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Generic Name: methohexital (METH oh HEX i tal)
Brand Name: Brevital Sodium

What is methohexital?

Methohexital is a barbiturate (bar-BIT-chur-ate). Methohexital slows the activity of your brain and nervous system.

Methohexital is used to make you fall asleep before a surgery or other medical procedure. It is usually given in combination with other types of anesthesia.

Methohexital may also be used for purposes not listed in this medication guide.

What is the most important information I should know about methohexital?

You should not receive this medication if you have porphyria, or if you are allergic to methohexital or similar medications such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Solfoton).

Before receiving methohexital, tell your doctor if you have a seizure disorder, asthma or COPD, anemia, an endocrine disorder, liver disease, high or low blood pressure, heart disease, congestive heart failure, or circulation problems.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Drowsiness may last for several hours. You will need someone to drive you home from after you receive methohexital.

Avoid drinking alcohol just after receiving methohexital.

What should I discuss with my health care provider before receiving methohexital?

You should not receive methohexital if you are allergic to it, or if you have:

  • porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system); or

  • if you are allergic to any other barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Solfoton).

To make sure you can safely receive methohexital, tell your doctor if you have any of these other conditions:

  • epilepsy or other seizure disorder;

  • asthma or chronic obstructive pulmonary disease (COPD);

  • anemia (lack of red blood cells);

  • an endocrine disorder;

  • liver disease;

  • high or low blood pressure;

  • heart disease, congestive heart failure; or

  • circulation problems.

FDA pregnancy category B. Methohexital is not expected to harm an unborn baby. Tell your doctor if you are pregnant.

It is not known whether methohexital passes into breast milk or if it could harm a nursing baby. Do not receive this medication without telling your doctor if you are breast-feeding a baby.

How is methohexital given?

Methohexital is given as an injection into a muscle, or into a vein through an IV. This medication is also given rectally when used in young children. A healthcare provider will give you this injection in a clinic or hospital setting.

Methohexital should make you fall asleep very quickly.

Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely while you are receiving methohexital. You will also be watched closely while you are coming out of the anesthesia.

Drowsiness may last for several hours. You will need someone to drive you home from after you receive methohexital.

What happens if I miss a dose?

Since methohexital is used as a single dose, it does not have a daily dosing schedule.

What happens if I overdose?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid after receiving methohexital?

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid drinking alcohol just after receiving methohexital.

Methohexital side effects

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

Tell your caregivers at once if you have any of these serious side effects:

  • severe burning or swelling where the medicine was injected;

  • seizure (convulsions);

  • numbness or tingly feeling;

  • feeling like you might pass out;

  • fast heart rate;

  • weak or shallow breathing; or

  • confusion, anxiety, or restless feeling when coming out of anesthesia.

Less serious side effects may include:

  • drowsiness;

  • nausea, vomiting, stomach pain;

  • chills or shivering;

  • coughing, hiccups;

  • muscle twitching; or

  • mild skin rash or itching.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Methohexital dosing information

Usual Adult Dose for Anesthesia:

Induction of anesthesia:
A 1% solution is administered intravenously at a rate of about 1 mL/5 seconds. Gaseous anesthetics and/or skeletal muscle relaxants may be administered concomitantly. The dose required for induction may range from 50 to 120 mg or more but averages about 70 mg. The usual dosage in adults ranges from 1 to 1.5 mg/kg. The induction dose usually provides anesthesia for 5 to 7 minutes.
Maintenance of anesthesia:
Maintenance of anesthesia may be accomplished by intermittent injections of the 1% solution or by continuous intravenous infusion of a 0.2% solution. Intermittent injections of about 20 to 40 mg may be given as required, usually every 4 to 7 minutes. For continuous infusion, the average rate of administration is about 3 mL of a 0.2% solution/minute. The rate of flow must be individualized for each patient. For longer surgical procedures, gradual reduction in the rate of administration is recommended. Other parenteral agents, usually narcotic analgesics, are ordinarily employed along with methohexital during longer procedures.

Usual Pediatric Dose for Anesthesia:

For induction of anesthesia:
1 month or older:

Intramuscular: 6.6 to 10 mg/kg using a 5% solution.
Rectal: 25 mg/kg using a 1% solution.

What other drugs will affect methohexital?

Tell your doctor about all other medicines you use, especially:

  • phenytoin (Dilantin);

  • a blood thinner such as warfarin (Coumadin, Jantoven); or

  • steroids such as prednisone, fluticasone (Advair, Flonase, Flovent), mometasone (Asmanex, Nasonex), dexamethasone (Cortastat, Dexasone, Solurex, DexPak), and others.

This list is not complete and other drugs may interact with methohexital. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about methohexital.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.05.

Last reviewed: September 10, 2013
Date modified: March 15, 2017