Fosphenytoin Sodium, Injection

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KEY POINTS

• This medicine is given by injection for short-term prevention and control of seizures.
• This medicine may cause an irregular heartbeat or low blood pressure. It may also increase suicidal thoughts or actions in some people.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antiseizure

Generic and brand names: fosphenytoin sodium, injection; Cerebyx

What is this medicine used for?

This medicine is given by injection for short-term prevention and control of seizures.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A blood disorder
• Depression or thoughts of suicide
• Diabetes
• Heart disease or an irregular heartbeat
• Liver or kidney disease
• Low blood pressure
• Porphyria (nerve pain or sensitivity to sunlight)
• Problems with alcohol abuse
• Thyroid problems

If you are of Asian ancestry, you may be at high risk of a serious skin reaction. Your provider may give you a blood test to find out if you carry the HLA-B*1502 gene. If the test is positive, you are at high risk for severe reaction. Talk with your provider about this.

You should not receive this medicine if you are also taking delavirdine (Rescriptor). Talk with your healthcare provider about this.

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your healthcare provider. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while you are receiving this medicine.

How do I use it?

Injections will be given by your healthcare provider.

What should I watch out for?

This medicine may cause an irregular heartbeat or low blood pressure. You will be watched closely when you are receiving this medicine.

Antiseizure medicines may increase suicidal thoughts or actions in some people. Call your healthcare provider right away if you have new or increased thoughts of suicide.

You need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests. This medicine may cause serious side effects that can affect your liver or kidneys. Contact your healthcare provider right away if you have a fever or rash, yellowing of the skin or eyes, dark urine, severe stomach pain, loss of appetite, unusual tiredness, unusual bruising or bleeding, or trouble urinating.

This medicine can make you drowsy or dizzy. It can also affect your coordination and reflexes. Do not drive or operate machinery unless you are fully alert and know how this medicine affects you.

Alcohol can affect antiseizure medicines. Do not drink alcohol while you are taking this medicine unless your healthcare provider approves.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you have received this medicine.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you have diabetes: This medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Abnormal heartbeat (too fast or too slow); chest pain; severe dizziness; fever; sore throat; rash; swollen glands; yellowing of your eyes and skin; dark urine; numbness or tingling; unusual bruising or bleeding; severe tiredness; muscle or joint pain; severe stomach pain; loss of appetite; pain, swelling, or discoloration in the hands or arms; confusion; blurred vision; problems with balance or walking; slurred speech; severe skin redness, burning, peeling, or blistering; new or worsening depression or thoughts of suicide; unusual changes in mood or behavior.

Other: Itching, itching or burning at the injection site, dizziness, drowsiness, lightheadedness, nausea, vomiting, dry mouth, change in sense of taste, ringing in ears, headache, constipation, tremors.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Antianxiety medicines such as alprazolam (Xanax), chlordiazepoxide, clonazepam (Klonopin), clorazepate (Gen-Xene, Tranxene), diazepam (Valium), lorazepam (Ativan), and oxazepam
• Antibiotics such as chloramphenicol, ciprofloxacin (Cipro), clarithromycin (Biaxin), doxycycline (Doryx, Monodox, Vibramycin), isoniazid, rifampin (Rifadin), rifapentine (Priftin), and telithromycin (Ketek)
• Antidepressants such as amitriptyline, amoxapine, bedaquiline (Sirturo), citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), imipramine (Tofranil), nefazodone, nortriptyline (Pamelor), sertraline (Zoloft), trazodone, venlafaxine (Effexor), vilazodone (Viibryd), and vortioxetine (Trintellix)
• Antifungal medicines such as fluconazole (Diflucan), isavuconazonium (Cresemba), itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Monistat, Oravig), posaconazole (Noxafil), and voriconazole (Vfend)
• Antihistamines such as azelastine (Astelin, Astepro), chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), and hydroxyzine (Vistaril)
• Antipsychotic medicines such as aripiprazole (Abilify), cariprazine (Vraylar), chlorpromazine, clozapine (Clozaril, FazaClo), fluphenazine, haloperidol (Haldol), lurasidone (Latuda), perphenazine, pimozide (Orap), quetiapine (Seroquel), and thioridazine
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), eslicarbazepine (Aptiom), ethosuximide (Zarontin), felbamate (Felbatol), gabapentin (Neurontin), lacosamide (Vimpat), lamotrigine (Lamictal), levetiracetam (Keppra), methsuximide (Celontin), oxcarbazepine (Trileptal), phenobarbital, phenytoin (Dilantin, Phenytek), primidone (Mysoline), rufinamide (Banzel), topiramate (Qudexy, Topamax, Trokendi), valproic acid (Depacon, Depakene, Depakote), vigabatrin (Sabril), and zonisamide (Zonegran)
• Antiviral medicines such as daclatasvir (Daklinza), elbasvir/grazoprevir (Zepatier), ledipasvir/sofosbuvir (Harvoni), ombitasvir/paritaprevir/ritonavir (Technivie), ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira), simeprevir (Olysio), and sofosbuvir (Sovaldi)
• Apremilast (Otezla)
• Bupropion (Aplenzin, Forfivo, Wellbutrin, Buproban, Zyban)
• Cancer medicines such as abiraterone (Zytiga), axitinib (Inlyta), bleomycin, bortezomib (Velcade), bosutinib (Bosulif), cabozantinib (Cometriq), capecitabine (Xeloda), carboplatin, ceritinib (Zykadia), cisplatin, cobimetinib (Cotellic), crizotinib (Xalkori), dabrafenib (Tafinlar), dasatinib (Sprycel), doxorubicin (Doxil), enzalutamide (Xtandi), erlotinib (Tarceva), fluorouracil (Adrucil, Carac, Efudex, Fluoroplex), ibrutinib (Imbruvica), idelalisib (Zydelig), irinotecan (Camptosar), lapatinib (Tykerb), nilotinib (Tasigna), olaparib (Lynparza), paclitaxel (Abraxane, Taxol), pazopanib (Votrient), ponatinib (Iclusig), romidepsin (Istodax), sonidegib (Odomzo), sorafenib (Nexavar), teniposide, vandetanib (Caprelsa), vemurafenib (Zelboraf), and vincristine (Marqibo)
• Cholesterol-lowering medicines such as atorvastatin (Lipitor), fluvastatin (Lescol), lomitapide (Juxtapid), lovastatin (Altoprev), rosuvastatin (Crestor), and simvastatin (Zocor)
• Corticosteroids such as cortisone, dexamethasone, fludrocortisone, hydrocortisone (A-Hydrocort, Cortef), methylprednisolone (Medrol, Solu-Medrol), prednisolone (Omnipred, Orapred, Prelone), and prednisone (Prednisone Intensol)
• Diabetes medicines such as glimepiride (Amaryl), glipizide (Glucotrol), glyburide (Glynase), insulin, linagliptin (Tradjenta), metformin (Fortamet, Glucophage, Riomet), nateglinide (Starlix), pioglitazone (Actos), repaglinide (Prandin), rosiglitazone (Avandia), saxagliptin (Onglyza), and tolbutamide
• Disulfiram (Antabuse)
• Diuretics (water pills) such as bumetanide, furosemide (Lasix), and torsemide (Demadex)
• Dopamine
• Doxepin (Silenor)
• Heart medicines such as amiodarone (Cordarone, Pacerone), digoxin (Lanoxin), diltiazem (Cardizem, Cartia, Tiazac), disopyramide (Norpace), dronedarone (Multaq), felodipine, mexiletine, nifedipine (Adalat CC, Procardia), nisoldipine (Sular), quinidine, ranolazine (Ranexa), and verapamil (Calan, Covera, Verelan)
• HIV medicines such as atazanavir (Reyataz), darunavir (Prezista), delavirdine (Rescriptor), dolutegravir (Tivicay), efavirenz (Sustiva), elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), etravirine (Intelence), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), and saquinavir (Invirase)
• Hormonal birth control implants, IUDs, patches, pills, shots, and vaginal rings, and hormones such as conjugated estrogens (Premarin), esterified estrogen (Estratab, Menest), estradiol (Climara, Estrace, Estraderm, Vivelle), and estropipate (Ogen)
• Immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune), and tacrolimus (Astagraf, Prograf, Protopic)
• Ivacaftor (Kalydeco)
• Macitentan (Opsumit)
• Malaria medicines such as artemether/lumefantrine (Coartem), chloroquine, mefloquine, primaquine, and quinine
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• Medicines to block or prevent stomach acid such as cimetidine (Tagamet), omeprazole (Prilosec), and ranitidine (Zantac)
• Medicines to treat breathing or lung problems such as aminophylline, montelukast (Singular), roflumilast (Daliresp), theophylline, and zafirlukast (Accolate)
• Medicines to treat low sodium levels such as conivaptan (Vaprisol) and tolvaptan (Samsca)
• Medicines to treat or prevent blood clots such as apixaban (Eliquis), clopidogrel (Plavix), dabigatran (Pradaxa), edoxaban (Savaysa), rivaroxaban (Xarelto), ticagrelor (Brilinta), and warfarin (Coumadin)
• Methotrexate (Otrexup, Rasuvo, Rheumatrex, Trexall)
• Mifepristone (Korlym, Mifeprex)
• Muscle relaxants such as baclofen (Gablofen, Lioresal), carisoprodol (Soma), cyclobenzaprine (Amrix), methocarbamol (Robaxin), and tizanidine (Zanaflex)
• Narcotic pain medicines such as codeine, fentanyl (Abstral, Actiq, Duragesic, Fentora, Sublimaze), hydrocodone (Hysingla, Zohydro), hydromorphone (Dilaudid, Exalgo), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Kadian, MS Contin), oxycodone (OxyContin, Roxicodone), and pentazocine (Talwin)
• Natural remedies such as Co-Q10, evening primrose, garlic, gotu kola, kava, red yeast rice, St. John's wort, and valerian
• Nausea medicines such as aprepitant (Emend), ondansetron (Zofran), prochlorperazine (Compro), promethazine, and rolapitant (Varubi)
• Nintedanib (Ofev)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Praziquantel (Biltricide)
• Reserpine
• Sevelamer (Renagel, Renvela)
• Sleeping pills such as butabarbital (Butisol), eszopiclone (Lunesta), flurazepam, suvorexant (Belsomra), temazepam (Restoril), triazolam (Halcion), zaleplon (Sonata), and zolpidem (Ambien, Edluar, Intermezzo)
• Stimulants such as armodafinil (Nuvigil), methylphenidate (Concerta, Daytrana, Metadate, Ritalin), and modafinil (Provigil)
• Sulfa antibiotics such as sulfadiazine, sulfamethoxazole/trimethoprim (Bactrim, Septra), and sulfasalazine (Azulfidine)
• Tadalafil (Adcirca, Cialis)
• Tofacitinib (Xeljanz)

Do not drink alcohol while taking this medicine without your healthcare provider’s approval.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.