Phenobarbitone Idaman

Phenobarb

Short-term treatment of insomnia. Relieve anxiety, tension & apprehension. Long-term anticonvulsant therapy for generalised tonic clonic & simple partial seizures. Prophylaxis & treatment of febrile seizures. Prevention & treatment of hyperbilirubinemia in neonates. Lower bilirubin conc in patients w/ congenital non-haemolytic unconjugated hyperbilirubinemia or chronic intrahepatic cholestasis.

Usual dose: 30-125 mg tds, up to 350 mg daily in divided doses.

Hypersensitivity to phenobarb or barbiturates. Acute intermittent or history or porphyria; severe resp depression. Severe renal or hepatic impairment.

Discontinue use if signs or symptoms of SJS or TEN, early manifestation of hypersensitivity are present; evidence of significant bone marrow depression develops. Resp depression; acute chronic pain. Monitor for signs of suicidal ideation & behaviours. Avoid sudden w/drawal. Long-term use. Not to be taken by patients w/ galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Avoid concomitant use of telithromycin during & for 2 wk after last dose; concomitant use of voriconazole, eplerenone. May affect ability to drive & use machines. Renal impairment, existing hepatic disease. During labour & delivery. Pregnancy & lactation. Childn. Young, debilitated, geriatric or senile patients.

Megaloblastic anaemia, agranulocytosis, thrombocytopenia; Dupuytren's contracture, frozen shoulder, arthralgia, osteomalacia, rickets; Peyronie's disease; paradoxical reaction, hallucinations, restlessness & confusion in elderly, mental depression, memory & cognitive impairment, drowsiness, lethargy, feeling faint, headache, nightmare, trouble sleeping, unusual irritability; hyperactivity, behavioural disturbances in childn, ataxia, nystagmus; hypotension; resp depression; hepatitis, cholestasis; allergic skin reactions, other skin reactions eg, exfoliative dermatitis, erythema multiforme; antiepileptic hypersensitivity syndrome, nausea, vomiting.

Additive CNS depressant effect w/ alcohol, other CNS depressants. Antagonized antiepileptic activity by antidepressants eg, MAOIs, SSRI, TCAs. Increased plasma conc by oxcarbazepine, phenytoin, Na valproate; methylphenidate. Decreased plasma conc by vigabatrin. Reduced serum levels of chlorpromazine, thioridazine; anticoagulants; paroxetine, mianserin; carbamazepine, lamotrigine, tiagabine, zonisamide, primidone, ethosuximide; itraconazole, posaconazole; aripiprazole; abacavir, amprenavir, darunavir, lopinavir, indinavir, nelfinavir, saquinavir; clonazepam; aprepitant; metoprolol, timolol, propranolol; felodipine, isradipine, diltiazem, verapamil, nimodipine, nifedipine; digitoxin; ciclosporin, tacrolimus; corticosteroids; etoposide, irinotecan; haloperidol; gestrinone, toremifene; methadone; montelukast; tibolone; tropisetron. Decreased seizure control w/ folic acid supplements. Reduced effect w/ memantine. Loss of disopyramide, quinidine arrhythmia control. Reduced antifungal effects of griseofulvin. Reduced contraceptive effects of oestrogens, progestogens. Enhanced effects of Na oxybate. Increased requirements for theophylline, thyroid hormones in hypothyroidism, vit D. Concomitant use w/ chloramphenicol, doxycycline, metronidazole, rifampicin.

Anticonvulsants

N03AA02 - phenobarbital ; Belongs to the class of barbiturates and derivatives antiepileptics.

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