Meprobamate

Pronunciation: meh-pro-BAM-ate
Class: Antianxiety agent

Trade Names

Meprobamate
- Tablets 200 mg
- Tablets 400 mg

Pharmacology

Produces CNS depressant action at multiple sites, including thalamic and limbic systems.

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Pharmacokinetics

Absorption

Meprobamate is well absorbed. T _max is 1 to 3 h.

Distribution

Meprobamate protein binding is approximately 15%.

Metabolism

80% to 92% is metabolized in the liver.

Elimination

90% is excreted renally and approximately 10% in feces. Plasma t _½ is 6 to 14 h for a single dose and 24 to 48 h for chronic dosing.

Indications and Usage

Management of anxiety.

Contraindications

Hypersensitivity to meprobamate or related compounds, such as carisoprodol; acute intermittent porphyria.

Dosage and Administration

PO 1.2 to 1.6 g/day in 3 to 4 divided doses (max, 2.4 g/day).

PO 100 to 200 mg 2 to 3 times daily.

Storage/Stability

Store in dry, cool place.

Drug Interactions

May produce additive CNS depression.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Palpitations; tachycardia; syncope; hypertension; hypotensive crisis; arrhythmias.

CNS

Drowsiness; ataxia; euphoria; slurred speech; dizziness; headache; paradoxical excitement.

GI

Nausea; vomiting; diarrhea.

Hematologic

Leukopenia; thrombocytopenia; agranulocytosis; aplastic anemia.

Miscellaneous

Hypersensitivity (eg, rash, itching, fever, chills, edema, bronchospasm, anaphylaxis, erythema multiforme, exfoliative dermatitis, Stevens-Johnson syndrome, bullous dermatitis); exacerbation of porphyria symptoms.

Precautions

Pregnancy

Category D . Use with extreme caution, if at all.

Lactation

Excreted in breast milk.

Children

Do not give to children younger than 6 yr of age; safety and efficacy not established.

Elderly

Use lowest effective dose to avoid oversedation.

Hypersensitivity

Usually seen between first and fourth dose in patients without previous exposure.

Renal Function

Use drug with caution to avoid accumulation in patients with renal function impairment.

Hepatic Function

Use drug with caution to avoid accumulation in patients with hepatic function impairment.

Dependence

Physical and psychological dependence and abuse may occur. Avoid prolonged use, especially in patients prone to addiction. Abrupt discontinuation after prolonged or excessive use may precipitate withdrawal symptoms with risk of seizures.

Debilitated patients

Use lowest effective dose to avoid oversedation.

Overdosage

Symptoms

Drowsiness, lethargy, stupor, ataxia, coma, shock, vasomotor and respiratory collapse, death.

Patient Information

• Instruct patient not to crush or chew tablets or capsules.
• Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.
• Instruct patient to avoid intake of alcoholic beverages or other CNS depressants.
• Explain potential adverse reactions, and encourage patient to notify health care provider if signs of itching, rash, fever, drowsiness, dizziness, difficulty walking, nausea, vomiting, diarrhea, palpitations, shortness of breath, or sore throat occur.
• Caution patient to change position slowly to minimize orthostatic hypotension.
• Caution patient not to discontinue taking drug abruptly because doing so may precipitate preexisting symptoms or withdrawal reactions.
• Advise women that if they become pregnant or intend to become pregnant to consult their health care provider about continued use of this drug.

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