The prodrug fosphenytoin is the preferred formulation of phenytoin for rapid intravenous loading based on a lower risk of side effects, including a reduced risk of local irritation at the site of infusion. Hypotension and cardiac arrhythmias remain a risk, however, and cardiac monitoring is required. The typical loading dose of fosphenytoin is 20 mg phenytoin equivalents (PE) per kg, at a rate of 3 mg PE/kg/minute. (See "Management of convulsive status epilepticus in children", section on 'Fosphenytoin and phenytoin'.