Generic Name and Formulations:
Pentobarbital sodium 50mg/mL; soln for IM or IV inj; contains alcohol.
Indications for NEMBUTAL:
Short-term (≤ 2 weeks) treatment of insomnia when oral route is not feasible.
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.
IM: 2–6mg/kg as a single deep IM inj; max 100mg. IV: inject slowly; reduce adult dose proportionally (see literature).
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 ℞ for smallest practical amount. Elderly. Debilitated. Labor & delivery. Pregnancy (Cat.D). Nursing mothers.
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).
Somnolence, respiratory depression, CNS effects, bradycardia, hypotension, syncope, GI upset, headache, inj site reactions, paradoxical excitement.
Multi-dose vials (20mL, 50mL)—1