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PHENobarbital
Phenobarbital is a barbiturate medication primarily used as an anticonvulsant to control seizures and as a sedative to treat anxiety and insomnia. It acts on the central nervous system by enhancing the effects of the neurotransmitter gamma-aminobutyric acid (GABA), leading to decreased neuronal excitability. Phenobarbital is effective for various types of seizures and is often used in combination with other anticonvulsants.
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Frequently Asked Questions
Can I stop taking Phenobarbital if my symptoms improve?
No, withdrawing suddenly can cause a recurrence of seizures or potentially severe withdrawal symptoms. Any changes to your medication plan should be done under the guidance of your healthcare provider.
Does Phenobarbital make me sleepy or drowsy?
It's possible as drowsiness is a common side effect of Phenobarbital. If you're feeling excessively drowsy or it's interfering with your life, please talk to your healthcare provider.
I missed a dose of Phenobarbital, what should I do?
Take the missed dose as soon as you remember unless it's almost time for your next dose. Never double up on doses to make up for a missed one.
Can I drink alcohol while on Phenobarbital?
It's generally not a good idea. Alcohol can enhance side effects like drowsiness or dizziness, and in severe cases, can depress your central nervous system.
Can Phenobarbital be used for anxiety?
Yes, Phenobarbital acts as a CNS depressant, and may be used off-label to treat short-term anxiety. However, due to its highly addictive nature and potential for tolerance, it's not usually the first line of treatment.
Will my mental state affect the effectiveness of Phenobarbital?
Phenobarbital can affect each individual's moods differently. If you're struggling with mental health issues, such as depression or anxiety, it's important to communicate this to your healthcare provider.
Comprehensive Drug Guide
How Does PHENobarbital Work?
Phenobarbital works by increasing the duration of the opening of chloride channels in response to GABA, enhancing inhibitory neurotransmission in the brain. This action helps stabilize electrical activity in the brain, reducing the frequency and severity of seizures, and providing a calming effect that can alleviate anxiety and promote sleep.
Common Dosages
Phenobarbital is available in the following forms:
- Tablets: 15 mg, 30 mg, 60 mg, and 100 mg
- Injection: 65 mg/mL (for intravenous or intramuscular use)
Typical Dosing
- Adults: The usual starting dose for seizure control is 100 mg to 200 mg per day, divided into 2-3 doses. Doses may be adjusted based on response and tolerance, with a maximum of 500 mg per day.
- Children: Dosing is typically based on weight, starting at 3-5 mg/kg per day, divided into 2-3 doses.
Typical Dosing
FDA Approved Indications
- Generalized tonic-clonic seizures
- Partial seizures
- Status epilepticus
- Sedation in anxious patients
- Preoperative sedation
Off-Label Uses
It's also used off-label for the treatment of neonatal withdrawal syndrome, and involuntary movement disorders, and to treat or prevent certain types of headaches.
Who Shouldn't Take PHENobarbital?
- Known hypersensitivity to phenobarbital or any component of the formulation
- Severe respiratory disease, including asthma
- A history of porphyria
- Significant liver dysfunction
Advice From The Pharmacist
- Take Phenobarbital exactly as prescribed by your healthcare provider; do not alter the dose without consulting them.
- Avoid alcohol and other CNS depressants while taking Phenobarbital, as they can enhance sedative effects.
- Regular blood tests may be necessary to monitor drug levels and liver function.
- Be aware of potential withdrawal symptoms if discontinuing the medication after long-term use; consult your healthcare provider for a tapering schedule.
Side Effects of PHENobarbital
Common Side Effects
- Drowsiness or sedation
- Dizziness
- Nausea
- Fatigue
Uncommon/Severe Side Effects
- Respiratory depression
- Allergic reactions (rash, itching, swelling)
- Severe confusion or behavioral changes
Risks and Warnings of PHENobarbital
Risks: Phenobarbital may lead to physical and psychological dependence. Abrupt cessation after prolonged use can lead to withdrawal symptoms.
Warnings: Patients with a history of porphyria and hypersensitivity to barbiturates should not use Phenobarbital.
Interactions with PHENobarbital
Common Drug Interactions
- Warfarin
- Phenytoin
- Theophylline
- Doxycycline
- Griseofulvin
- Birth Control Pills
Common Food Interactions
- Avoid alcohol
- Limit caffeine intake
Alternatives to PHENobarbital
- Topiramate
- Levetiracetam
- Gabapentin
- Carbamazepine
- Lamotrigine
- Oxcarbazepine
- Pregabalin
- Primidone
