Abstract
We investigated the conversion of mephenytoin to nirvanol in five patients with uncontrolled complex partial seizures. After a 50-mg single oral dose, mean peak mephenytoin level was 0.48 μ/ml and nirvanol0.37 μg/ml. After 400 mg, peak mephenytoin level was 3.9 μg/ml and nirvanol 2.5 μg/ml. On 400 mg daily, mephenytoin reached a mean steady-state level of 1.5 μg/ml. Nirvanol mean steady-state level was 18 μg/ml. Mean plasma half-life was 17 hours for mephenytoin and 114 hours for nirvanol. Two patients had reduced seizures during mephenytoin therapy and one a transient increase during drug withdrawal. No toxicity was seen, but mephenytoin was not more effective than phenytoin.
- © 1984 by the American Academy of Neurology
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