Pentobarbital, Injection

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KEY POINTS

• This medicine is used to relieve tension or anxiety, to help you sleep, or to prevent seizures.
• This medicine will make you drowsy. Do not drive or operate machinery until you are fully alert.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: barbiturate

Generic and brand names: pentobarbital, injection; Nembutal

What is this medicine used for?

This medicine is used to relieve tension or anxiety, to help you sleep, or to prevent seizures. It may also be used to make you sleepy before a surgery or procedure.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Depression or thoughts of suicide
• Heart disease
• Liver or kidney disease
• Lung disease
• Porphyria (chemical imbalance that can affect the nerves and skin)
• Problems with alcohol or substance abuse
• Uncontrolled pain

Females of childbearing age: Tell your healthcare provider if you are pregnant or become pregnant while taking this medicine. This medicine is not usually taken during pregnancy because it may harm the baby. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your healthcare provider right away. This medicine may make birth control pills less effective. If you need birth control, talk to your healthcare provider about methods that are effective while you are taking this medicine. Do not breast-feed while you are taking this medicine.

How do I use it?

This medicine is given by your healthcare provider as an injection (shot) in the muscle or IV infusion (slow drip through a needle into a large vein) while you are in the hospital or clinic.

What should I watch out for?

This medicine will make you drowsy. Do not drive or operate machinery until you are fully alert.

This medicine may cause memory loss or amnesia. You may not know what you are doing for several hours after taking the medicine, including driving in your sleep. If you have memory problems while taking this medicine, contact your healthcare provider right away.

You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help.

If you take this medicine for a long time, you may need blood tests to find out how this medicine affects you. Keep all appointments for these tests.

This medicine may increase the effects of alcohol and other drugs that slow down your nervous system. Do not drink alcohol or take other medicines unless your healthcare provider approves.

This medicine may produce excitement rather than calming in some people. If this happens, contact your healthcare provider.

This medicine is a controlled substance. It is illegal to give this medicine to anyone else.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist that you are taking this medicine.

If you are taking this medicine to help you sleep, contact your healthcare provider if your insomnia does not improve in 7 to 10 days or if it gets worse.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Yellowing of your skin or eyes, dark urine, severe stomach pain, severe nausea or vomiting, fever, hallucinations (seeing or hearing things that are not there), trouble breathing, severe dizziness or fainting, new or worsening depression, confusion, slow heartbeat, unusual thoughts or behavior, worsening trouble sleeping, unusual excitement or agitation, memory problems, trouble walking; unusual tiredness or weakness; severe drowsiness; severe skin redness, peeling, or blisters; burning, pain, redness, or swelling at the injection site.

Other: Dizziness, mild drowsiness, headache, nervousness, nightmares, mild nausea, constipation.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Acetaminophen and medicines that contain acetaminophen
• Antianxiety medicines such as alprazolam (Xanax), clonazepam (Klonopin), clorazepate (Gen-Xene, Tranxene), diazepam (Valium), lorazepam (Ativan), and oxazepam
• Antiarrhythmic medicines (to treat irregular heartbeat) such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dronedarone (Multaq), propafenone (Rythmol), and quinidine
• Antibiotics such as chloramphenicol, doxycycline (Doryx, Monodox, Vibramycin), rifabutin (Mycobutin), rifampin (Rifadin), and rifapentine (Priftin)
• Antidepressants such as amitriptyline, amoxapine, citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), desvenlafaxine (Pristiq), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), imipramine (Tofranil), nefazodone, nortriptyline (Pamelor), protriptyline (Vivactil), sertraline (Zoloft), trimipramine (Surmontil), and venlafaxine (Effexor)
• Antihistamines such as chlorpheniramine (Chlor-Trimeton) and diphenhydramine (Benadryl)
• Antipsychotic medicines such as aripiprazole (Abilify), asenapine (Saphris), chlorpromazine, clozapine (Clozaril, FazaClo), fluphenazine, haloperidol (Haldol), iloperidone (Fanapt), olanzapine (Zyprexa), paliperidone (Invega), pimozide (Orap), quetiapine (Seroquel), risperidone (Risperdal), thioridazine, trifluoperazine, and ziprasidone (Geodon)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), ethotoin (Peganone), felbamate (Felbatol), lamotrigine (Lamictal), phenytoin (Dilantin, Phenytek), topiramate (Qudexy, Topamax, Trokendi), and valproic acid (Depacon, Depakene, Depakote)
• Beta blockers such as acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Zebeta), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), nebivolol (Bystolic), pindolol, and sotalol (Betapace, Sorine)
• Blood pressure medicines such as hydralazine, methyldopa, minoxidil, and reserpine
• Bupropion (Aplenzin, Forfivo, Wellbutrin, Buproban, Zyban)
• Calcium channel blockers such as diltiazem (Cardizem, Cartia, Tiazac), felodipine, isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera, Verelan)
• Corticosteroids such as betamethasone, cortisone, dexamethasone, fludrocortisone, hydrocortisone (A-Hydrocort, Cortef), methylprednisolone (Medrol, Solu-Medrol), prednisolone (Omnipred, Orapred, Prelone), prednisone (Prednisone Intensol), and triamcinolone (Aristospan, Kenalog)
• Doxepin (Silenor)
• Griseofulvin (Grifulvin V, Gris-PEG)
• Hormonal birth control implants, IUDs, patches, pills, shots, and vaginal rings, and hormones such as conjugated estrogens (Premarin), estradiol (Climara, Estrace, Estraderm, Vivelle), and norethindrone (Aygestin, Micronor) (Talk to your healthcare provider if you need birth control.)
• Immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune), and tacrolimus (Astagraf, Prograf, Protopic)
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• Mefloquine
• Muscle relaxants such as baclofen (Gablofen, Lioresal), carisoprodol (Soma), cyclobenzaprine (Amrix), dantrolene (Dantrium), methocarbamol (Robaxin), and tizanidine (Zanaflex)
• Narcotic pain medicines such as codeine, fentanyl (Abstral, Actiq, Duragesic, Fentora, Sublimaze), hydrocodone/acetaminophen (Norco, Vicodin), hydromorphone (Dilaudid, Exalgo), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Kadian, MS Contin), oxycodone (OxyContin, Roxicodone), oxycodone/acetaminophen (Percocet, Roxicet), and pentazocine (Talwin)
• Natural remedies such as gotu kola, kava, St. John's wort, and valerian
• Nausea medicines such as prochlorperazine (Compro) and promethazine
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Propranolol (Hemangeol, Inderal, InnoPran)
• Sleeping pills such as flurazepam, suvorexant (Belsomra), temazepam (Restoril), triazolam (Halcion), zaleplon (Sonata), and zolpidem (Ambien, Edluar, Intermezzo)
• Theophylline
• Warfarin (Coumadin)

Do not drink alcohol while you are taking this medicine.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.