What are barbiturates?
Barbiturates are central nervous depressants. They reduce the activity of
nerves causing muscle relaxation. They can reduce heart rate, breathing, and
blood pressure. All barbiturates affect gamma-aminobutyric acid (GABA), a
neurotransmitter (chemical) that nerves use to communicate with one another.
For what conditions are barbiturates prescribed?
Barbiturates are medications used for treating
headaches, insomnia, and
seizures. Barbiturates are one of the older classes of medications.
What are examples of barbiturates available in the US?
Examples of barbiturates available in the US include:
- amobarbital (Amytal)
- butabarbital (Butisol)
- pentobarbital (Nembutal)
- secobarbital (Seconal)
- belladonna and phenobarbital (Donnatal)
- butalbital/acetaminophen/caffeine (Esgic, Fioricet)
- butalbital/aspirin/caffeine (Fiorinal Ascomp, Fortabs)
What are the side effects of barbiturates?
Common side effects of barbiturates are:
- dizziness,
- lightheadedness,
- sedation,
- headache,
- nausea,
- vomiting, and
- abdominal pain.
Barbiturates can slow breathing, reduce heart rate, and they can be habit forming.
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What drugs interact with barbiturates?
Barbiturates should be used with caution with some medications because they
accelerate the breakdown of these medications leading to decreased
effectiveness. Examples of these medications that interact with barbiturates
include:
-
atazanavir
(Reyataz), - boceprevir (Victrelis),
- lurasidone (Latuda),
- ranolazine (Ranexa),
- telaprevir (Incivek),
- voriconazole, (Vfend), and
- ritonavir (Norvir).
Concomitant use of barbiturates and other central nervous system depressant
medications should be used with caution because concomitant use can lead to
excessive sedation, lethargy, and in severe cases coma and death. Examples of
these medications that should be used with caution with other central nervous system
depressant medications such as:
- alprazolam (Xanax),
- clonazepam (Klonopin),
- diazepam (Valium),
- zolpidem (Ambien), and
-
zaleplon
(Sonata).
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What formulations of barbiturates are available?
- Amobarbital and pentobarbital are available as injections.
- Butabarbital, phenobarbital, belladonna and phenobarbital, butalbital/aspirin/caffeine, and butalbital/acetaminophen/caffeine are available as tablets.
- Butalbital/acetaminophen/caffeine, butalbital/aspirin/caffeine, and secobarbital are available as capsules.
- Butabarbital, phenobarbital, belladonna and phenobarbital, and butalbital/acetaminophen/caffeine are available as oral liquids.
What about taking barbiturates during pregnancy or while breastfeeding?
FDA has listed amobarbital, phenobarbital, pentobarbital, secobarbital as Pregnancy Category D. This means they should not be used
during pregnancy. FDA
has listed belladonna and phenobarbital, butabarbital, butalbital/acetaminophen/caffeine,
and butalbital/acetaminophen/caffeine as Pregnancy Category C. Pregnancy
Category C classification means that
there is no evidence of safe and effective use of barbiturates established for
pregnant women. Therefore, risk to the infant cannot be ruled out. It is not
known whether barbiturates enter
breast milk; however, barbiturates should be
avoided in nursing mothers to avoid harm to the infant.