According to 2008:  It is a prodrug of phenytoin.  Folloiwng parenteral injection rapidly converted to phenytoin with a half-life of 15 minutes.  It is an L2.  Compatible with breastfeeding.  Check Hales' on Dilantin. 

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Julie Conaway
Sent: Thursday, February 05, 2009 2:43 PM
Subject: Cerebyx (fosphenytoin)

I tried to post to Dr. Hale's forum, but it doesn't seem to be working for me.  
(Very possibly user error!)  Can anyone give me info regarding the drug Cerebyx (fosphenytoin)?

Cerebyx converts rapidly to phenytoin, so I have been reading the info regarding phenytoin in Hale. The information for Phenytoin addresses its safety in mothers who are receiving doses of 300 - 600mg daily, and I assume that these are long-term doses in mothers with mature milk. I need info regarding safety when the medication is given in high doses for a short term period during labor and early postpartum. 

In our hospital, Cerebyx is given to mothers IV, with the intent to keep therapeutic blood levels of 13-15 for 24 hours. Generally (depending on length of labor), 1-2 doses of 0.7g are given during labor, then another dose of 0.7g is given 12-15 hours after delivery. This results in anywhere from 700 to 2100mg within a 24 hours period. 

Our current policy is to pump and dump during treatment and for 24 hours after the final dose. Would it be safe for infants to consume their mothers colostrum during therapy? If not, how long should we continue discarding colostrum after discontinuing therapy?  

Thank  you,
Julie Conaway, RN, IBCLC
Rolla, MO USA

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