The removal of phenytoin by hemodialysis was determined in seven uremic patients. Four patients were receiving phenytoin sodium for therapeutic purposes; three received one dose each intravenously to quantitate its disposition in uremia. The drug was measured in whole blood, plasma, saliva, and dialysate. Only 2% to 4% of the intravenous dose was recovered in the dialysate. Phenytoin clearance by dialysis was 7 to 14 ml/min; plasma clearance was 53 to 133 ml/min. Since hemodialysis contributes little toward shortening the 11-to-18-hour half-life of phenytoin in the uremic patient, no supplemental dose is necessary for uremic patients undergoing hemodialysis.
(JAMA 238:1750-1753, 1977)
Martin E, Gambertoglio JG, Adler DS, Tozer TN, Roman LA, Grausz H. Removal of Phenytoin by Hemodialysis in Uremic Patients. JAMA. 1977;238(16):1750-1753. doi:10.1001/jama.1977.03280170044025