Phenytoin (Dilantin) Level

Therapeutic Drug Monitoring

Normal Reference Ranges

Adult

Therapeutic: 10 - 20 mcg/mL

Pediatric

Therapeutic: 10 - 20 mcg/mL

Clinical Significance

Anti-epileptic drug with zero-order (non-linear) kinetics at higher doses. Must adjust for low albumin (calculate free phenytoin).

Causes of High

  • Toxicity (causes nystagmus, ataxia, lethargy)

Causes of Low

  • Non-compliance
  • Subtherapeutic dosing (risk of seizures)