Pentobarbital Side Effects

Some side effects of pentobarbital may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to pentobarbital: injectable solution

Get emergency medical help if you have any of these signs of an allergic reaction while taking pentobarbital: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

• confusion, hallucinations;

• weak or shallow breathing;

• slow heart rate, weak pulse; or

• feeling like you might pass out.

Less serious side effects of pentobarbital may include:

• problems with memory or concentration;

• excitement, irritability, or aggression (especially in children or older adults);

• loss of balance or coordination;

• nightmares;

• nausea, vomiting, constipation;

• headache; or

• "hangover" effect (drowsiness the day after a dose).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

For Healthcare Professionals

Applies to pentobarbital: compounding powder, injectable solution, oral capsule, oral elixir, rectal suppository

Nervous system

Nervous system side effects have been common and have included drowsiness, sedation, lethargy, and somnolence. Paradoxical stimulation has also been reported in the elderly.

Behavioral problems, impaired memory, impaired cognition, decreased perceptuomotor performance, tics, dyskinesias, nystagmus, oculogyric crises, dystonic reactions, and ataxia have also been reported.

Respiratory

Respiratory side effects including life threatening respiratory depression have been reported, particularly during acute intoxication.

Other

Other side effects from pentobarbital use have included physical and psychological dependence. Withdrawal symptoms have been reported when pentobarbital therapy has been discontinued suddenly.

Withdrawal symptoms may include hallucinations, sweating, insomnia, and hypertension.

An increased frequency of seizures may occur if barbiturate therapy is suddenly discontinued.

Cardiovascular

Cardiovascular side effects including hypotension and bradycardia have been reported.

Musculoskeletal

Musculoskeletal side effects including myopathy in association with anticonvulsant osteomalacia has been reported in patients taking other barbiturates. Reflex sympathetic dystrophy of the upper extremities, Dupuytren's contractures, Peyronie's disease, the "shoulder-hand syndrome" and other musculoskeletal and joint pains have been reported in as many as 5% of patients treated with other barbiturates.

Hypersensitivity

Hypersensitivity side effects have included a variety of hypersensitivity reactions reported in association with use of pentobarbital and other barbiturates. The reactions frequently involved generalized rashes, fever, and hepatic derangements.

Hepatic

The more serious hepatic effects have often been reported in association with hypersensitivity reactions.

Hepatic side effects including elevated liver function tests, hepatitis, cholestasis, and fulminant hepatic failure have all been reported in association with use of other barbiturates.

Hematologic

Hematologic side effects including macrocytosis and, more rarely, megaloblastic anemia have been reported with use of other barbiturates.

Animal studies have suggested that pentobarbital may inhibit prostaglandin l2 and thereby promote platelet aggregation.

Endocrine

Endocrine side effects including alterations in vitamin D metabolism have been reported in patients taking barbiturates and other anticonvulsants. Hypocalcemia and osteomalacia have been specifically reported.

Oncologic

Oncologic side effects have been reported. Some investigators have reported a possible increased frequency of malignancy (particularly brain tumors, lung cancer, and liver cancer) in patients taking pentobarbital and other barbiturates chronically. Other investigators have not found an association with malignancy.

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