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Therapeutic Drug Levels

Phenytoin Level

Normal range 10–20 µg/mL (40–79 µmol/L SI). Specimen: Serum (trough).

Also known as: Dilantin level.

10–20 µg/mLCritical: read below

Reference range

Conventionalµg/mL
1020
SIµmol/L
4079
SpecimenSerum (trough)
Conventional range10–20 µg/mL
SI range40–79 µmol/L
Conversion factor×3.96 (conventional → SI)
Critical value> 20 µg/mL (nystagmus, ataxia); > 30 confusion
PanelTherapeutic Drug Levels

Convert any Phenytoin Level result between units on the unit converter.

What is the normal range for Phenytoin Level?

The standard teaching reference range for Phenytoin Level is 10–20 µg/mL in conventional units, or 40–79 µmol/L in SI units. This value is measured in serum (trough).

A commonly taught critical (panic) value is > 20 µg/mL (nystagmus, ataxia); > 30 confusion. Critical results are reported to the provider immediately under your facility's policy.

Source: Adult reference values compiled from Pagana & Pagana, Mosby's Diagnostic and Laboratory Test Reference, and Fischbach & Dunning, A Manual of Laboratory and Diagnostic Tests. Reference ranges vary by laboratory, method, age, sex, and population — always use the range printed on the actual result.

Above the range

Common causes of a high Phenytoin Level

  • Excess dosing
  • Liver disease
  • Drug interactions
  • Low albumin (raises free fraction)

Below the range

Common causes of a low Phenytoin Level

  • Nonadherence
  • Enzyme-inducing drugs

At the bedside

Nursing considerations

  • Toxicity progresses from nystagmus to ataxia to lethargy as levels climb.
  • Correct the measured level for low albumin, or measure free phenytoin.

Study aid

Your notes on Phenytoin Level

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