I'm curious.  What is the indication for use of cerebyx? If it is  
being used for seizure prophylaxis in PIH, isn't magnesium sulphate  
the drug of choice?  Is it possible that there is a safer medication  
to use that is as effective.

Cordelia Merritt RN, BSN, IBCLC

On Feb 5, 2009, at 12:43 PM, LACTNET automatic digest system wrote:

> Subject: Cerebyx (fosphenytoin)
>
> I tried to post to Dr. Hale's forum, but it doesn't seem to be  
> working fo=
> r me.=20=20
> (Very possibly user error!)  Can anyone give me info regarding the  
> drug=20=
>
> Cerebyx (fosphenytoin)?
>
> Cerebyx converts rapidly to phenytoin, so I have been reading the  
> info=20=
>
> regarding phenytoin in Hale. The information for Phenytoin addresses  
> its =
> safety=20
> in mothers who are receiving doses of 300 - 600mg daily, and I  
> assume tha=
> t=20
> these are long-term doses in mothers with mature milk. I need info  
> regard=
> ing=20
> safety when the medication is given in high doses for a short term  
> period=
> =20
> during labor and early postpartum.=20
>
> In our hospital, Cerebyx is given to mothers IV, with the intent to  
> keep=20=
>
> therapeutic blood levels of 13-15 for 24 hours. Generally (depending  
> on l=
> ength=20
> of labor), 1-2 doses of 0.7g are given during labor, then another  
> dose of=
> 0.7g=20
> is given 12-15 hours after delivery. This results in anywhere from  
> 700 to=
> =20
> 2100mg within a 24 hours period.=20
>
> Our current policy is to pump and dump during treatment and for 24  
> hours=20=
>
> after the final dose. Would it be safe for infants to consume their  
> mothe=
> rs=20
> colostrum during therapy? If not, how long should we continue  
> discarding=20=
>
> colostrum after discontinuing therapy?=20=20
>
> Thank  you,
> Julie Conaway, RN, IBCLC
> Rolla, MO USA

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