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Amytal Sodium Disease Interactions

There are 13 disease interactions with Amytal Sodium (amobarbital).

Major

Barbiturates (applies to Amytal Sodium) acute alcohol intoxication

Major Potential Hazard, High plausibility.

The use of barbiturates is contraindicated in patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of barbiturates may be additive with those of alcohol. Severe respiratory depression and death may occur. Therapy with barbiturates should be administered cautiously in patients who might be prone to acute alcohol intake.

References

  1. Plaa GL "Acute toxicity of antiepileptic drugs." Epilepsia 16 (1975): 183-91
  2. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company PROD (2001):
  3. "Multum Information Services, Inc. Expert Review Panel"
  4. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company PROD (2001):
  5. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical PROD (2001):
  6. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company PROD (2001):
  7. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals PROD (2001):
  8. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories PROD (2001):
View all 8 references
Major

Barbiturates (applies to Amytal Sodium) drug dependence

Major Potential Hazard, High plausibility. Applicable conditions: Alcoholism, Drug Abuse/Dependence

Barbiturates have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages. Abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance to a barbiturate, overdosage can still produce respiratory depression and death, and cross-tolerance usually will occur with other agents in the class. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with barbiturates. It may be prudent to refrain from dispensing large quantities of medication to these patients. After prolonged use or if dependency is suspected, withdrawal of barbiturates should be undertaken gradually using a dosage-tapering schedule.

References

  1. Boisse NR, Okamoto M "Physical dependence to barbital compared to pentobarbital. II. Tolerance characteristics." J Pharmacol Exp Ther 204 (1978): 507-13
  2. Gersema LM, Alexander B, Kunze KE "Major withdrawal symptoms after abrupt discontinuation of phenobarbital." Clin Pharm 6 (1987): 420-2
  3. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company PROD (2001):
  4. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  5. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company PROD (2001):
  6. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical PROD (2001):
  7. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company PROD (2001):
  8. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals PROD (2001):
  9. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories PROD (2001):
View all 9 references
Major

Barbiturates (applies to Amytal Sodium) liver disease

Major Potential Hazard, High plausibility.

Barbiturates are extensively metabolized by the liver. The plasma clearance of barbiturates may be decreased and the half-lives prolonged in patients with impaired hepatic function. Therapy with barbiturates should be administered cautiously and initiated at reduced dosages in patients with liver disease. Barbiturates are not recommended for use in patients with cirrhosis, hepatic failure, hepatic coma, or other severe hepatic impairment.

References

  1. Alvin J, McHorse T, Hoyumpa A, et al. "The effect of liver disease in man on the disposition of phenobarbital." J Pharmacol Exp Ther 192 (1975): 224-35
  2. Kallberg N, Agurell S, Ericsson O, et al. "Quantitation of phenobarbital and its main metabolites in human urine." Eur J Clin Pharmacol 9 (1975): 161-8
  3. Whyte MP, Dekaban "Metabolic fate of phenobarbital: a quantitative study of p-hydroxyphenobarbital elimination in man." Drug Metab Dispos 5 (1977): 63-9
  4. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company PROD (2001):
  5. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company PROD (2001):
  6. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical PROD (2001):
  7. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company PROD (2001):
  8. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals PROD (2001):
  9. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories PROD (2001):
View all 9 references
Major

Barbiturates (applies to Amytal Sodium) porphyria

Major Potential Hazard, High plausibility.

The use of barbiturates is contraindicated in patients with a history of porphyria. Barbiturates may exacerbate acute intermittent porphyria or porphyria variegata by inducing the enzymes responsible for porphyrin synthesis.

References

  1. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company PROD (2001):
  2. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  3. Braunwald E, Hauser SL, Kasper DL, Fauci AS, Isselbacher KJ, Longo DL, Martin JB, eds., Wilson JD "Harrison's Principles of Internal Medicine." New York, NY: McGraw-Hill Health Professionals Division (1998):
  4. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company PROD (2001):
  5. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical PROD (2001):
  6. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company PROD (2001):
  7. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals PROD (2001):
  8. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories PROD (2001):
View all 8 references
Major

Barbiturates (applies to Amytal Sodium) rash

Major Potential Hazard, High plausibility. Applicable conditions: Dermatitis - Drug-Induced

Skin eruptions may precede rare but potentially fatal barbiturate-induced reactions such as systemic lupus erythematosus and exfoliative dermatitis, the latter of which may be accompanied by hepatitis and jaundice. Therapy with barbiturates should be administered cautiously in patients with preexisting drug-induced dermatitis, since it may delay the recognition of a potential reaction to barbiturates. Barbiturate therapy should be withdrawn promptly at the first sign of a dermatologic adverse effect. However, cutaneous reactions may proceed to an irreversible stage even after cessation of medication due to the slow rate of metabolism and excretion of barbiturates. Patients should be advised to promptly report signs that may indicate impending development of barbiturate-related cutaneous lesions, including high fever, severe headache, stomatitis, conjunctivitis, rhinitis, urethritis, and balanitis. Rashes may be more likely to occur with phenobarbital and mephobarbital.

References

  1. Pelekanos J, Camfield P, Camfield C, Gordon K "Allergic rash due to antiepileptic drugs: clinical features and management." Epilepsia 32 (1991): 554-9
  2. Pagliaro L, Campesi G, Aguglia F "Barbiturate jaundice. Report of a case due to a barbital-containing drug, with positive rechallenge to phenobarbital." Gastroenterology 56 (1969): 938-43
  3. Shear NH, Spielberg SP "Anticonvulsant hypersensitivity syndrome. In vitro assessment of risk." J Clin Invest 82 (1988): 1826-32
  4. Stuttgen G "Toxic epidermal necrolysis provoked by barbiturates." Br J Dermatol 88 (1973): 291-3
  5. Fernandez de Corres L, Leanizbarrutia I, Munoz D "Eczematous drug reaction from phenobarbitone." Contact Dermatitis 11 (1984): 319
  6. Dourmishev AL, Rahman MA "Phenobarbital-induced pemphigus vulgaris." Dermatologica 173 (1986): 256-8
  7. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company PROD (2001):
  8. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company PROD (2001):
  9. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical PROD (2001):
  10. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company PROD (2001):
  11. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals PROD (2001):
  12. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories PROD (2001):
View all 12 references
Major

Barbiturates (applies to Amytal Sodium) respiratory depression

Major Potential Hazard, High plausibility. Applicable conditions: Pulmonary Impairment, Asphyxia, Respiratory Arrest

Barbiturates may produce severe respiratory depression, apnea, laryngospasm, bronchospasm and cough, particularly during rapid intravenous administration. In usual hypnotic dosages, the degree of respiratory depression produced is similar to that which occurs during physiologic sleep, while at higher dosages, the rate, depth and volume of respiration may be markedly decreased. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with barbiturates should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are particularly important, and equipment for resuscitation should be immediately available if the parenteral route is used. Barbiturates, especially injectable formulations, should generally be avoided in patients with sleep apnea, hypoxia, or severe pulmonary diseases in which dyspnea or obstruction is evident.

References

  1. Plaa GL "Acute toxicity of antiepileptic drugs." Epilepsia 16 (1975): 183-91
  2. Lund A, Gormsen H "The role of antiepileptics in sudden death in epilepsy." Acta Neurol Scand 72 (1985): 444-6
  3. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company PROD (2001):
  4. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  5. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company PROD (2001):
  6. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical PROD (2001):
  7. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company PROD (2001):
  8. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals PROD (2001):
  9. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories PROD (2001):
View all 9 references
Major

Barbiturates IV (applies to Amytal Sodium) cardiovascular

Major Potential Hazard, Moderate plausibility. Applicable conditions: Hypotension, Heart Disease, Hypertension

The intravenous administration of barbiturates may produce severe cardiovascular reactions such as bradycardia, hypertension, or vasodilation with fall in blood pressure, particularly during rapid infusion. Parenteral therapy with barbiturates should be administered cautiously in patients with hypertension, hypotension, or cardiac disease. The intravenous administration of barbiturates should be reserved for emergency treatment of acute seizures or for anesthesia.

References

  1. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company PROD (2001):
  2. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  3. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company PROD (2001):
  4. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical PROD (2001):
  5. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company PROD (2001):
View all 5 references
Major

Barbiturates IV/IM (applies to Amytal Sodium) prolonged hypotension

Major Potential Hazard, High plausibility. Applicable conditions: Shock, Altered Consciousness

Barbiturates should not be administered by injection to patients in shock or coma or who have recently received another respiratory depressant. The hypnotic and hypotensive effects of these agents may be prolonged and intensified in such patients.

References

  1. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company PROD (2001):
  2. "Multum Information Services, Inc. Expert Review Panel"
  3. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company PROD (2001):
  4. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical PROD (2001):
  5. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company PROD (2001):
View all 5 references
Moderate

Barbiturates (applies to Amytal Sodium) adrenal insufficiency

Moderate Potential Hazard, High plausibility. Applicable conditions: Panhypopituitarism

Barbiturates, especially phenobarbital, secobarbital and butabarbital, may diminish the systemic effects of exogenous and endogenous corticosteroids via induction of hepatic microsomal enzymes, thereby accelerating the metabolism of corticosteroids. In addition, barbiturates may interfere with pituitary corticotropin production. Therapy with barbiturates should be administered cautiously in patients with adrenal insufficiency. Patients with borderline hypoadrenalism should be monitored closely, and patients receiving steroid supplementation may require an adjustment in dosage when barbiturates are added to or withdrawn from their medication regimen.

References

  1. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company PROD (2001):
  2. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company PROD (2001):
  3. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical PROD (2001):
  4. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company PROD (2001):
  5. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals PROD (2001):
  6. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories PROD (2001):
View all 6 references
Moderate

Barbiturates (applies to Amytal Sodium) depression

Moderate Potential Hazard, High plausibility.

Barbiturates depress the central nervous system and may cause or exacerbate mental depression. Therapy with barbiturates should be administered cautiously in patients with a history of depression or suicidal tendencies. It may be prudent to refrain from dispensing large quantities of medication to these patients.

References

  1. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company PROD (2001):
  2. "Multum Information Services, Inc. Expert Review Panel"
  3. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company PROD (2001):
  4. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical PROD (2001):
  5. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company PROD (2001):
  6. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals PROD (2001):
  7. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories PROD (2001):
View all 7 references
Moderate

Barbiturates (applies to Amytal Sodium) hematologic toxicity

Moderate Potential Hazard, Low plausibility. Applicable conditions: Bone Marrow Depression/Low Blood Counts

Hematologic toxicity, including agranulocytosis, thrombocytopenic purpura and megaloblastic anemia, has been reported rarely during use of barbiturates. Therapy with barbiturates should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow suppression. Blood counts are recommended prior to and periodically during long-term therapy, and patients should be instructed to immediately report any signs or symptoms suggestive of blood dyscrasia such as fever, sore throat, local infection, easy bruising, petechiae, bleeding, pallor, dizziness, or jaundice. Barbiturate therapy should be discontinued if blood dyscrasias occur.

References

  1. Van Hoof A, Chamone DA, Vermylen J "Platelet aggregation and anaesthesia." Lancet 2 (1980): 373
  2. Kiorboe E, Plum CM "Megaloblastic anaemia developing during treatment of epilepsy." Acta Med Scand Suppl 445 (1966): 349-57
  3. Iivanainen M, Savolainen H "Side effects of phenobarbital and phenytoin during long-term treatment of epilepsy." Acta Neurol Scand Suppl 97 (1983): 49-67
  4. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company PROD (2001):
  5. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company PROD (2001):
  6. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical PROD (2001):
  7. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company PROD (2001):
  8. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals PROD (2001):
  9. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories PROD (2001):
View all 9 references
Moderate

Barbiturates (applies to Amytal Sodium) osteomalacia

Moderate Potential Hazard, Low plausibility. Applicable conditions: Vitamin D Deficiency

Rickets and osteomalacia have rarely been reported following prolonged use of barbiturates, possibly due to increased metabolism of vitamin D as a result of enzyme induction by barbiturates. Long-term therapy with barbiturates should be administered cautiously in patients with vitamin D deficiency.

References

  1. Sotaniemi EA, Hakkarainen HK, Puranen JA, Lahti RO "Radiologic bone changes and hypocalcemia with anticonvulsant therapy in epilepsy." Ann Intern Med 77 (1972): 389-94
  2. Zerwekh JE, Homan R, Tindall R, Pak CY "Decreased serum 24,25-dihydroxyvitamin D concentration during long- term anticonvulsant therapy in adult epileptics." Ann Neurol 12 (1982): 184-6
  3. Marsden CD, Reynolds EH, Parsons V, Harris R, Duchen L "Myopathy associated with anticonvulsant osteomalacia." Br Med J 4 (1973): 526-7
  4. Iivanainen M, Savolainen H "Side effects of phenobarbital and phenytoin during long-term treatment of epilepsy." Acta Neurol Scand Suppl 97 (1983): 49-67
  5. Doriguzzi C, Mongini T, Jeantet A, Monga G "Tubular aggregates in a case of osteomalacic myopathy due to anticonvulsant drugs." Clin Neuropathol 3 (1984): 42-5
  6. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company PROD (2001):
View all 6 references
Moderate

Barbiturates (applies to Amytal Sodium) paradoxical reactions

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Hyperkinetic Syndrome of Childhood

Paradoxical reactions characterized by excitability and restlessness may occur in pediatric patients with hyperactive aggressive disorders. Such patients should be monitored for signs of paradoxical stimulation during therapy with barbiturates.

References

  1. Mayhew LA, Hanzel TE, Ferron FR, Kalachnik JE, Harder SR "Phenobarbital exacerbation of self-injurious behavior." J Nerv Ment Dis 180 (1992): 732-3
  2. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company PROD (2001):
  3. Sylvester CE, Marchlewski A, Manaligod JM "Primidone or phenobarbital use complicating disruptive behavior disorders." Clin Pediatr (Phila) 33 (1994): 252-3
  4. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  5. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company PROD (2001):
  6. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical PROD (2001):
  7. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company PROD (2001):
  8. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals PROD (2001):
  9. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories PROD (2001):
View all 9 references

Amytal Sodium drug interactions

There are 596 drug interactions with Amytal Sodium (amobarbital).

Amytal Sodium alcohol/food interactions

There are 2 alcohol/food interactions with Amytal Sodium (amobarbital).


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.