Generic Name: pentobarbital (pen-toe-BAR-bi-tal)

Brand Names: Nembutal®

Classification: Barbiturates

Issue Date: 1976

Nembutal is in a class of drugs called barbiturates (bar-bi-TURE-ates). Nembutal depresses the activity of your brain and nervous system. Nembutal is used to treat insomnia (for up to 2 weeks) and to induce sleep before surgery.

Call your doctor immediately if you develop

• a fever
• a sore throat
• sores in your mouth
• broken blood vessels under your skin
• easy bruising or bleeding

These could be early signs of a serious side effect.

Use caution when driving, operating machinery, or performing other hazardous activities. Nembutal will cause drowsiness. If you experience drowsiness, avoid these activities.

Do not drink alcohol or take other sleep medicines, antihistamines, narcotic pain relievers, or other drugs that also cause drowsiness unless your doctor approves. Dangerous sedation could result.

Nembutal may decrease the effectiveness of birth control pills. Use a second method of birth control while taking Nembutal to prevent pregnancy.

Take Nembutal exactly as directed by your doctor. If you do not understand the directions on your prescription bottle, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

The suppositories are for rectal use. Ask your pharmacist, nurse, or doctor for instructions if you do not know how to insert a suppository.

To treat insomnia, Nembutal is usually taken just before bedtime. Take your dose when you are ready to get into bed, or not long before, so that if you become sleepy, you will not fall or become confused and accidentally injure yourself. Nembutal should not be used for longer than 2 weeks to treat insomnia.

To cause sedation, Nembutal may be taken several times a day at regular intervals, or shortly before surgery.

Do not increase your dosage of this medicine without the approval of your doctor. If your symptoms are not being adequately treated, talk to your doctor.

Do not take Nembutal if you have:

• porphyria
• liver disease
• kidney disease
• severe respiratory disease such as:
• severe asthma
• severe chronic obstructive pulmonary disorder (COPD)

Before taking this medication, tell your doctor if you have ever had a drug or alcohol addiction in the past. Nembutal is habit forming, which means that you can become addicted to it.

Nembutal is known to harm an unborn baby. Do not take Nembutal if you are pregnant. Nembutal passes into breast milk and could affect a nursing infant. Do not take Nembutal without first talking to your doctor if you are breast-feeding a baby.

Nembutal may cause excitement, irritability, aggression, depression, or confusion, particularly in children and in adults over 60 years of age. Lower doses and close monitoring may be necessary.

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a Nembutal overdose may include:

• difficulty breathing
• back-and-forth movements of the eyes
• appearance of being drunk
• fast heartbeat
• low body temperature
• heavy sedation
• coma
• death

Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction:

• hives
• difficulty breathing
• swelling of your face, lips, tongue, or throat

Call your doctor at once if you have any of these SERIOUS side effects:

• a fever or a sore throat
• sores in your mouth
• broken blood vessels under your skin
• easy bruising or bleeding

Other, less serious side effects may be more likely to occur. Continue to take Nembutal and talk to your doctor if you experience:

• drowsiness or dizziness
• confusion
• agitation, irritability, or excitability
• nightmares, nervousness, or anxiety
• headache
• "hangover" effect (drowsiness the day after a dose)

Nembutal is habit forming, which means that you can become addicted to it. Your doctor will want to monitor how much medicine you are taking. Your dosage may have to be reduced slowly to prevent withdrawal effects.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Large chronic doses of Nembutal may cause liver damage if it is taken with acetaminophen (Tylenol, others). Tell your doctor and pharmacist if you are taking Nembutal on a regular basis. Pain and fever reducers other than acetaminophen are available and may be more suitable choices. Nembutal may decrease the effectiveness of many drugs, including the following:

• warfarin (Coumadin®)
• carbamazepine (Tegretol®)
• clonazepam (Klonopin®)
• birth control pills - Breakthrough bleeding or unplanned pregnancy could result
• hydrocortisone (Cortef®, Hydrocortone®)
• prednisone (Orasone®, Deltasone®)
• prednisolone (Prelone®, DeltaCortef®)
• methylprednisolone (Medrol®)
• felodipine (Plendil®)
• verapamil (Calan®, Verelan®, Isoptin®)
• quinidine (Cardioquin®, Quinidex®, Quinora®, Quinaglute®)
• fenoprofen (Nalfon®)
• griseofulvin (Grisactin®, FulvicinPG®, GrifulvinV®)
• metronidazole (Flagyl®, Metryl®, Metizol®)
• theophylline (Theo-Dur®, Theochron®, Theolair®, Slo-Bid®)

Other drugs may also influence the activity of Nembutal:

• Alcohol
• sleep aids
• antihistamines
• antidepressants
• drugs that cause tiredness or sedation may increase the drowsiness
• Rifampin (Rifadin®, Rimactine®) may decrease the effects of Nembutal

There may be other drugs not listed that can affect Nembutal. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.