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Nembutal

Generic Name: pentobarbital (pen toe BAR bi tal)
Brand Names: Nembutal, Nembutal Sodium

What is Nembutal (pentobarbital)?

Pentobarbital is in a class of drugs called barbiturates (bar bi TURE ates). Pentobarbital depresses the activity of your brain and nervous system.

Pentobarbital is used to treat insomnia (for up to 2 weeks) and to induce sleep before surgery.

Pentobarbital may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Nembutal (pentobarbital)?

Call your doctor immediately if you develop a fever, a sore throat, sores in your mouth, broken blood vessels under your skin, or easy bruising or bleeding. These could be early signs of a serious side effect.

Use caution when driving, operating machinery, or performing other hazardous activities. Pentobarbital will cause drowsiness. If you experience drowsiness, avoid these activities. Do not drink alcohol or take other sleep medicines, antihistamines, narcotic pain relievers, or other drugs that also cause drowsiness unless your doctor approves. Dangerous sedation could result. Pentobarbital may decrease the effectiveness of birth control pills. Use a second method of birth control while taking pentobarbital to prevent pregnancy.

Who should not take Nembutal (pentobarbital)?

Do not take pentobarbital if you have

• porphyria,

• liver disease,
• kidney disease, or

• severe respiratory disease such as severe asthma or severe chronic obstructive pulmonary disorder (COPD).

Before taking this medication, tell your doctor if you have ever had a drug or alcohol addiction in the past. Pentobarbital is habit forming, which means that you can become addicted to it.

Pentobarbital is in the FDA pregnancy category D. This means that it is known to harm an unborn baby. Do not take pentobarbital if you are pregnant. Pentobarbital passes into breast milk and could affect a nursing infant. Do not take pentobarbital without first talking to your doctor if you are breast-feeding a baby.

Pentobarbital may cause excitement, irritability, aggression, depression, or confusion-- particularly in children and in adults over 60 years of age. Lower doses and close monitoring may be necessary.

How should I take Nembutal (pentobarbital)?

Take pentobarbital exactly as directed by your doctor. If you do not understand the directions on your prescription bottle, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

The suppositories are for rectal use. Ask your pharmacist, nurse, or doctor for instructions if you do not know how to insert a suppository.

To treat insomnia, pentobarbital is usually taken just before bedtime. Take your dose when you are ready to get into bed, or not long before, so that if you become sleepy, you will not fall or become confused and accidentally injure yourself. Pentobarbital should not be used for longer than 2 weeks to treat insomnia.

To cause sedation, pentobarbital may be taken several times a day at regular intervals, or shortly before surgery.

Do not increase your dosage of this medicine without the approval of your doctor. If your symptoms are not being adequately treated, talk to your doctor. Store pentobarbital at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a pentobarbital overdose include difficulty breathing, back-and-forth movements of the eyes, appearance of being drunk, fast heartbeat, low body temperature, heavy sedation, coma, and death.

What should I avoid while taking Nembutal (pentobarbital)?

Use caution when driving, operating machinery, or performing other hazardous activities. Pentobarbital will cause drowsiness. If you experience drowsiness, avoid these activities. Do not drink alcohol or take other sleep medicines, antihistamines, narcotic pain relievers, or other medicines that cause drowsiness unless your doctor approves. Dangerous sedation could result. Do not increase your dosage of this medicine without the approval of your doctor. If your symptoms are not being adequately treated, talk to your doctor.

Do not take this medicine for longer than 2 weeks to treat insomnia.

Pentobarbital may decrease the effectiveness of birth control pills. Use a second method of birth control while taking pentobarbital to prevent pregnancy.

Nembutal (pentobarbital) side effects

If you experience any of the following serious side effects, stop taking pentobarbital and seek emergency medical attention or call your doctor immediately:

• an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

• a fever or a sore throat;

• sores in your mouth;

• broken blood vessels under your skin; or

• easy bruising or bleeding.

Other, less serious side effects may be more likely to occur. Continue to take pentobarbital and talk to your doctor if you experience

• drowsiness or dizziness;

• confusion;

• agitation, irritability, or excitability;

• nightmares, nervousness, or anxiety;

• headache; or

• "hangover" effect (drowsiness the day after a dose).

Pentobarbital is habit forming, which means that you can become addicted to it. Your doctor will want to monitor how much medicine you are taking. Your dosage may have to be reduced slowly to prevent withdrawal effects.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Nembutal (pentobarbital)?

Large chronic doses of pentobarbital may cause liver damage if it is taken with acetaminophen (Tylenol, others). Tell your doctor and pharmacist if you are taking pentobarbital on a regular basis. Pain and fever reducers other than acetaminophen are available and may be more suitable choices.

Pentobarbital may decrease the effectiveness of many drugs, including the following:

• blood thinners such as warfarin (Coumadin). Blood clotting could result.

• carbamazepine (Tegretol) and clonazepam (Klonopin). Reduced effectiveness of these medicines could lead to poor seizure control.

• birth control pills. Breakthrough bleeding or unplanned pregnancy could result. Use of a second form of birth control is recommended.

• steroid medicines such as hydrocortisone (Cortef, Hydrocortone), prednisone (Orasone, Deltasone), prednisolone (Prelone, Delta Cortef), methylprednisolone (Medrol), and others.

• felodipine (Plendil), verapamil (Calan, Verelan, Isoptin), and quinidine (Cardioquin, Quinidex, Quinora, Quinaglute). Reduced effectiveness could lead to poor control of blood pressure, irregular heartbeats, or other heart conditions.

• fenoprofen (Nalfon). Reduced effectiveness could lead to a loss of inflammation or pain control.

• griseofulvin (Grisactin, Fulvicin PG, Grifulvin V), and metronidazole (Flagyl, Metryl, Metizol). Reduced effectiveness could lead to recurrence or worsening of an infection.

• theophylline (Theo-Dur, Theochron, Theolair, Slo-Bid, others). Asthma, COPD, or other respiratory conditions could grow worse.

Other drugs may also influence the activity of pentobarbital:

• Alcohol, sleep aids, antihistamines, antidepressants, and other drugs that cause tiredness or sedation may increase the drowsiness caused by pentobarbital.

• Rifampin (Rifadin, Rimactine) may decrease the effects of pentobarbital.

Drugs other than those listed here may also interact with pentobarbital. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

• Your pharmacist has more information about pentobarbital written for health professionals that you may read.

What does my medication look like?

Pentobarbital is available with a prescription generically and under the brand name Nembutal in capsules, suppositories, and as an injection. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Nembutal Sodium 50 mg--orange-and-clear capsules

• Nembutal Sodium 100 mg--yellow capsules

• Nembutal Sodium Suppositories in 30 mg, 60 mg, 120 mg, and 200 mg strengths

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

http://www.drugs.com/mtm/nembutal.html

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