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Luminal Side Effects

Generic name: phenobarbital

Medically reviewed by Drugs.com. Last updated on Jul 28, 2023.

Note: This document contains side effect information about phenobarbital. Some dosage forms listed on this page may not apply to the brand name Luminal.

Applies to phenobarbital: intravenous powder for solution.

Warning

Intravenous route (Powder for Solution)

Risks from Concomitant Use with OpioidsConcomitant use of phenobarbital products including phenobarbital sodium powder for solution, and opioids, may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs for patients whom alternative treatment options are inadequate. If a decision is made for concomitant use of these drugs, limit dosages and durations to the minimum required, and follow patients for signs and symptoms of respiratory depression and sedation.Dependence and Withdrawal Reactions After Use of Phenobarbital Sodium Powder for Solution for a Longer Duration than RecommendedThe continued use of phenobarbital may lead to clinically significant physical dependence. The risks of dependence and withdrawal increase with longer treatment duration and higher daily dose. Although phenobarbital sodium powder for solution is indicated only for short-term use, if used for a longer duration than recommended, abrupt discontinuation or rapid dosage reduction of phenobarbital sodium powder for solution may precipitate acute withdrawal reactions, which can be life-threatening. For patients receiving phenobarbital sodium powder for solution for longer duration than recommended, to reduce the risk of withdrawal reactions, use a gradual taper to discontinue phenobarbital sodium powder for solution.Abuse, Misuse, and Addiction with Unapproved Use in Adolescents and AdultsPhenobarbital sodium powder for solution is not approved for use in adolescent or adults. The unapproved use of phenobarbital sodium powder for solution, in adolescents and adults exposes them to risks of abuse, misuse, and addiction, which can lead to overdose or death. Abuse and misuse of phenobarbital commonly involve concomitant use of other drugs, alcohol, and/or illicit substances, which is associated with and increased frequency of serious adverse outcomes.

Serious side effects of Luminal

Along with its needed effects, phenobarbital (the active ingredient contained in Luminal) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking phenobarbital:

More common

Less common

Incidence not known

Get emergency help immediately if any of the following symptoms of overdose occur while taking phenobarbital:

Symptoms of overdose

Other side effects of Luminal

Some side effects of phenobarbital may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

For Healthcare Professionals

Applies to phenobarbital: compounding powder, injectable solution, intravenous powder for injection, oral capsule, oral elixir, oral tablet.

General

The most commonly reported side effect was somnolence.[Ref]

Nervous system

Drowsiness/sedation tended to decrease with continued use.

Localized or diffuse neuralgic pain occurred, especially in psychoneurotic patients with insomnia. This pain was most frequently located in the neck, shoulders, and upper limbs and appeared in paroxysms that were most intense early in the morning. In some patients, the pain continued for days after discontinuation of this drug.

Hyperactivity occurred in pediatric and geriatric patients.[Ref]

Common (1% to 10%): Somnolence

Postmarketing reports: Sedation, residual sedation/"hangover" effect, drowsiness, lethargy, vertigo, localized/diffuse neuralgic pain, headache, hyperactivity, hypotension, hyperkinesia, ataxia, central nervous system (CNS) depression, dizziness, impairment of fine motor skills, Grand mal convulsion, prolonged coma, depressed/absent reflexes, nystagmus[Ref]

Psychiatric

Some patients have experienced paradoxical excitement, restlessness, or delirium in the presence of pain.

Paradoxical reactions, hallucinations, restlessness, hyperexcitability, and confusion have occurred in geriatric and pediatric patients. Pediatric patients were more likely to experience aggression or irritability.[Ref]

Postmarketing reports: Accentuated emotional disturbances/phobias, aggression, excitement/hyperexcitability, restlessness, delirium, irritability, agitation, confusion, nightmares, nervousness, psychiatric disturbance, hallucinations, insomnia/sleep disturbance, anxiety, abnormality in thinking, paradoxical reaction (unusual excitement), mental depression/depression, cognitive impairment, behavioral disturbances in children, abnormal behavior, mood altered, subtle mood changes, menstrually related mood disorder, suicidal ideation, memory/concentration/judgment impairment, withdrawal syndrome, tolerance, dependence, psychic/physical dependence, mental confusion/confusion, disorientation[Ref]

Immunologic

Postmarketing reports: Antiepileptic hypersensitivity syndrome (e.g., fever, rash, lymphadenopathy, lymphocytosis, eosinophilia, hematological abnormalities, hepatic and other organ involvement [renal, pulmonary])[Ref]

Antiepileptic hypersensitivity syndrome typically occurred 1 to 8 weeks after first exposure or within 1 day of rechallenge. This syndrome may have cross reactivity with other antiepileptic agents.[Ref]

Dermatologic

Postmarketing reports: Erythematous dermatitis, exfoliative dermatitis (e.g., Stevens-Johnson syndrome, toxic epidermal necrolysis), skin eruptions, maculopapular/morbilliform/scarlatiniform rashes, dermatitis, erythema multiforme, drug eruption, evidence of connective tissue changes, skin blisters/bullae, photosensitivity, erythroderma, urticaria[Ref]

Skin eruptions may be associated with fever, delirium, and marked changes in the liver and other organs.[Ref]

Musculoskeletal

Postmarketing reports: Localized/diffuse myalgic or arthritic pain, osteomalacia, rickets, decreased bone mineral density, increased risk of fracture, Dupuytren's contracture, bone metabolism disorder, frozen shoulder, Ledderhose's syndrome, general joint pain, osteopenia, osteoporosis, fractures[Ref]

Localized or diffuse myalgic or arthritic pain occurred, especially in psychoneurotic patients with insomnia. This pain was most frequently located in the neck, shoulders, and upper limbs and appeared in paroxysms that were most intense early in the morning. In some patients, pain continued for days after discontinuation of therapy.

Decreased bone mineral density, Dupuytren's contracture, osteopenia, osteoporosis, and fractures occurred in patients receiving long-term therapy; however, the exact mechanism of action in bones was not identified.[Ref]

Other

Postmarketing reports: Inebriation (drunk-like effect), fever, neonatal sedation, neonatal drug dependence/withdrawal, neonatal symptoms resembling vitamin K deficiency, neonatal bleeding due to vitamin K deficiency, congenital anomaly, cleft lip and palate, lowered body temperature[Ref]

Hematologic

Postmarketing reports: Megaloblastic anemia, macrocytic anemia, aplastic anemia, agranulocytosis, thrombocytopenia, hypoprothrombinemia, methemoglobinemia, purpura, lymphocytosis[Ref]

Megaloblastic anemia occurred after chronic use of this drug, and may be due to folate deficiency.

Methemoglobinemia has occurred in infants nursed by mothers receiving this drug.[Ref]

Cardiovascular

Postmarketing reports: Circulatory collapse, peripheral vascular collapse, weak heartbeat, circulatory failure, bradycardia, hypotension, profound shock, vasodilation[Ref]

Respiratory

Postmarketing reports: Respiratory depression, severe/significant respiratory depression, apnea, hypoventilation, bronchospasm, laryngospasm[Ref]

Bronchospasm and laryngospasm were reported, especially in patients given the IV formulation.[Ref]

Hepatic

Postmarketing reports: Abnormal hepatic function, hepatitis, liver damage, cholestasis, toxic hepatitis, jaundice[Ref]

Metabolic

Postmarketing reports: Hypocalcemia, folate deficiency, abnormal vitamin D metabolism, increased vitamin D requirements (possibly resulting from abnormal vitamin D metabolism), vitamin K deficiency, hypophosphatemia[Ref]

Gastrointestinal

Postmarketing reports: Nausea, vomiting, constipation, diarrhea[Ref]

Hypersensitivity

Postmarketing reports: Localized swelling (e.g. eyelids, cheeks, lips), hypersensitivity reactions (e.g., angioedema, skin rashes, exfoliative dermatitis), angioedema[Ref]

Hypersensitivity reactions generally consisted of acquired hypersensitivity. Patients with a higher risk of developing reactions were more likely to have asthma, urticaria, and angioedema.[Ref]

Local

Postmarketing reports: Injection site reactions, local necrosis after extravasation (IV/subcutaneous injection)[Ref]

Renal

Postmarketing reports: Renal failure[Ref]

Oncologic

Postmarketing reports: Fibromas[Ref]

Endocrine

Postmarketing reports: Reduced serum concentrations of thyroid hormones[Ref]

Genitourinary

Postmarketing reports: Peyronie's disease[Ref]

References

1. Product Information. Phenobarbital (phenobarbital). Lilly, Eli and Company. 2001;PROD.

2. Cerner Multum, Inc. UK Summary of Product Characteristics.

3. Cerner Multum, Inc. Australian Product Information.

Further information

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

Some side effects may not be reported. You may report them to the FDA.