Delavirdine Mesylate and Phenytoin Sodium

• Generic Name: delavirdine
• Dosage Forms: n.a.
• Other Brand Names: Rescriptor

Treatment of HIV-1 infection in adults; usually used in conjunction with 2 HIV nucleoside reverse transcriptase inhibitors (NRTIs).

Experts state delavirdine not recommended for initial treatment regimens in antiretroviral-naive adults because of inferior virologic efficacy and inconvenient dosing regimen.

Data insufficient comparing delavirdine regimens to the preferred 3-drug regimens for initial treatment in antiretroviral-naive adults; consider that the proportion of clinical study patients responding to regimen of delavirdine and 2 NRTIs with sustained plasma HIV-1 levels <400 copies/mL over 1 year has been relatively low.

• Generic Name: phenytoin
• Dosage Forms: injection, solution
• Other Brand Names: Dilantin, Dilantin Infatabs, Phenytek, Phenytoin Sodium, Prompt

Management of generalized tonic-clonic (grand mal) seizures.

Management of partial seizures with complex symptomatology (psychomotor and temporal lobe seizures).

Not recommended for treatment of pure absence (petit mal) seizures since the drug may increase frequency of these seizures, but may be used in conjunction with other anticonvulsants when mixed seizure types are present.

Prevention and treatment of seizures occurring during and following neurosurgery.

Used IV for treatment of status epilepticus; however, use may be limited by its slow onset of action and need for slow administration.

Benzodiazepines (e.g., diazepam, lorazepam, midazolam) are considered drugs of choice for initial treatment of status epilepticus; IV phenytoin (or fosphenytoin) may be used as a second-line agent if seizures continue.

Concurrent administration with an IV benzodiazepine or short-acting barbiturate will usually be necessary for rapid control of seizures.

Fosphenytoin appears to be better tolerated than phenytoin, and some experts state that fosphenytoin is preferred when both drugs are available.

Has been used IV for treatment of cardiac arrhythmias, particularly ventricular arrhythmias, in patients who do not respond to conventional antiarrhythmic agents or cardioversion. However, current use as an antiarrhythmic agent is limited by the drug's narrow therapeutic window, multiple drug interactions, and adverse effect profile.

Has been used IV for treatment of arrhythmias caused by cardiac glycoside intoxication, especially in the presence of AV block, because the drug improves conduction through the AV node.