| USED FOR:
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Tonic-clonic (grand mal) seizures |
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Partial seizures |
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Neonatal seizures |
PRECAUTIONS:
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Phenobarbital may be habit forming. |
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Inform your doctor if there is a history of drug dependence or abuse. |
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Consuming alcohol or other drugs that slow down the nervous system (CNS depressnts) can cause serious phenobarbital toxicity. |
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Tell your doctor if you have porphyria, impaired liver or kidney function, any respiratory difficulties, or have recently taken any respiratory depressants. |
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Use caution when driving or operating hazardous machinery. |
POSSIBLE SIDE EFFECTS:
Depending on the individual, side effects may occur at varying degrees or not at all, including:
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drowsiness |
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depression |
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blurred vision |
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excitement, confusion in the elderly |
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loss of coordination |
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hyperactivity in children |
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fatigue |
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mental dullness |
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dizziness |
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bone pain, tenderness or aching (usually with long-term use) |
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vertigo |
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anemia |
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headaches |
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withdrawal symptoms if discontinued abruptly |
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breathing difficulties |
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stomach upset |
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sleep disturbances |
|
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Allergic Reactions/Idiosyncratic - skin rash (if you notice a rash, seek immediate medical help) - jaundice, toxic hepatitis
- facial swelling
DRUG INTERACTIONS:
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Alcohol should be avoided by patients on phenobarbital. |
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Phenobarbital may decrease the effectiveness of anticoagulants, corticosteroids (potentially exascerbating asthma), some antibiotics (griseofulvin, doxycycline), some antidepressants, acetaminophen, cyclosporin, lamotrigine, digitoxin and verapamil. |
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Antihistamines, narcotic pain killers, tranquilizers and medication for seizures acid may increase the action of phenobarbital and result in oversedation. |
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Administration with valproic acid can lead to increased levels of phenobarbital. |
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Monoamine oxidase (MAO) inhibitors may cause increased levels of phenobarbital |
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Phenytoin (Dilantin®) interacts in variable ways. |
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- Oral contraceptives may be made less effective, leading potentially to breakthrough bleeding and contraceptive failure. |
Inform your doctor and pharmacist of any other medicines (prescription and nonprescription) or substances you are taking.
DAILY DOSAGE:
Adults - 60 to 250 mg/day (maximum of 600 mg/day)
Children - 1 to 6 mg/kg/day
Regimen - Total daily dose can be administered once daily at bedtime or in divided doses.
Dosage should be individualized. Doses that can result in toxicity vary widely between patients.
FORMS:
Elixir - 4 mg/ml
Tablets - 15, 30, 60, and 100 mg
Injection - 30 and 120 mg/ml
TIPS FOR USING PHENOBARBITAL:
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Avoid alcohol or any other drugs that slow down the nervous system (CNS depressants). |
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Prolonged use may cause dependence. |
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Mild overdose resembles alcohol intoxication. |
MISSED DOSE:
Try to take each dose at the scheduled time. If you miss a dose, take it as soon as remembered. Do not take it if it is near the time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up. If you skip a whole day, inform your doctor.
STORAGE:
Store at room temperature (15 to 30oC), protect from light heat and moisture and keep out of reach of children.
IN PREGNANCY:
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Anti-epileptic medications do slightly increase the risk of fetal abnormalities. |
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Safe use of phenobarbital during pregnancy or breastfeeding has not been established. |
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Increased incidence of cleft lip/palate, heart malformations, changes in neural development with reduced head circumference and reduced birth weight in children of women receiving phenobarbital. |
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Women who are considering pregnancy should first consult their doctor. |
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Vitamin K may be given to correct neonatal coagulation defects. |
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Newborns may experience withdrawal symptoms such as vomiting and irritability. |
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Mothers should discontinue breastfeeding if they notice that the baby is drowsy, has feeding problems, a rash or other adverse affects. |
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Discontinuation of breastfeeding may result in withdrawal symptoms |
WARNING:
Abrupt withdrawal of any anti-epileptic medication may trigger status epilepticus, a potentially fatal condition of continued seizures without recovery. When there is a need for reduction, discontinuation or substitution of the medication, this should be done gradually and under the physician's care.
MORE INFORMATION YOU NEED TO KNOW ABOUT YOUR MEDICATION
CREDIT:
This drug fact sheet has been reviewed by the pharmacists of the Ontario Pharmacists' Association Drug Information and Research Centre (DIRC).
DISCLAIMER:
The material offered on the website of Epilepsy Toronto is to provide general information about epilepsy to the public. It is not intended to be taken as personal medical advice. Epilepsy Toronto, its employees, Board members, Medical Advisors, volunteers, agents and sponsors do not assume responsibility for inaccuracies or omissions or for consequences from the use of information obtained over this site or any links accessed through this site, and is not liable for any outcome or damages resulting from information in its content in either an indirect or direct form. We recognize that each individual's experience of epilepsy is different. Consult your physician and/or neurologist with any questions you have.
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