Butisol Sodium
Classifications: barbiturate; anxiolytic; sedative-hypnotic;
Therapeutic: antianxiety
; sedative-hypnotic
Prototype: Phenobarbital
Pregnancy Category: C
Controlled Substance: Schedule III


30 mg, 50 mg tablets; 30 mg/5 mL elixir


Intermediate-acting barbiturate that appears to act at thalamus level, where it interferes with transmission of impulses to the cerebral cortex.

Therapeutic Effect

Preoperative sedative agent that also is an effective antianxiety agent.


Hypnotic in short-term treatment of simple insomnia, as sedative for relief of anxiety, and to provide sedation preoperatively.


Porphyria; uncontrolled pain; severe respiratory disease; history of addiction; pregnancy (category C), lactation.

Cautious Use

Severe renal or hepatic impairment; acute abdominal conditions; head trauma, history of seizures; history of herpes infection; older adults or debilitated patients.

Route & Dosage

Daytime Sedation
Adult: PO 15–30 mg t.i.d. or q.i.d.

Preoperative Sedation
Adult: PO 50–100 mg 60–90 min before surgery
Child: PO 2–6 mg/kg/dose (max: 100 mg)

Adult: PO 50–100 mg h.s.


  • Schedule slow withdrawal following long-term use to avoid precipitating withdrawal symptoms.
  • Store in tightly covered containers, preferably at 15°–30° C (59°–86° F), unless otherwise directed.

Adverse Effects (≥1%)

CNS: Drowsiness, residual sedation ("hangover"), headache. GI: Nausea, vomiting, constipation, diarrhea. Skin: Urticaria, skin rash. Musculoskeletal: Muscle or joint pain.


Drug: Alcohol and other cns depressants add to CNS and respiratory depression; butabarbital increases the metabolism of oral anticoagulants, beta blockers, corticosteroids, doxycycline, griseofulvin, quinidine, theophyllines, oral contraceptives, decreasing their effectiveness. Herbal: Kava, valerian may potentiate sedation.


Absorption: Readily from GI tract. Onset: 40–60 min. Peak: 3–4 h. Duration: 6–8 h. Distribution: Crosses placenta; distributed into breast milk. Metabolism: In liver. Elimination: In urine primarily as metabolites. Half-Life: Average 100 h.

Nursing Implications

Assessment & Drug Effects

  • Assess for adverse effects. Older adults and debilitated patients sometimes manifest excitement, confusion, or depression. Children also may react with paradoxical excitement. Side rails may be advisable. Report these reactions to physician.

Patient & Family Education

  • Do not drive or engage in other potentially hazardous activities until response to drug is known.
  • Do not drink alcoholic beverages while taking this drug. Other CNS depressants may produce additive drowsiness; do not take without approval of physician.
  • Note: Prolonged use is not recommended because tolerance to drug occurs in about 14 d.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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