Mebubarbital Uses

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What is Mebubarbital?

Mebubarbital is a barbiturate (bar-BIT-chur-ate). Mebubarbital slows the activity of your brain and nervous system.

Mebubarbital is used short-term as a sedative to treat insomnia, or to cause you to fall asleep for surgery. Mebubarbital is also used as an emergency treatment for seizures.

Mebubarbital may also be used for purposes not listed in this medication guide.

Mebubarbital indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Intramuscular

Hypnotic

Adult: 150-200 mg.

Child: 2-6 mg/kg. Max: 100 mg.

Elderly: Dosage adjustment needed.

Intravenous

Hypnotic

Adult: Initial: 100 mg, then increase to 200-500 mg.

Elderly: Dosage adjustment needed.

Oral

Hypnotic

Adult: 100-200 mg at bedtime.

Elderly: Dosage adjustment needed.

Oral

Sedation

Adult: 20-40 mg 2-4 times daily.

Child: 2-6 mg/kg daily in 3 divided doses. Max: 100 mg.

Elderly: Dosage adjustment needed.

Rectal

Sedation

Child: 2-6 mg/kg daily in 3 divided doses. Max: 100 mg.

Elderly: Dosage adjustment needed.

Rectal

Hypnotic

Adult: 120-200 mg.

Child: 2 mth-1yr 30 mg; 2-4 yr 30 or 60 mg; 5-12 yr 60 mg; 12-14 yr 60 or 120 mg.

Elderly: Dosage adjustment needed.

Uses of Mebubarbital in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.

Use: Labeled Indications

Sedative/hypnotic/preanesthesia: Short-term (<2 weeks) treatment of insomnia or as preanesthesia.

Seizures: Emergency control of certain anticonvulsive episodes (eg, status epilepticus, cholera, eclampsia, meningitis, tetanus, toxic reactions to strychnine or local anesthetics).

Off Label Uses

Barbiturate coma in severe brain injury patients/elevated intracranial pressure

Based on the Brain Trauma Foundation Guidelines for the Management of Severe Traumatic Brain Injury, in patients with increased intracranial pressure (ICP) or traumatic brain injury, high-dose barbiturate therapy is effective and recommended for control of ICP when all other medical and surgical treatments have failed. Utilization of barbiturates for the prophylactic treatment of ICP in not indicated. Based on potential complications of barbiturate therapy, guidelines suggest use should be limited to patients who are hemodynamically stable prior to its introduction, and appropriate, continuous systemic monitoring should be available to avoid or treat any hemodynamic instability. Note: Barbiturate therapy has not shown clear benefit in improving outcomes.

Mebubarbital description

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A short-acting barbiturate that is effective as a sedative and hypnotic (but not as an anti-anxiety) agent and is usually given orally. It is prescribed more frequently for sleep induction than for sedation but, like similar agents, may lose its effectiveness by the second week of continued administration. (From AMA Drug Evaluations Annual, 1994, p236)

Mebubarbital dosage

Dosages of barbiturates must be individualized with full knowledge of their particular characteristics and recommended rate of administration. Factors of consideration are the patient's age, weight, and condition.

Parenteral routes should be used only when oral administration is impossible or impractical.

Intramuscular Administration

IM injection of the sodium salts of barbiturates should be made deeply into a large muscle, and a volume of 5 mL should not be exceeded at any one site because of possible tissue irritation. After IM injection of a hypnotic dose, the patient's vital signs should be monitored. The usual adult dosage of Mebubarbital Sodium is 150 to 200 mg as a single IM injection; the recommended pediatric dosage ranges from 2 to 6 mg/kg as a single IM injection not to exceed 100 mg.

Intravenous Administration

Mebubarbital Sodium should not be admixed with any other medication or solution. IV injection is restricted to conditions in which other routes are not feasible, either because the patient is unconscious (as in cerebral hemorrhage, eclampsia, or status epilepticus), or because the patient resists (as in delirium), or because prompt action is imperative. Slow IV injection is essential, and patients should be carefully observed during administration. This requires that blood pressure, respiration, and cardiac function be maintained, vital signs be recorded, and equipment for resuscitation and artificial ventilation be available. The rate of IV injection should not exceed 50 mg/min for Mebubarbital Sodium.

There is no average intravenous dose of Mebubarbital Sodium that can be relied on to produce similar effects in different patients. The possibility of overdose and respiratory depression is remote when the drug is injected slowly in fractional doses.

A commonly used initial dose for the 70 kg adult is 100 mg. Proportional reduction in dosage should be made for pediatric or debilitated patients. At least one minute is necessary to determine the full effect of intravenous Mebubarbital. If necessary, additional small increments of the drug may be given up to a total of from 200 to 500 mg for normal adults.

Anticonvulsant use

In convulsive states, dosage of Mebubarbital Sodium should be kept to a minimum to avoid compounding the depression which may follow convulsions. The injection must be made slowly with due regard to the time required for the drug to penetrate the blood-brain barrier.

Special patient population

Dosage should be reduced in the elderly or debilitated because these patients may be more sensitive to barbiturates. Dosage should be reduced for patients with impaired renal function or hepatic disease.

Inspection

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution containers permit. Solutions for injection showing evidence of precipitation should not be used.

Mebubarbital interactions

See also:
What other drugs will affect Mebubarbital?

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Most reports of clinically significant drug interactions occurring with the barbiturates have involved phenobarbital. However, the application of these data to other barbiturates appears valid and warrants serial blood level determinations of the relevant drugs when there are multiple therapies.

Anticoagulants: Phenobarbital lowers the plasma levels of dicumarol (name previously used: bishydroxycoumarin) and causes a decrease in anticoagulant activity as measured by the prothrombin time. Barbiturates can induce hepatic microsomal enzymes resulting in increased metabolism and decreased anticoagulant response of oral anticoagulants (e.g., warfarin, acenocoumarol, dicumarol and phenprocoumon). Patients stabilized on anticoagulant therapy may require dosage adjustments if barbiturates are added to or withdrawn from their dosage regimen.

Corticosteroids: Barbiturates appear to enhance the metabolism of exogeneous corticosteroids probably through the induction of hepatic microsomal enzymes. Patients stabilized on corticosteroid therapy may require dosage adjustments if barbiturates are added to or withdrawn from their dosage regimen.

Griseofulvin: Phenobarbital appears to interfere with the absorption of orally administered griseofulvin, thus decreasing its blood level. The effect of the resultant decreased blood levels of griseofulvin on therapeutic response has not been established. However, it would be preferable to avoid concomitant administration of these drugs.

Doxycycline: Phenobarbital has been shown to shorten the half-life of doxycycline for as long as 2 weeks after barbiturate therapy is discontinued.

This mechanism is probably through the induction of hepatic microsomal enzymes that metabolize the antibiotic. If phenobarbital and doxycycline are administered concurrently, the clinical response to doxycycline should be monitored closely.

Phenytoin, sodium vaiproate, valproic acid: The effect of barbiturates on the metabolism of phenytoin appears to be variable. Some investigators report an accelerating effect, while others report no effect. Because the effect of barbiturates on the metabolism of phenytoin is not predictable, phenytoin and barbiturate blood levels should be monitored more frequently if these drugs are given concurrently. Sodium vaiproate and valproic acid appear to decrease barbiturate metabolism; therefore, barbiturate blood levels should be monitored and appropriate dosage adjustments made as indicated.

Central nervous system depressants: The concomitant use of other central nervous system depressants, including other sedatives or hypnotics, antihistamines, tranquilizers, or alcohol, may produce additive depressant effects.

Monoamine oxidase inhibitors (MAOI): M.O. prolong the effects of barbiturates probably because metabolism of the barbiturate is inhibited.

Estradiol, estrone, progesterone and other steroidal hormones: Pretreatment with or concurrent administration of phenobarbital may decrease the effect of estradiol by increasing its metabolism. There have been reports of patients treated with antiepileptic drugs (e.g., phenobarbital) who became pregnant while taking oral contraceptives. An alternate contraceptive method might be suggested to women taking phenobarbital.

Mebubarbital side effects

See also:
What are the possible side effects of Mebubarbital?

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Applies to Mebubarbital: parenteral solution for injection

Side effects include:

Residual sedation, drowsiness, lethargy, vertigo, nausea, vomiting, headache.

Mebubarbital contraindications

See also:
What is the most important information I should know about Mebubarbital?

Barbiturates are contraindicated in patients with known barbiturate sensitivity. Barbiturates are also contraindicated in patients with a history of manifest or latent porphyria.

Active ingredient matches for Mebubarbital:

Pentobarbital


List of Mebubarbital substitutes (brand and generic names)

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Unit description / dosage (Manufacturer)Price, USD
20 milliliter in 1 vial
50 milliliter in 1 vial
Nembutal Sodium injection 50 mg/mL (Oak Pharmaceuticals, Inc. (Subsidiary of Akorn, Inc., US))
Capsule; Oral; Pentobarbital Sodium 100 mg
Capsule; Oral; Pentobarbital Sodium 100 mg
Tablet; Oral; Pentobarbital Sodium 100 mg
Capsule; Oral; Pentobarbital Sodium 50 mg
Injectable; Injection; Pentobarbital Sodium 50 mg / ml
Pentobarbital sodium powder$ 27.00
Nembutal sodium 50 mg/ml via$ 20.65
1 g x 1's (Chandra Bhagat Pharma)$ 0.94
500 mg x 1's (Chandra Bhagat Pharma)$ 0.63
Pentone 1g VIAL / 1 (Chandra Bhagat Pharma)$ 0.94
Pentone 500mg VIAL / 1 (Chandra Bhagat Pharma)$ 0.63
PENTONE 1GM INJECTION 1 vial / 1 injection each (Chandra Bhagat Pharma)$ 0.79
Pentone 1gm Injection (Chandra Bhagat Pharma)$ 0.79
Capsule; Oral; Manganese / Manganese Citrate 1.25 mg; Vitamin C / Calcium Ascorbate 30 mg (Kamakshi)

References

  1. DailyMed. "PENTOBARBITAL SODIUM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "pentobarbital". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "pentobarbital". http://www.drugbank.ca/drugs/DB00312 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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