Barbit 30mg Tablet

Uses of Barbit 30mg Tablet

• Epilepsy/Seizures

How does Barbit 30mg Tablet work?

This medication works by affecting GABA receptors. The drug facilitates the production of GABA (Gamma AminoButyric Acid) an amino acid that helps in reducing the excitability of neurons.

Side Effects of Barbit 30mg Tablet

• Drowsiness
• Skin Rash
• Nausea
• Vomiting
• Vertigo
• Diarrhea
• Dermatitis
• Constipation
• Respiratory Depression

Quick Suggestions:

• Phenobarbitone helps in the treatment and prevention of seizures.
• It may be habit-forming with long-term use.
• Talk with your doctor if it stops working well. Do not take more than prescribed.
• It may make you very sleepy. Don't drive or do anything that requires mental focus until you know how it affects you.
• Inform your doctor if you notice pain in your joints or if you have a history of bone disease.
• Get regular blood tests done to monitor the amount of medication in your body.
• Talk to your doctor immediately if you notice a skin rash accompanied by a fever.
• Do not stop taking the medication suddenly without talking to your doctor.

Indication

The uses of Barbit 30mg Tablet include:

1. Seizures: It is used to treat seizures, a brain disorder characterized by uncontrolled jerking movements and loss of consciousness.
2. Insomnia: It helps in the treatment of insomnia, a sleep disorder characterized by difficulty in falling asleep or staying asleep.
3. Daytime Sedation: It is used to relieve symptoms of anxiety and tension during the daytime.
4. Status Epilepticus: It is used to treat status epilepticus, a condition where seizures occur for an extended period or one seizure follows immediately after another.
5. Preoperative Sedation: It is used to relieve symptoms of anxiety and tension in patients before undergoing surgical procedures.

Pharmacology

Phenobarbital is a long-acting barbiturate that works by depressing the sensory cortex, reducing motor activity, and changing cerebellar function, leading to drowsiness, sedation, and hypnosis. It acts on GABAA receptors to increase synaptic inhibition, elevating the seizure threshold and reducing seizure activity. Additionally, it may inhibit calcium channels, decreasing excitatory transmitter release. The sedative and hypnotic effects are likely due to its impact on the polysynaptic midbrain reticular formation, which controls CNS arousal.

Dosage & Administration of Barbit 30mg Tablet

Adult Dose:

• Sedation: 30-120 mg daily in 2-3 divided doses, not exceeding 400 mg/day.
• Status Epilepticus; Emergency management of acute seizures: 100-300 mg daily at bedtime.
• Generalized tonic-clonic seizures, Partial seizures: 60-180 mg/day at night.
• Insomnia: 100-200 mg daily at bedtime, not exceeding 400 mg/day.
• As a hypnotic: 100-320 mg. Do not administer for >2 weeks for the treatment of insomnia. Elderly: Reduce dose. Hepatic impairment: Reduce dose. Severe: Contraindicated.

Child Dose:

• Sedation: 2 mg/kg daily in 3 divided doses.
• Status Epilepticus; Emergency management of acute seizures: 3-5 mg/kg or 125 mg/m2 daily.
• Seizures Neonates (<28 days): 3-5 mg/kg/day in 1-2 divided doses.
• Infants: 5-6 mg/kg/day in 1-2 divided doses.
• 1-5 years: 6-8 mg/kg/day in 1-2 divided doses.
• 6-12 years: 4-6 mg/kg/day in 1-2 divided doses.

12 years: 1-3 mg/kg/day in 1-2 divided doses, OR 50-100 mg BID/TID.

• Preoperative sedation: 1-3 mg/kg pre-op.

Renal Dose:

• Reduce dose in renal impairment. Severe cases: Contraindicated.

Administration:

• May be taken with or without food. Swallow it whole, do not chew, crush or break it. It is better to take at a fixed time.

Interaction

Phenobarbital may interact with several medications and substances, leading to potential effects on their levels and actions. Some notable interactions include:

1. Enhanced hepatotoxic potential of paracetamol overdoses.
2. Decreased levels/effects of various drugs metabolized by CYP isoenzymes, including teniposide, methotrexate, antipsychotics, beta-blockers, calcium-channel blockers, other anticonvulsants, chloramphenicol, cimetidine, corticosteroids, ciclosporin, doxycycline, estrogens, felbamate, griseofulvin, tacrolimus, furosemide, methadone, oral contraceptives, theophylline, TCAs, and warfarin.
3. Reduced effects of guanfacine.
4. Reduced metabolism and/or increased toxicity with chloramphenicol, felbamate, MAOIs (monoamine oxidase inhibitors), and valproic acid.
5. Enhanced nephrotoxic effects of methoxyflurane.
6. Potentially fatal additive sedation and/or respiratory depression when used with ethanol, sedatives, antidepressants, opioid analgesics, benzodiazepines, and other CNS depressants.
7. Reduced levels/effects of antiarrhythmic drugs like disopyramide, propafenone, and quinidine.

It is crucial for patients and healthcare professionals to be aware of these interactions and adjust treatment plans accordingly to avoid adverse effects or reduced efficacy of medications. Always consult a healthcare provider before starting or stopping any medications or substances while taking phenobarbital.

Contraindications

• Severe renal and hepatic disorders.
• Severe respiratory depression, dyspnea, or airway obstruction.
• Porphyria.
• Pregnancy.

Barbit 30mg Tablet should not be used in individuals with these conditions as it may cause adverse effects or worsen the existing health conditions. Pregnant women should avoid using this medication due to potential risks to the unborn baby. It is important to consult a healthcare professional before starting or stopping any medication.

Pregnancy & Lactation

Phenobarbital is classified as Pregnancy Category D, which means it has the potential to cause fetal harm when used during pregnancy. The drug, either used alone or in combination with other anticonvulsants, may lead to coagulation defects in the newborn infant. This effect can be prevented by giving the mother prophylactic Vitamin K before delivery.

Furthermore, phenobarbital is excreted in human breast milk, so caution should be exercised when using the medication during the lactation period. The potential risk to the nursing infant should be carefully weighed against the benefits of using phenobarbital in lactating mothers. It is essential for pregnant or breastfeeding women to consult their healthcare provider before using phenobarbital or any other medications to ensure the safety of both the mother and the child.

Precautions & Warnings

Phenobarbital should be used with caution and under the supervision of a healthcare professional in the following conditions:

• History of sedative/hypnotic addiction.
• Respiratory disease.
• Depression or suicidal tendencies.
• Hypoadrenalism.
• Mild to moderate renal and hepatic impairment.
• Elderly or debilitated patients.
• Children.
• Pregnancy and lactation.

Patients should be aware that phenobarbital may impair their ability to drive or operate machinery. Regular monitoring of complete blood count (CBC), liver function tests (LFTs), mental status, and seizure activity may be necessary during treatment. For lactating women, nursing should be avoided while using phenobarbital. It is essential to discuss any medical history or concerns with the prescribing healthcare professional. Abrupt withdrawal from the medication should also be avoided

Storage Conditions

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.