Mephobarbital Brand Name– Mebaral
What is Mephobarbital
NOTE: This drug is discontinued in the U.S.
Mephobarbital also known as methylphenobarbital) was an oral sedative-hypnotic and anticonvulsant barbiturate agent. It is used for short-term sedation and sleep induction.
Mephobarbital also is used prophylactically to treat tonic-clonic (grand mal) and absence (petit mal) seizures and is often administered with other anticonvulsants.
Mephobarbital is not available in a parenteral formulation and is not used for status epilepticus. Mephobarbital’s actions are secondary to the CNS-depressant properties of the barbiturate class.
Mephobarbital is a long-acting agent with an onset of 30 to 60 minutes and a duration of action of 10 to 16 hours.
Mephobarbital is metabolized to phenobarbital, and most of mephobarbital’s pharmacologic properties are similar to phenobarbital. However, many clinicians prefer mephobarbital over phenobarbital as a seizure medication in children due to an apparently lesser effect on acute cognitive function.
This agent can be habit-forming, causing psychological or physical dependence. As with all anticonvulsants, a warning was in the label regarding an increased risk of suicidal behavior and depression in patients receiving anticonvulstant therapy.
Mephobarbital was in clinical use for decades; the manufacturer discontinued the drug in the UK in 2001, and then the drug was discontinued in the U.S. in 2012.
Indications
- absence seizures
- sedation induction
- sedation maintenance
- tonic-clonic seizures
For short term sedation maintenance or sedation induction, to relieve anxiety, tension, and apprehension
Side Effects
- agitation
- agranulocytosis
- anemia
- angioedema
- anxiety
- apnea
- asthenia
- ataxia
- bradycardia
- bullous rash
- coma
- confusion
- constipation
- depression
- diarrhea
- dizziness
- drowsiness
- ecchymosis
- elevated hepatic enzymes
- emotional lability
- erythema
- exfoliative dermatitis
- fatigue
- fever
- headache
- hepatitis
- hypoprothrombinemia
- impaired cognition
- impotence (erectile dysfunction)
- insomnia
- interstitial nephritis
- irritability
- jaundice
- lethargy
- libido decrease
- lupus-like symptoms
- maculopapular rash
- megaloblastic anemia
- miosis
- mydriasis
- nausea
- neonatal abstinence syndrome
- neutropenia
- nightmares
- nystagmus
- osteomalacia
- osteopenia
- photosensitivity
- physiological dependence
- porphyria
- psychological dependence
- ptosis
- purpura
- rash
- respiratory depression
- seizures
- serum sickness
- Stevens-Johnson syndrome
- suicidal ideation
- syncope
- teratogenesis
- thrombocytopenia
- tolerance
- toxic epidermal necrolysis
- urticaria
- vertigo
- vomiting
- weakness
- withdrawal
Monitoring Parameters
- CBC
- LFTs
- serum creatinine
Contraindications
- abrupt discontinuation
- alcoholism
- anuria
- barbiturate hypersensitivity
- breast-feeding
- chronic obstructive pulmonary disease (COPD)
- CNS depression
- coadministration with other CNS depressants
- depression
- dialysis
- driving or operating machinery
- ethanol ingestion
- geriatric
- hepatic disease
- hepatic encephalopathy
- labor
- myasthenia gravis
- myxedema
- neonates
- obstetric delivery
- osteomalacia
- osteoporosis
- pain
- porphyria
- pregnancy
- pulmonary disease
- renal disease
- renal failure
- renal impairment
- respiratory depression
- respiratory insufficiency
- sleep apnea
- status epilepticus
- substance abuse
- suicidal ideation
Interactions
- Abemaciclib
- Abiraterone
- Acalabrutinib
- Acetaminophen
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Dichloralphenazone; Isometheptene
- Acetaminophen; Diphenhydramine
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Propoxyphene
- Acetaminophen; Pseudoephedrine
- Acetaminophen; Tramadol
- Acetazolamide
- Acrivastine; Pseudoephedrine
- Afatinib
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- Amlodipine; Olmesartan
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- Aspirin, ASA; Caffeine; Orphenadrine
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- Hydrocodone
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