Classifications: barbiturate; anxiolytic; sedative-hypnotic; Therapeutic: antianxiety; sedative-hypnotic
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.
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.
Severe renal or hepatic impairment; acute abdominal conditions; head trauma, history of seizures; history of herpes infection;
older adults or debilitated patients.
Route & Dosage
Adult: PO 1530 mg t.i.d. or q.i.d.
Adult: PO 50100 mg 6090 min before surgery
Child: PO 26 mg/kg/dose (max: 100 mg)
Adult: PO 50100 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
Adverse Effects (≥1%)CNS:
Drowsiness, residual sedation
("hangover"), headache. GI:
Nausea, vomiting, constipation
Urticaria, skin rash. Musculoskeletal:
Muscle or joint pain.
and other cns depressants
add to CNS
and respiratory depression; butabarbital increases the metabolism
of oral anticoagulants
, beta blockers
, doxycycline, griseofulvin, quinidine, theophyllines
, oral contraceptives
, decreasing their effectiveness. Herbal: Kava, valerian
may potentiate sedation.
Readily from GI tract. Onset:
4060 min. Peak:
34 h. Duration:
68 h. Distribution:
Crosses placenta; distributed into breast milk. Metabolism:
In liver. Elimination:
In urine primarily as metabolites. Half-Life:
Average 100 h.
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.