$Unique_ID{BRK03275} $Pretitle{} $Title{pentobarbital} $Subject{Nembutal Abbott sodium Sedative/hypnotic pentobarbital barbiturates central nervous system brain spinal cord depressants sleeping aid insomnia} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. pentobarbital ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) Nembutal (Abbott) pentobarbital sodium (various manufacturers) TYPE OF DRUG Sedative/hypnotic INGREDIENT pentobarbital DOSAGE FORMS Capsules (50 mg and 100 mg) Oral elixir (20 mg per 5-ml spoonful, with 18% alcohol) Suppositories (30 mg, 60 mg, 120 mg, and 200 mg) STORAGE Pentobarbital capsules and oral elixir should be stored at room temperature in tightly closed containers. The suppositories should be stored in the refrigerator. Pentobarbital should never be frozen. USES This medication belongs to a group of drugs known as barbiturates, which are central nervous system (brain and spinal cord) depressants. It is used as a sleeping aid in the treatment of insomnia. TREATMENT You can take pentobarbital at bedtime. The capsules can be taken with water, food, or milk. Each dose of the oral elixir form of this medication should be measured carefully with a specially designed 5-ml measuring spoon. An ordinary kitchen teaspoon is not accurate enough. The elixir can be taken by itself or mixed with water, milk, or fruit juice. To insert the suppository form of this medication, first unwrap it and moisten it slightly with water (if the suppository is too soft to insert, run cold water over it or refrigerate it for 30 minutes before you unwrap it). Lie down on your left side, with your right knee bent. Push the suppository well into the rectum with your finger. Try to avoid having a bowel movement for at least an hour so that the medication can be absorbed. You should not use this drug as a sleeping aid for more than two weeks. With prolonged use, pentobarbital loses its ability to induce and sustain sleep. SIDE EFFECTS Minor. Constipation, diarrhea, dizziness, drowsiness, a "hangover" feeling, headache, nausea, stomach upset, or vomiting. These side effects should disappear as your body adjusts to the medication. If you feel dizzy or light-headed, sit or lie down for a while; get up slowly from a sitting or reclining position, and be careful on stairs. To relieve constipation, increase the amount of fiber in your diet (fresh fruits and vegetables, salads, bran, and whole-grain breads), exercise, and drink more water (unless your doctor directs you to do otherwise). Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about chest tightness, confusion, depression, difficulty in breathing, excitation, fatigue, feeling faint, hives or itching, loss of coordination, muscle or joint pain, skin rash, slurred speech, sore throat, unusual bleeding or bruising, unusual weakness, or yellowing of the eyes or skin. INTERACTIONS Pentobarbital interacts with several other types of drugs: 1. Concurrent use of it with other central nervous system depressants (such as alcohol, antihistamines, benzodiazepine tranquilizers, muscle relaxants, narcotics, pain medications, and phenothiazine tranquilizers) or with tricyclic antidepressants can cause extreme drowsiness. 2. Valproic acid, chloramphenicol, and monoamine oxidase (MAO) inhibitors can prolong the effects of pentobarbital. 3. Pentobarbital can decrease the blood levels and, therefore, the effectiveness of oral anticoagulants (blood thinners, such as warfarin), digitoxin, tricyclic antidepressants, doxycycline, cortisone-like medicines, metronidazole, quinidine, estrogens, birth control pills, phenytoin, acetaminophen, and carbamazepine. 4. The combination of pentobarbital and furosemide can cause low blood pressure and fainting. 5. Pentobarbital can increase the side effects of cyclophosphamide or large doses of acetaminophen. Before starting to take pentobarbital, BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking, especially any of those listed above. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to pentobarbital or to other barbiturates (such as amobarbital, butabarbital, mephobarbital, metharbital, phenobarbital, primidone, and secobarbital). * Before starting to take this medication, be sure to tell your doctor if you now have or if you have ever had acute or chronic (long-term) pain, Addison's disease (an underactive adrenal gland), diabetes mellitus, kidney disease, liver disease, lung disease, mental depression, porphyria, or thyroid disease. * Since this medication makes you drowsy, do not take part in any activity that requires alertness, such as driving a car or operating potentially dangerous machinery. * This drug has the potential for abuse and must be used with caution. Tolerance develops quickly; do not increase the dosage or stop taking this drug without consulting your doctor. * If you have been taking pentobarbital for a long time or have been taking large doses, you may experience anxiety, muscle twitching, tremors, weakness, dizziness, nausea, vomiting, insomnia, or blurred vision when you stop taking it. To avoid this reaction, your doctor may want to reduce your dosage gradually. * Be sure to tell your doctor if you are pregnant. Barbiturates cross the placenta, and there has been an association between birth defects and the use of this class of drugs during pregnancy. Such drugs may also lead to an increase in bleeding complications in the newborn. The risks should be discussed with your doctor. In addition, if pentobarbital is used for prolonged periods during the last three months of pregnancy, there is a chance that the infant will be born addicted to the medication and will experience a withdrawal reaction (convulsions or irritability) at birth. Also, tell your doctor if you are breastfeeding an infant. Small amounts of pentobarbital pass into breast milk and may cause excessive drowsiness or breathing problems in nursing infants. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.