O

Fosphenytoin (a pro-drug)

Figure 14.5 • Biotransformation of fosphenytoin to phenytoin.

Fosphenytoin (a pro-drug)

Phenytoin

Figure 14.5 • Biotransformation of fosphenytoin to phenytoin.

text). Phenytoin is very effective against all seizure types except absence; however, the drug may be incompletely or erratically absorbed from sites of administration because of its very low water solubility. For this reason, fospheny-toin, a prodrug of phenytoin, was developed and marketed to avoid complications such as vein irritation, tissue damage, and muscle necrosis associated with parenteral phenytoin administration. Fosphenytoin is rapidly absorbed either by intravenous or intramuscular administra-tion.43 It is converted into phenytoin through phosphatase catalyzed hydrolysis of the phosphate ester as shown in Figure 14.5.

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