Mephobarbital
Mechanism :
It is the methyl derivative of phenobarbitone used in the treatment of epilepsy and as a sedative.
Indication :
Contraindications :
Barbiturate sensitivity, porphyria, liver disease, severe respiratory disease.
Caution: Reduce dose in hepatic/renal impairment.
Dosing :
Sedation:
16-32 mg PO TID/QID.
Epilepsy:
<5 years: 16-32 mg PO TID/QID.
>5 years: 32-64 mg PO TID/QID.
The dose may be gradually increased over 4 or 5 days until the optimum dosage is determined. Similarly, when the dose is to be lowered to a maintenance level or is to be discontinued, the dose should be reduced gradually over 4 or 5 days.
Adverse Effect :
Somnolence, bradycardia, hypotension, hypoventilation, agitation, confusion, hyperkinesia, ataxia, CNS depression, nightmares, nervousness, constipation, nausea, vomiting.
Interaction :
Aminophylline: The barbiturate, methylphenobarbital, decreases the effect of aminophylline.
Betamethasone: The barbiturate, methylphenobarbital, may decrease the effect of the corticosteroid, betamethasone.
Clomifene: The enzyme inducer, methylphenobarbital, decreases the effect of the hormone agent, clomifene.
Conjugated Estrogens: The enzyme inducer, methylphenobarbital, decreases the effect of the hormone agent, conjugated estrogens.
Cyclosporine: The barbiturate, methylphenobarbital, increases the effect of cyclosporine.
Delavirdine: The anticonvulsant, methylphenobarbital, decreases the effect of delavirdine.
Dexamethasone: The barbiturate, methylphenobarbital, may decrease the effect of the corticosteroid, dexamethasone.
Diethylstilbestrol: The enzyme inducer, methylphenobarbital, decreases the effect of the hormone agent, diethylstilbestrol.
Doxycycline: The anticonvulsant, methylphenobarbital, decreases the effect of doxycycline.
Estradiol: The enzyme inducer, methylphenobarbital, decreases the effect of the hormone agent, estradiol.
Ethinyl: Estradiol This product may cause a slight decrease of contraceptive effect.
Felodipine: The barbiturate, methylphenobarbital, decreases the effect of felodipine.
Fludrocortisone: The barbiturate, methylphenobarbital, may decrease the effect of the corticosteroid, fludrocortisone.
Folic Acid: Decreases the effect of anticonvulsant, methylphenobarbital.
Gefitinib: The CYP3A4 inducer, methylphenobarbital, may decrease the serum concentration and therapeutic effects of gefitinib.
Griseofulvin: The barbiturate, methylphenobarbital, decreases the effect of griseofulvin.
Hydrocortisone: The barbiturate, methylphenobarbital, may decrease the effect of the corticosteroid, hydrocortisone.
Levonorgestrel: Phenobarbital decreases the effect of levonorgestrel.
Medroxyprogesterone Acetate: The enzyme inducer, methylphenobarbital, decreases the effect of the hormone agent, medroxyprogesterone.
Megestrol Acetate: The enzyme inducer, methylphenobarbital, decreases the effect of the hormone agent, megestrol.
Methadone: The barbiturate, methylphenobarbital, decreases the effect of methadone.
Metronidazole: The barbiturate, methylphenobarbital, decreases the effect of metronidazole.
Nifedipine: The barbiturate, methylphenobarbital, decreases the effect of the calcium channel blocker, nifedipine.
Norethindrone: This product may cause a slight decrease of contraceptive effect.
Oxtriphylline: The barbiturate, methylphenobarbital, decreases the effect of oxtriphylline.
Prednisolone: The barbiturate, methylphenobarbital, may decrease the effect of the corticosteroid, prednisolone.
Prednisone: The barbiturate, methylphenobarbital, may decrease the effect of the corticosteroid, prednisone.
Quinidine: The anticonvulsant, methylphenobarbital, decreases the effect of quinidine.
Theophylline: The barbiturate, methylphenobarbital, decreases the effect of theophylline.
Triamcinolone: The barbiturate, methylphenobarbital, may decrease the effect of the corticosteroid, triamcinolone.
Verapamil: Methylphenobarbital, a CYP3A4 inducer, may increase the serum concentration of Verapamil, a CYP3A4 substrate. Monitor for changes in the therapeutic/adverse effects of Verapamil if Methylphenobarbital is initiated, discontinued or dose changed.
Hepatic Dose :
Use with caution and reduce dose.