Suggested maintenance dose of phenytoin in ESRF patient

• Phenytoin in ESRF patient tends to poorly bind to albumin and may have low serum albumin level. 
• Therefore, maintenance dose of phenytoin needs to be titrated cautiously according to the response and unbound blood concentration. 
• Monitoring should be done closely to ensure optimal efficacy and minimize toxicity.

References:
1. The Renal Drug Reference Guide 2008