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NEUROLOGY 1983;33:173
© 1983 American Academy of Neurology

Phenytoin elimination in newborns

Blaise F. D. Bourgeois, MD and W. Edwin Dodson, MD

Departments of Neurology and Neurological Surgery (Neurology) and the Edward Mallinckrodt Department of Pediatrics, and the Division of Clinical Neuropharmacology, Washington University School of Medicine, St. Louis, and the Division of Pediatric Neurology, St. Louis Children's Hospital.

We measured the apparent half-life (t50%) of phenytoin (PHT) 30 times in 16 infants (aged 2 to 36 days) who had seizurtes. During the first week of life, the t50% s ranged from 6 to 140 hours. After the first week, the concentration dependence of PHT elimination was demonstrated; the t50% was related to the initial concentration (CJ. The t50% also decreased with postnatal age. Controlling for a C1 of 18 mg per liter, the average t50% decreased threefold between the first (57.3 ± 48.2 hours) and fourth weeks (19.7 ± 1.31). In newborns, both age-related changes and the concentration dependence of PHT elimination can cause PHT levels to decrease when constant doses are given.

Address correspondence and reprint requests to Dr. Dodson, St. Louis Children's Hospital, 500 South Kingshighway, P.O. Box 14871, St. Louis, MO 63178.

Supported by Biotechnology Mass Spectrometry Resource Grant No. RR 00954.

Blaise F.D. Bourgeois is the recipient of a Merritt-Putnam Clinical Research Fellowship of the Epilepsy Foundation of America.

Presented at the meeting of the American Epilepsy Society, New York, December 3-5, 1981. Preliminary results were presented at the Society for Pediatric Research Meeting, San Franciso, April 28-30. 1981.

Accepted for publication June 15, 1982.




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