Barbit 60mg Tablet

Uses of Barbit 60mg Tablet

• Seizures
• Insomnia
• Daytime Sedation
• Status Epilepticus
• Preoperative sedation

How does Barbit 60mg Tablet work?

Barbit 60mg Tablet controls seizures or fits by increasing the action of GABA, a chemical messenger which suppresses the abnormal and excessive activity of the nerve cells in the brain.

Side Effects of Barbit 60mg Tablet

• Dizziness
• Drowsiness
• Tiredness
• Headache
• Confusion
• Depression
• Hyperactivity
• Nausea and vomiting
• Constipation
• Anemia

Quick Suggestions:

• Barbit 60mg Tablet 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 fever.
• Do not stop taking the medication suddenly without talking to your doctor.

Indication of Barbit 60mg Tablet

The following conditions are treated with phenobarbital:

• Sedatives
• Hypnotics are used to cure insomnia in the short term.
• Pre-anesthetics
• Anticonvulsants used for a long time to treat generalized tonic-clonic and cortical local seizures. In addition, in the treatment of some acute convulsive episodes (those associated with status epilepticus, eclampsia meningitis, tetanus, and toxic reactions to Strychnine or local anesthetics).

Pharmacology

Phenobarbital, the longest-acting barbiturate, is commonly used as an anticonvulsant and sedative-hypnotic medication. It is effective in treating various seizure disorders, excluding absence seizures (petit mal). The mechanism of action of phenobarbital involves increasing synaptic inhibition by targeting GABAA receptors. By doing so, it raises the seizure threshold and restricts the spread of seizure activity originating from a seizure focus. Additionally, phenobarbital may inhibit calcium channels, leading to a decrease in the release of excitatory neurotransmitters.

The sedative-hypnotic effects of phenobarbital are thought to be mediated through its actions on the polysynaptic midbrain reticular formation, which plays a role in regulating central nervous system (CNS) alertness. By acting on this region, phenobarbital induces sedation and promotes sleep.

It's important to note that the specific mechanisms of action for phenobarbital may involve other factors as well, and the overall effects on the CNS contribute to its anticonvulsant and sedative-hypnotic properties.

Dosage & Administration of Barbit 60mg Tablet

The recommended doses of Barbit 60mg Tablet for different indications and patient populations are as follows:

Adult Dose:

• Oral Sedation: 30-120 mg daily in 2-3 divided doses, with a maximum daily dose of 400 mg.
• Emergency management of acute seizures (Status epilepticus): 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, with a maximum daily dose of 400 mg. Do not administer for more than 2 weeks for the treatment of insomnia.
• As a hypnotic: 100-320 mg. Do not exceed the recommended duration of use for insomnia.
• Elderly: Reduce the dose.
• Hepatic impairment: Reduce the dose. A severe impairment is contraindicated.

Child Dose:

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

• Renal impairment: Reduce the dose according to the degree of impairment.
• Severe renal impairment: Contraindicated.

It is important to note that the dosages mentioned here are general guidelines, and the specific dosage and treatment regimen should be determined by a healthcare professional based on the individual patient's condition and response to the medication.

Interaction

• Phenobarbital has several interactions with other medications. Some of the important interactions include:
• Enhanced hepatotoxicity of paracetamol (acetaminophen) overdoses: Phenobarbital may increase the potential for liver damage when taken in combination with high doses of paracetamol.
• Decreased levels/effects of various CYP isoenzyme substrates: Phenobarbital can reduce the effectiveness of medications that are metabolized by certain enzymes in the liver, 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, tricyclic antidepressants (TCAs), and warfarin.
• Reduced effects of guanfacine: Phenobarbital may diminish the effectiveness of guanfacine, a medication used to treat high blood pressure and attention deficit hyperactivity disorder (ADHD).
• Altered metabolism and increased toxicity with certain medications: Phenobarbital can affect the metabolism and increase the potential toxicity of medications such as chloramphenicol, felbamate, monoamine oxidase inhibitors (MAOIs), and valproic acid.
• Enhanced nephrotoxic effects of methoxyflurane: Phenobarbital may increase the risk of kidney damage when used in combination with methoxyflurane, an anesthetic.
• Additive sedation and respiratory depression: Taking phenobarbital together with ethanol, sedatives, antidepressants, opioid analgesics, benzodiazepines, or another central nervous system (CNS) depressants can result in increased sedation and respiratory depression.
• Decreased levels/effects of antiarrhythmic drugs: Phenobarbital can reduce the effectiveness of antiarrhythmic medications such as disopyramide, propafenone, and quinidine.

Contraindications

• Severe renal and hepatic disorders: Phenobarbital should not be used in individuals with severe kidney or liver dysfunction as it may worsen the condition and lead to complications.
• Severe respiratory depression, dyspnea, or airway obstruction: Phenobarbital can depress respiratory function, and therefore, it is contraindicated in individuals with severe respiratory depression, difficulty breathing, or airway obstruction.
• Porphyria: Phenobarbital is contraindicated in individuals with porphyria, a group of rare genetic disorders that affect the production of heme, a component of hemoglobin. Phenobarbital can trigger an acute attack of porphyria and worsen the symptoms.
• Pregnancy: Phenobarbital should not be used during pregnancy unless specifically advised by a healthcare professional. It may have harmful effects on the developing fetus.

Pregnancy & Lactation

Phenobarbital is classified as category D in pregnancy, indicating that there is positive evidence of fetal risk based on human studies. When given to a pregnant woman, phenobarbital can potentially harm the fetus, and its use during pregnancy should be carefully considered and weighed against the potential benefits.

Additionally, phenobarbital can be excreted into breast milk in small amounts. Therefore, caution should be exercised when administering phenobarbital to breastfeeding mothers. The potential risks and benefits should be discussed with a healthcare professional to make an informed decision about its use during breastfeeding.

Precautions & Warnings

• Patients with a history of sedative/hypnotic addiction, respiratory diseases, depression, suicidal tendencies, or hypoadrenalism should exercise caution when using phenobarbital. It is important to avoid abrupt withdrawal of the medication.
• For patients with mild to moderate renal or hepatic impairment, phenobarbital should be used with caution and at appropriate dosages.
• Elderly or debilitated patients and children should be closely monitored when taking phenobarbital.
• During pregnancy and lactation, phenobarbital should be avoided unless the potential benefits outweigh the risks. It is important to consult with a healthcare professional for personalized advice in these situations.
• Patients taking phenobarbital should be aware that it may impair their ability to drive or operate machinery.
• Monitoring of complete blood count (CBC), liver function tests (LFTs), mental status, and seizure activity may be necessary during treatment with phenobarbital.
• In lactating mothers, nursing should be avoided while using phenobarbital.
• With continued use of phenobarbital, tolerance, and psychological as well as physical dependency may develop. Patients with a history of depression, suicidal tendencies, or drug misuse should be given phenobarbital with caution.
• Individuals with hepatic impairment should use phenobarbital with care and at low dosages.

Storage Conditions

Keep the temperature below 30°C and away from light and moisture. Keep out of children's reach.