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Corrected Phenytoin Calculator

Correct a serum phenytoin concentration for hypoalbuminaemia using the Sheiner-Tozer equation.

Clinical Chemistry #albumin #phenytoin #therapeutic-drug-monitoring #anti-epileptic #pharmacology
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Formula & Clinical Notes

Formula

Corrected Phenytoin = Measured Phenytoin / (0.2 × Albumin + 0.1)

Clinical Notes

The Sheiner-Tozer equation corrects a measured total phenytoin concentration for the reduced protein binding seen in hypoalbuminaemia. Phenytoin is highly protein-bound (about 90%), primarily to albumin; with low albumin the free (pharmacologically active) fraction rises while the measured total stays normal or low. The correction allows comparison against the standard therapeutic total range of about 10-20 µg/mL. It assumes normal renal function; in renal failure the correction is not as reliable because a structurally altered albumin binds phenytoin less well.