$Unique_ID{BRK02078}
$Pretitle{}
$Title{PENTOBARBITAL}
$Subject{Nembutal (Abbott)
pentobarbital sodium (various manufacturers)}
$Volume{}
$Log{}

Copyright (C) 1991 Publications International, Ltd.


PENTOBARBITAL
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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 breast-feeding an infant.  Small amounts of pentobarbital
pass into breast milk and may cause excessive drowsiness or breathing problems
in nursing infants.

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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.
