Monograph Details
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Central Nervous System
> Insomnia
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NEMBUTAL |
| Manufacturer |
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Ovation Pharmaceuticals, Inc. |
| Legal Classification |
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CII |
| Pharmacological Class |
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Barbiturate. |
| Generic Name |
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Pentobarbital sodium 50mg/mL; soln for IM or IV inj; contains alcohol. |
| Indications |
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Short-term (≤ 2 weeks) treatment of insomnia when oral route is not feasible. |
| Children |
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IM: 2–6mg/kg as a single deep IM inj; max 100mg. IV: inject slowly; reduce adult dose proportionally (see literature). |
| Adults |
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IM: 150mg–200mg (max 5mL/inj) as a single deep IM inj. IV: Inject slowly (max 50mg/min). ≥70kg: initially 100mg; observe and monitor vital signs at least 1 minute, then may increase as needed in small increments to usual max 500mg. Elderly, debilitated, renal or hepatic impairment: reduce dose. |
| Contraindications |
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Porphyria. |
| Precautions |
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Prehepatic coma: not recommended. Avoid abrupt cessation. Acute or chronic pain. Depression. Suicidal tendencies. Drug abuser. Hepatic or renal impairment. Monitor BP, respiration, cardiac function. Avoid extravasation. Write Rx for smallest practical amount. Elderly. Debilitated. Labor & delivery. Pregnancy (Cat.D). Nursing mothers. |
| Interactions |
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Potentiated by MAOIs, valproic acid, sodium valproate (monitor). CNS depression potentiated with alcohol, other CNS depressants. Antagonizes anticoagulants, corticosteroids, other steroid hormones (eg, oral contraceptives), doxycycline. May interfere with griseofulvin absorption. Variable effects with phenytoin (monitor). |
| Adverse Reactions |
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Somnolence, respiratory depression, CNS effects, bradycardia, hypotension, syncope, GI upset, headache, inj site reactions, paradoxical excitement. |
| How Supplied |
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Multi-dose vials (20mL, 50mL)—1 |
| Additional Resources |
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• Related Prescribing Note |
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