • casimersen
  • carisoprodol, aspirin, and codeine
  • carisoprodol
  • carboprost tromethamine
  • flurandrenolide
  • brinzolamide/brimonidine
  • betamethasone topical
  • omaveloxolone
  • bardoxolone
  • allogeneic processed thymus tissue
  • fluocinolone topical
  • tacrolimus topical
  • ruxolitinib topical
  • pimecrolimus topical
  • sofosbuvir, velpatasvir and voxilaprevir
  • sofosbuvir/velpatasvir
  • mitotane
  • elbasvir/​grazoprevir
  • wheat dextrin
  • vanadium
  • iron/folic acid/vitamin/mineral
  • molybdenum
  • sparsentan
  • velmanase alfa-tycv
  • pegcetacoplan
  • ferrous sulfate
  • cyclosporine ophthalmic
  • ferric pyrophosphate
  • ammonium lactate
  • etelcalcetide
  • iodoquinol
  • sucroferric oxyhydroxide
  • doxercalciferol
  • terconazole vaginal
  • cortisone
  • pyronaridine
  • tetrahydrozoline, ophthalmic
  • tenapanor
  • tesamorelin
  • benazepril/hydrochlorothiazide
  • nadolol and bendroflumethiazide
  • spironolactone and hydrochlorothiazide
  • COVID-19 Vaccine, mRNA
  • atosiban
  • bisoprolol and hydrochlorothiazide
  • ephedrine/guaifenesin
fosphenytoin + 

trimethoprim 

fosphenytoin: they may diminish the serum concentration of trimethoprim

canagliflozin 

fosphenytoin: they may diminish the serum concentration of canagliflozin

rilpivirine 

it decreases the concentration of rilpivirine in the serum

pemigatinib 

It may diminish the effect when combined with pemigatinib by affecting CYP3A4 metabolism

alpelisib

when both drugs are combined, there may be a decreased level of serum concentration of alpelisib   

romidepsin

when both drugs are combined, there may be a reduced level or effect of romidepsin by affecting hepatic or intestinal enzyme cyp3a4 metabolism  

ixazomib

fosphenytoin decreases the effect of ixazomib by altering intestinal/hepatic CYP3A4 enzyme metabolism

fedratinib

fosphenytoin decreases the effect of fedratinib by altering the intestinal/hepatic CYP3A4 enzyme metabolism

floxuridine

CYP2C9 inhibitors enhance the plasma concentration of fosphenytoin

edoxaban 

may increase the level of effectiveness through P-glycoprotein MDR1 efflux transporter

pancuronium

may decrease the neuromuscular-blocking effect when combined with neuromuscular-blocking agents

botulinum toxin

may decrease the neuromuscular-blocking effect when combined with neuromuscular-blocking agents

abobotulinumtoxinA

may decrease the neuromuscular-blocking effect when combined with neuromuscular-blocking agents

rimabotulinumtoxinB

may decrease the neuromuscular-blocking effect when combined with neuromuscular-blocking agents

daxibotulinumtoxinA

may decrease the neuromuscular-blocking effect when combined with neuromuscular-blocking agents

mipomersen 

It may enhance the toxicity when combined with mipomersen

potassium iodide

it decreases the concentration of thyroid products in serum

propylthiouracil

it decreases the concentration of thyroid products in serum

liotrix

it decreases the concentration of thyroid products in serum

potassium perchlorate

it decreases the concentration of thyroid products in serum

miconazole oral 

The miconazole (oral) has the potential to elevate the levels of fosphenytoin in the bloodstream

cannabidiol 

It may enhance the effect when combined with cannabidiol by affecting CYP3A4 metabolism

metformin 

It may diminish the effects when combined with metformin by pharmacodynamic antagonism

vitamin d 

It may diminish the effects when combined with vitamin D

fencamfamin 

The potential for CNS depression may enhanced when fosphenytoin is used together with fencamfamin

niaprazine 

When fosphenytoin is used together with niaprazine, the risk or seriousness of CNS depression is enhanced

levosulpiride 

When fosphenytoin is used together with levosulpiride, the risk or seriousness of CNS depression is enhanced

alprazolam 

When alprazolam and fosphenytoin is used together, this leads to reduction in the alprazolam’s metabolism

dexrabeprazole 

When dexrabeprazole and fosphenytoin is used together, this leads to reduction in the dexrabeprazole’s metabolism

maralixibat

fosphenytoin: they may enhance the serum concentration of CYP3A4 Inhibitors

lenacapavir

fosphenytoin: they may enhance the serum concentration of CYP3A4 Inhibitors

curcumin

fosphenytoin: they may enhance the serum concentration of CYP3A4 Inhibitors

glecaprevir

fosphenytoin: they may enhance the serum concentration of CYP3A4 Inhibitors

caspofungin

fosphenytoin: they may enhance the serum concentration of CYP3A4 Inhibitors

ridaforolimus 

When fosphenytoin is used together with ridaforolimus, this leads to enhanced concentration serum of fosphenytoin

calcipotriol 

the serum concentration of calcipotriol can be diminished when it is combined with fosphenytoin

tacalcitol 

the serum concentration of tacalcitol can be lessened when it is associated with fosphenytoin

carmustine

when both the drugs are combined, the serum concentration of fosphenytoin decreases    

methotrexate

the interaction may decrease the serum concentration of fosphenytoin by increasing the unbound protein metabolites. It also increases the serum concentration of methotrexate

brentuximab

is having an antagonistic impact over brentuximab vedotin, by showing altered intestinal/hepatic CYP3A4 enzyme metabolism.

cabazitaxel

increases serum level of cabazitaxel by affecting the enzyme CYP3A4

fluorouracil

the levels of fosphenytoin are increased by fluorouracil via an unknown mechanism

gefitinib

fosphenytoin decreases the effect of gefitinib by altering the intestinal/ hepatic CYP3A4 enzyme metabolism

lacosamide

may decrease the level by affecting the hepatic enzyme CYP3A4 metabolism

cefazolin 

may increase the serum concentration of cefazolin

albendazole 

It may diminish levels when combined with albendazole by enhancing metabolism

medroxyprogesterone

It may enhance the risk of adverse effects when combined with progesterone derivatives

medrogestone

It may enhance the risk of adverse effects when combined with progesterone derivatives

medroxyprogesterone acetate

It may enhance the risk of adverse effects when combined with progesterone derivatives

mefenamic acid

It may enhance the risk of adverse effects when combined with progesterone derivatives

nomegestrol

It may enhance the risk of adverse effects when combined with progesterone derivatives

lomitapide 

When fosphenytoin is used together with lomitapide, this leads to an enhancement in lomitapide’s metabolism

finasteride

it decreases the effect or level of finasteride by altering the intestinal/hepatic enzyme CYP3A4 metabolism

dutasteride

it decreases the effect or level of dutasteride by altering the intestinal/hepatic enzyme CYP3A4 metabolism

Actions and Spectrum: 

fosphenytoin is a prodrug of the anticonvulsant medication phenytoin. When administered, fosphenytoin is converted into phenytoin, which then acts on the brain to prevent seizures. 

The spectrum of action of fosphenytoin is quite broad, as it can be used to prevent and treat seizures of various types, including generalized tonic-clonic seizures, partial seizures, and status epilepticus.

Phenytoin works by stabilizing neuronal membranes and decreasing the activity of voltage-gated sodium channels in the brain, thereby reducing the abnormal electrical activity that leads to seizures. 

Frequency defined 

>10% 

IV, adults 

Nystagmus (44%) 

Dizziness (31%) 

Pruritus (49%) 

Ataxia (11%) 

Somnolence (20%) 

Adults and children 

General 

Injection-site reaction, Chills, Fever, Face edema, Injection-site pain, Infection 

Musculoskeletal 

Leg cramps, myalgia, arthralgia, myopathy 

Nervous  

Dysarthria, Intracranial hypertension, reflexes increased, thinking abnormal, Speech disorder, Nervousness. 

Skin 

Rash 

Respiratory 

Pneumonia 

Digestive 

Constipation 

Cardiovascular 

Hypertension 

IV, children and adolescents 

Nystagmus (18%) 

Vomiting (21%) 

IM 

Nystagmus (15%) 

1-10% 

IV, adults 

Pelvic pain (4%) 

Extrapyramidal syndrome (4%) 

Incoordination (4%) 

Dry mouth (4%) 

Tongue disorder (4%) 

Paresthesia (4%) 

Vasodilatation (6%) 

Hypotension (8%) 

Stupor (8%) 

Tinnitus (9%) 

Nausea (9%) 

Tremor (3%) 

Diplopia (3%) 

Taste perversion (3%) 

Agitation (3%) 

Dysarthria (2%) 

Hypesthesia (2%) 

Vomiting (2%) 

Brain edema (2%) 

Vertigo (2%) 

Asthenia (2%) 

Deafness (2%) 

Amblyopia (2%) 

Headache (2%) 

Back pain (2%) 

IV, children and adolescents 

Rash (5%) 

Somnolence (6%) 

Ataxia (10%) 

Nervousness (7%) 

Hypotension (5%) 

Pruritus (6%) 

Fever (8%) 

Adults and children 

General 

injection-site hemorrhage, sepsis, injection-site inflammation, photosensitivity reaction 

injection-site edema, malaise, generalized edema, shock, cachexia, flu syndrome, cryptococcosis. 

Nervous 

CNS depression, confusion, twitching, akathisia, positive Babinski sign, circumoral paresthesia, hemiplegia, hypotonia, convulsion, extrapyramidal syndrome, insomnia, meningitis, depersonalization, depression, hypokinesia, hyperkinesia, paralysis, psychosis, aphasia, emotional lability, coma, hyperesthesia, myoclonus, personality disorder, acute brain syndrome, encephalitis, subdural hematoma, encephalopathy, hostility, amnesia, and neurosis. 

Urogenital 

Urinary retention, oliguria, dysuria, genital edema, kidney failure, polyuria, urethral pain, urinary incontinence, albuminuria, vaginitis, and vaginal moniliasis 

Special senses 

Visual field defect, eye pain, conjunctivitis, photophobia, hyperacusis, mydriasis, ear pain, taste loss, and parosmia 

Skin 

Contact dermatitis, pustular rash,urticaria, maculopapular rash, skin discoloration 

skin nodule, sweating.  

IM 

Somnolence (7%) 

Reflexes decreased (3%) 

Ataxia (8%) 

Pruritus (3%) 

Dizziness (5%) 

Incoordination (8%) 

Paresthesia (4%) 

Headache (9%) 

Vomiting (3%) 

Asthenia (9%) 

Nausea (5%) 

Tremor (10%)

Black Box Warning: 

The black box warning for fosphenytoin is related to the risk of cardiovascular adverse reactions, including severe hypotension and arrhythmias, particularly when the drug is administered too rapidly or in excessive doses. 

The black box warning specifically cautions that fosphenytoin should be administered slowly and in a manner that allows for cardiac monitoring, especially in patients with a history of cardiovascular disease. It also warns that the drug should not be used to treat certain types of arrhythmias, such as atrial fibrillation or flutter. 

Contraindication/Caution: 

Contraindication 

  • Hypersensitivity: fosphenytoin should not be used in patients allergic to the drug or to phenytoin. 
  • Bradycardia: fosphenytoin can cause bradycardia, which is a slow heart rate. Therefore, it should not be used in patients with a history of bradycardia or other cardiac conduction abnormalities, unless they have a pacemaker in place. 
  • Heart block: fosphenytoin can worsen heart block, which is a condition where the electrical impulses that regulate the heartbeat are disrupted. Therefore, it should not be used in patients with second- or third-degree heart block. 
  • Porphyria: fosphenytoin can trigger an acute attack of porphyria, which is a rare genetic disorder that affects the production of heme, a component of hemoglobin. Therefore, it should not be used in patients with this condition. 
  • Preexisting hypotension: fosphenytoin can cause a drop in blood pressure, which can be dangerous in patients with preexisting hypotension. 

Caution 

  • Pregnancy and breastfeeding: fosphenytoin may be harmful to a developing fetus, so it should only be used in pregnant women if the potential benefits outweigh the risks. It may also be excreted in breast milk, so breastfeeding should be avoided while taking fosphenytoin. 
  • Liver disease: fosphenytoin is metabolized by the liver, caution in patients with liver disease, as they may be at increased risk of toxicity. 
  • Kidney disease: fosphenytoin is excreted by the kidneys, caution in patients with kidney disease, as they may be at increased risk of toxicity. 
  • Elderly patients: Elderly patients may be more susceptible to the side effects of fosphenytoin, such as dizziness, confusion, and sedation, so they should be monitored closely while taking the medication. 
  • Drug interactions: fosphenytoin may interact with other medications, such as oral contraceptives, warfarin, and corticosteroids, so healthcare professionals should review a patient’s medication history carefully before prescribing fosphenytoin. 
  • Seizure control: fosphenytoin is used to prevent and treat seizures, but it is important to monitor a patient’s seizure control while they are taking the medication, as it may require adjustments in dosing or other medications. 

Pregnancy consideration:  

US FDA pregnancy category: Not assigned. 

Lactation:   

Excreted into human milk is Not known.  

Pregnancy category: 

  • Category A: well-controlled and Satisfactory studies do not show risk to the fetus in the first/later trimester.       
  • Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women       
  • Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.     
  • Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.      
  • Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.      
  • Category N: There is no data available for the drug under this category 

Pharmacology:

fosphenytoin is a prodrug of phenytoin, meaning that it is metabolized in the body to produce phenytoin, which is the active form of the drug. The pharmacology of fosphenytoin and phenytoin is similar, but there are some differences in their pharmacokinetics, which may affect their clinical use. 

Pharmacodynamics: 

Mechanism of Action: Phenytoin works by stabilizing neuronal membranes and reducing the spread of abnormal electrical activity in the brain, which can cause seizures. It appears to work by blocking voltage-dependent sodium channels in the neurons, thereby reducing the influx of sodium ions and stabilizing the neuronal membrane. 

Pharmacokinetics: 

Absorption 

fosphenytoin exhibits complete bioavailability when administered via intramuscular injection. Maximum plasma concentration is achieved at the end of the infusion when given through intravenous route. When administered intramuscularly, the plasma concentration is lower, but the effect is more sustained than intravenous due to the time required for absorption of fosphenytoin from the injection site. Peak plasma concentration is reached approximately 30 minutes after the intramuscular administration. 

Distribution 

The human plasma proteins, primarily albumin, bind protein at a rate of approximately 95-99%, while the volume of distribution is between 4.3-10.8 L. 

Metabolism 

Upon administration, fosphenytoin undergoes rapid hydrolysis, converting it to phenytoin. Phenytoin is metabolized in the liver and gives rise to various metabolites. 

Elimination and Excretion 

The half-life of fosphenytoin, resulting from its conversion to phenytoin, is approximately 15 minutes. fosphenytoin or its metabolites are not excreted in the urine. 

Administration: 

IV/IM administration 

fosphenytoin is usually administered by injection into a vein (intravenously), although it can also be given by intramuscular injection in certain situations. Here are some general guidelines for the administration of fosphenytoin: 

  • fosphenytoin should be given slowly, over a period of at least 30 minutes, to minimize the risk of cardiovascular adverse reactions. Rapid administration can cause severe hypotension and arrhythmias. 
  • The dose of fosphenytoin is based on the patient’s weight and the indication for treatment. The maximum recommended loading dose is 20 mg phenytoin equivalents per kilogram of body weight. 
  • fosphenytoin should be administered with caution in patients with cardiac disease or those who are receiving other medications that can affect cardiac function. 
  • fosphenytoin should not be mixed with other medications or solutions, as this can cause precipitation or inactivation of the drug. 
  • fosphenytoin should be stored at room temperature and protected from light. 
  • When administering fosphenytoin intravenously, it is important to use a large bore needle or catheter to minimize the risk of tissue irritation or necrosis. 
  • During and after administration patients should be monitored closely for signs of adverse reactions, such as hypotension, arrhythmias or hypersensitivity reactions. 

Patient information leaflet 

Generic Name: fosphenytoin 

Pronounced: [ fos-FEN-i-toyn ] 

Why do we use fosphenytoin? 

fosphenytoin is a medication used for the prevention and treatment of seizures in patients with epilepsy or other neurological disorders. Here are some specific uses of fosphenytoin: 

  • Status epilepticus: fosphenytoin can be used in the emergency treatment of status epilepticus, which is a medical emergency characterized by prolonged or repeated seizures. 
  • Prophylaxis of seizures: fosphenytoin can be used to prevent seizures before and after neurosurgery, during diagnostic procedures involving the brain, or in other situations where seizure activity is anticipated. 
  • Substitution for phenytoin: fosphenytoin can be used as a substitute for phenytoin when oral administration is not possible, such as in patients with swallowing difficulties or gastrointestinal dysfunction. 
  • Convulsive status epilepticus in children: fosphenytoin can be used to treat convulsive status epilepticus in children when other treatments have failed or are not feasible. 
  • Acute treatment of seizures: fosphenytoin can be used for the acute treatment of seizures, especially in patients who cannot tolerate phenytoin.