Meprobamate

Debilitated patients: Use the lowest effective dose.

Hypersensitivity to meprobamate or related compounds (e.g. carisoprodol, carbromal, mebutamate, tybamate). Acute intermittent porphyria.

Patient with suicidal tendencies or ideation, depression; seizure disorder or history of seizure disorder; history of drug abuse or acute alcoholism; muscle weakness, respiratory disease. Avoid abrupt withdrawal. Debilitated patient. Renal and hepatic impairment. Children and elderly. Pregnancy (avoid use during 1st trimester) and lactation.

Significant: CNS depression; tolerance, physical and psychological dependence (prolonged use); withdrawal symptoms (upon abrupt discontinuation); seizures (particularly in patients with seizure disorder); allergic or idiosyncratic reactions (e.g. erythematous maculopapular rash, urticaria, pruritus), may exacerbate porphyria. Rarely, severe haematologic reactions (e.g. aplastic anaemia, agranulocytosis, thrombocytopenic purpura), severe hypersensitivity reactions (e.g. anaphylaxis, angioedema, bronchospasm, exfoliative dermatitis, erythema multiforme, Stevens-Johnson syndrome, bullous dermatitis).
Cardiac disorders: Tachycardia, palpitations, cardiac arrhythmias.
Ear and labyrinth disorders: Vertigo.
Eye disorders: Visual disturbances.
Gastrointestinal disorders: Nausea, vomiting, diarrhoea.
General disorders and administration site conditions: Weakness.
Investigations: Transient ECG changes; fast EEG activity.
Nervous system disorders: Drowsiness, dizziness, headache, paraesthesia, ataxia.
Psychiatric disorders: Euphoria, paradoxical excitement.
Vascular disorders: Syncope.
Potentially Fatal: Hypotensive crisis.

This drug may cause drowsiness, if affected, do not drive or operate machinery.

Monitor mental status, potential abuse or overuse, and symptoms of anxiety.

Symptoms: Drowsiness, lethargy, stupor, ataxia, shock, hypotension, respiratory collapse and coma. Management: Symptomatic and supportive treatment. Monitor urine output and avoid overhydration. Induce vomiting in fully conscious patients. Forced diuresis with osmotic diuretics (e.g. mannitol), peritoneal dialysis, or haemodialysis may be used to increase drug elimination. Maintain an adequate airway, employ assisted respiration, and administer vasopressor agents cautiously if necessary. Gastric lavage may be performed in patients in a comatose state, having seizures, or lacking a gag reflex. Consider administering activated charcoal after gastric lavage and/or emesis to adsorb any remaining drug.

May result in additive CNS depression with other CNS depressants and psychotropic agents.

May result in additive CNS depression when used with alcohol.

May cause false elevation of urinary 17-ketosteroid and 17-ketogenicsteroid concentrations in the Zimmerman reaction and 17-hydroxycorticosteroid concentration in the modified Glenn-Nelson technique.

Description:
Mechanism of Action: Meprobamate, a carbamate derivative, is an anxiolytic agent. Its exact mechanism of action is unknown; however, it appears to act at numerous CNS sites, including the thalamus and limbic system, and inhibits multineuronal spinal reflexes.
Onset: Sedation: Approx 1 hour.
Pharmacokinetics:
Absorption: Readily absorbed from the gastrointestinal tract. Time to peak plasma concentration: 1-3 hours.
Distribution: Widely distributed in the body. Crosses the placenta and enters breast milk. Plasma protein binding: Approx 20%.
Metabolism: Extensively metabolised in the liver into inactive metabolites.
Excretion: Via urine (8-20% as unchanged drug); faeces (10% as metabolites). Elimination half-life: Approx 6-17 hours.

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 4064, Meprobamate. https://pubchem.ncbi.nlm.nih.gov/compound/Meprobamate. Accessed July 26, 2024.

Store between 15-30°C.

Anxiolytics

N05BC01 - meprobamate ; Belongs to the class of carbamates anxiolytics. Used in the management of anxiety, agitation or tension.

Anon. Meprobamate. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 28/06/2024.

Brayfield A, Cadart C (eds). Meprobamate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 28/06/2024.

Meprobamate Tablet (Alembic Pharmaceuticals Limited). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 28/06/2024.

Meprobamate. Gold Standard Drug Database in ClinicalKey [online]. Elsevier Inc. https://www.clinicalkey.com. Accessed 23/07/2024.

Meprobamate. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 28/06/2024.