Single daily dose of diphenylhydantoin in children

Abstract

Once daily administration of the 24 hour diphenylhydantoin anticonvulsant requirement was studied in children. Each patient served as his own control by means of a crossover design. Comparison between the single and divided dose schedules failed to reveal any clinically significant differences in seizure control or drug-related toxicity. Serum levels were remarkably uniform for each patient regardless of whether the drug was administered three times per day or all at one time. No evidence of excessive drug accumulation occurred at the time of peak absorption following single daily administration. Levels obtained 24 hours after administration of the dosage were the same as those at 12 hours, indicating no tendency for subtherapeutic levels just prior to the next dose. A dose of 5 mg. per kilogram per day of diphenylhydantoin generally will produce serum concentrations of 10 μg per milliliter. The potential advantages of single daily administration are: reduced hospital nursing costs, patient convenience, and improved seizure control due to better reliability. The single daily dose must not be inadvertently forgotten.