The authors make no claims of the accuracy of the information contained
herein; and these suggested doses and/or guidelines are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the
preparation of this document shall be liable for any special,
consequential, or exemplary damages resulting in whole or part from any
user's use of or reliance upon this material. PLEASE
READ THE DISCLAIMER CAREFULLY BEFORE
ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE
TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.
Standard Dilutions [Amount of drug]
[Infusion volume] [Infusion rate]
(Concentrations from 0.5 to 8 mg/ml appear to be stable)
Infusion rate: As directed.
Stability / Miscellaneous
EXP: 12 to 24 hrs (RT) variable (Review specialized
reference for additional info). Label: Do not refrigerate.
Onset: 15-60 min Duration:
(Oral): 1-4 hrs (IV): 15 min
May be given deep IM (max 250mg per site) or by slow IV injection.
Note: can be given IV undiluted.
Oral: 100-200mg qhs.
IV: Initially 100mg, may repeat q1-3min up to 200-500mg total dose.
Rectal: 120-200mg at bedtime.
Preoperative sedation: IM: 150-200 mg.
Barbiturate coma in head injury patients: IV loading dose of 5-10 mg/kg
over 1 to 2 hours. Maintenance: Initial: 1 mg/kg/hr; may increase to
2-3 mg/kg/hr. Monitor for dose-dependent cardiovascular and respiratory
depression. Maintain serum concentration at 2-4 mg/dl.
Supplied: 50mg/ml-1ml, 2 ml, 20ml, 50ml. (C-II)
DOSAGE AND ADMINISTRATION
Dosages of barbiturates must be individualized with full knowledge of
their particular characteristics and recommended rate of
administration. Factors of consideration are the patient’s age, weight,
and condition. Parenteral routes should be used only when oral
administration is impossible or impractical.
IM injection of the sodium salts of barbiturates should be made deeply
into a large muscle, and a volume of 5 mL should not be exceeded at any
one site because of possible tissue irritation. After IM injection of a
hypnotic dose, the patient’s vital signs should be monitored. The usual
adult dosage of NEMBUTAL Sodium Solution is 150 to 200 mg as a single
IM injection; the recommended pediatric dosage ranges from 2 to 6 mg/kg
as a single IM injection not to exceed 100 mg.
NEMBUTAL Sodium Solution should not be admixed with any other
medication or solution. IV injection is restricted to conditions in
which other routes are not feasible, either because the patient is
unconscious (as in cerebral hemorrhage, eclampsia, or status
epilepticus), or because the patient resists (as in delirium), or
because prompt action is imperative. Slow IV injection is essential,
and patients should be carefully observed during administration. This
requires that blood pressure, respiration, and cardiac function be
maintained, vital signs be recorded, and equipment for resuscitation
and artificial ventilation be available. The rate of IV injection
should not exceed 50 mg/min for pentobarbital sodium.
There is no average intravenous dose of NEMBUTAL Sodium Solution
(pentobarbital sodium injection) that can be relied on to produce
similar effects in different patients. The possibility of overdose and
respiratory depression is remote when the drug is injected slowly in
A commonly used initial dose for the 70 kg adult is 100 mg.
Proportional reduction in dosage should be made for pediatric or
debilitated patients. At least one minute is necessary to determine the
full effect of intravenous pentobarbital. If necessary, additional
small increments of the drug may be given up to a total of from 200 to
500 mg for normal adults.
In convulsive states, dosage of NEMBUTAL Sodium Solution should be kept
to a minimum to avoid compounding the depression which may follow
convulsions. The injection must be made slowly with due regard to the
time required for the drug to penetrate the blood-brain barrier.
Special patient population
Dosage should be reduced in the elderly or debilitated because these
patients may be more sensitive to barbiturates. Dosage should be
reduced for patients with impaired renal function or hepatic disease.
Parenteral drug products should be inspected visually for particulate
matter and discoloration prior to administration, whenever solution
containers permit. Solutions for injection showing evidence of
precipitation should not be used.
NEMBUTAL Sodium Solution (pentobarbital sodium injection, USP) is
available in the following sizes: 20-mL multiple-dose vial, 1 g per
vial (NDC 67386- 501-52); and 50-mL multiple-dose vial, 2.5 g per vial
Lake Forest, Illinois 60045 U.S.A.
OVATION Pharmaceuticals, Inc.
Deerfield, Illinois, U.S.A. 60015
Source: [package insert]
The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical
judgment. Neither GlobalRPh Inc. nor any other party involved in the
preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material. PLEASE READ THE DISCLAIMER
BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU
AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.