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Phenobarbital 200 mg Rectal Suppository

The Phenobarbital 200 mg Rectal Suppository is a solid dosage form designed for insertion into the rectum. Upon administration, it dissolves or melts, facilitating the release of the active ingredient, phenobarbital, for both local and systemic absorption. This formulation is primarily used in the management of seizures and epilepsy. It may also be utilized for its sedative and hypnotic effects in the treatment of anxiety or to induce sleep in patients with insomnia. Additionally, phenobarital suppositories can be employed in the emergency control of certain acute convulsive episodes, such as those associated with status epilepticus, febrile convulsions, or eclampsia.

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Formula Information

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Phenobarbital 200 mg Rectal Suppository is a solid dosage form designed for insertion into the rectum, where it dissolves or melts to release the active medication, phenobarbital, for local or systemic absorption. This route of administration is particularly useful when oral administration is not feasible due to vomiting, unconsciousness, or difficulty swallowing. Phenobarbital is a long-acting barbiturate that exerts its effect by enhancing the activity of gamma-aminobutyric acid (GABA), a neurotransmitter in the brain that inhibits neuronal activity. This action results in sedative, hypnotic (sleep-inducing), and anticonvulsant properties, making phenobarbital particularly effective in the treatment of epilepsy and in the management of seizures.

The 200 mg dose of phenobarbital in the suppository form is typically used in the management of acute convulsive episodes, as it can provide rapid systemic absorption and quick onset of action. It is also used for its sedative effects to relieve anxiety or tension and in the preoperative setting to reduce anxiety and induce sedation. In the management of epilepsy, phenobarbital helps to stabilize nerve activity in the brain, preventing the spread of seizure activity and reducing the frequency of seizure occurrence.

It is important for both patients and prescribers to be aware that while phenobarbital can be highly effective, it also has the potential for dependence and tolerance with long-term use. Additionally, it may interact with other medications and has a range of potential side effects, including drowsiness, dizziness, and cognitive impairment. Monitoring of blood levels may be necessary to ensure therapeutic effectiveness and to avoid toxicity. As with any medication, the benefits and risks should be carefully considered, and the use of phenobarbital should be individualized based on the patient's specific medical condition and history.

At Bayview Pharmacy, we understand the importance of providing tailored pharmaceutical care. Our team of compounding pharmacists is equipped to prepare Phenobarbital 200 mg Rectal Suppositories with precision and care, ensuring that each suppository meets the required specifications for dose and purity. If you have any questions about this formulation or its appropriateness for your patient's needs, please do not hesitate to reach out to us. We are here to support healthcare providers and patients with the information and resources needed for effective treatment.

Drug Interactions

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Phenobarbital is a long-acting barbiturate that is commonly used as a sedative and an anticonvulsant. When formulated as a 200 mg rectal suppository, it is typically used for the emergency management of seizures and for preoperative sedation. As with any medication, phenobarbital can interact with a variety of drugs, which can lead to altered effects of either the phenobarbital or the concomitant medication. It is important for both patients and prescribers to be aware of these potential interactions to ensure safe and effective use of this formulation.

Phenobarbital may increase the metabolism of other drugs through induction of hepatic enzymes, particularly cytochrome P450 enzymes. This can lead to decreased plasma concentrations and reduced efficacy of medications such as warfarin, oral contraceptives, and other anticonvulsants like phenytoin and valproate. Patients taking these medications may require dosage adjustments and close monitoring when starting or stopping phenobarbital therapy.

Conversely, drugs that inhibit cytochrome P450 enzymes, such as certain antifungals (e.g., ketoconazole), macrolide antibiotics (e.g., erythromycin), and cimetidine, can increase phenobarbital levels, potentially leading to toxicity. Signs of phenobarbital toxicity include sedation, ataxia, respiratory depression, and in severe cases, coma. It is crucial to monitor patients for these symptoms and adjust the phenobarbital dosage as necessary.

Phenobarbital's CNS depressant effects can be potentiated by other CNS depressants, including alcohol, opioids, benzodiazepines, and other sedative-hypnotics. This can result in excessive sedation, respiratory depression, and even death. Patients should be advised to avoid alcohol and be cautious when using other CNS depressants concurrently with phenobarbital.

Additionally, phenobarbital may reduce the effectiveness of corticosteroids and doxycycline due to increased metabolism. Patients on these medications may require dose adjustments to maintain therapeutic effects. Furthermore, the anticoagulant effect of warfarin and other coumarin derivatives may be diminished when used with phenobarbital, necessitating more frequent monitoring of INR and potential dose adjustments.

It is also important to note that abrupt discontinuation of phenobarbital, especially after long-term use, can lead to withdrawal symptoms and an increased risk of seizures. Tapering the dose gradually is recommended to minimize these risks.

Given the potential for significant drug interactions, it is essential for prescribers to thoroughly review a patient's medication history before initiating treatment with phenobarbital rectal suppositories. Pharmacists can play a key role in identifying and managing drug interactions to optimize patient outcomes. If you have any questions or concerns regarding the use of phenobarbital or its interactions with other medications, please reach out to us at Bayview Pharmacy for further assistance.

How Does it Work

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Phenobarbital is a barbiturate that is commonly used as a sedative and an anticonvulsant. The 200 mg rectal suppository form of phenobarbital is designed to be inserted into the rectum, where it dissolves or melts at body temperature. Once the suppository base dissolves, the active drug, phenobarbital, is released and absorbed through the rectal mucosa into the bloodstream. This route of administration can be particularly useful when the oral route is not feasible due to vomiting, difficulty swallowing, or the need for a rapid onset of action.

The rectal administration of phenobarbital provides several advantages. It bypasses the first-pass metabolism in the liver, which can lead to a more predictable pharmacokinetic profile. This is especially important for phenobarbital, as it is subject to significant first-pass metabolism when taken orally. By avoiding the gastrointestinal tract, rectal administration also reduces the risk of gastric irritation and is beneficial in patients with nausea or vomiting.

Phenobarbital works by enhancing the activity of gamma-aminobutyric acid (GABA), a neurotransmitter in the brain that is responsible for inhibiting nerve transmission. By increasing GABAergic activity, phenobarbital effectively slows down the activity of the central nervous system. This action helps to stabilize neuronal membranes and prevents the spread of electrical charges in the brain that cause seizures. As a result, phenobarbital is effective in treating various types of epilepsy and is particularly useful in the emergency management of acute convulsive episodes.

In addition to its anticonvulsant properties, phenobarbital has sedative effects, which can be beneficial in calming patients and inducing sleep. However, it is important to note that tolerance and dependence can occur with prolonged use, and careful monitoring by healthcare professionals is necessary.

For patients and prescribers considering the use of phenobarbital 200 mg rectal suppository, it is crucial to understand that while this formulation provides a convenient and effective route of administration, it must be used with caution. Dosing should be individualized, and the patient's medical history, potential drug interactions, and specific condition should be taken into account. Monitoring for therapeutic and adverse effects is essential to ensure safety and efficacy.

If you have any questions or require further information about the phenobarbital 200 mg rectal suppository, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to provide guidance and support to ensure the best possible outcomes for our patients and prescribers.

Other Uses

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Phenobarbital is primarily known for its anticonvulsant and sedative properties, typically prescribed for managing seizure disorders and promoting sedation in various medical contexts. However, this phenobarbital 200 mg rectal suppository formulation may also have alternative uses, due to its pharmacological actions. For instance, in palliative care settings, it may be useful for alleviating symptoms like agitation or restlessness, particularly in patients who have difficulty taking medications orally or where other routes of administration are not practical.

Moreover, due to its sedative effects, phenobarbital rectal suppositories could potentially be used in situations where rapid sedation is required but oral or intravenous access is not available, such as in emergency settings or with pediatric or geriatric patients. While less common, there have been instances where barbiturates like phenobarbitone have been employed off-label for the management of acute withdrawal symptoms in substance detoxification processes.

It is essential to note that the use of phenobarbital, especially in a potent dosage of 200 mg, should be carefully considered by health care practitioners due to the risks of dependence, tolerance, and significant central nervous system depression. The therapeutic applications beyond those typically indicated should only be explored when the benefits outweigh potential risks and alternative treatments are not suitable. Always a consult with a healthcare provider is necessary to determine if this suppository could be an appropriate choice for off-label use.

This formulation allows for an alternative route of drug delivery that may be particularly beneficial in patients with gastrointestinal difficulties, those experiencing nausea and vomiting, or individuals who are not conscious. The rectal suppository form bypasses the gastrointestinal system, potentially reducing gastric irritation, and can offer a more consistent absorption rate compared to oral formulations in certain situations. Nevertheless, careful monitoring for adverse effects is required as phenobarbital has a narrow therapeutic index.

If there are any questions regarding the potential off-label uses of phenobarbital 200 mg rectal suppositories, dosing, possible side effects, or contraindications, we encourage both patients and prescribers to reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is ready to provide detailed information and support to ensure safe and effective medication use.

Frequently Asked Questions

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What is Phenobarbital 200 mg Rectal Suppository used for?

Phenobarbital 200 mg Rectal Suppository is a medication commonly used to treat seizures and to maintain control over seizure disorders. It can also be used for sedation and to treat anxiety on a short-term basis. This specific dosage form is designed to be administered rectally and delivers a high dose of phenobarbital for therapeutic effect.

How is the Phenobarbital suppository administered?

The suppository is inserted into the rectum, where it dissolves or melts and the medication is then absorbed into the bloodstream. Proper insertion technique involves lying on your side and inserting the suppository, pointed end first, well into the rectum.

How long does it take for the Phenobarbital suppository to work?

The onset of action for a Phenobarbital 200 mg Rectal Suppository may vary between individuals. However, rectal administration typically results in medication absorption within 15 to 30 minutes, with peak effects usually observed within the first few hours after administration.

Are there any side effects associated with Phenobarbital rectal suppositories?

Yes, side effects may include drowsiness, dizziness, nausea, vomiting, constipation, and headache. It's important to contact your healthcare provider if you experience any severe or persistent side effects.

Can the Phenobarbital suppository be used in pediatric patients?

Phenobarbital rectal suppositories can be used in pediatric patients but dosing will vary based on the child's weight and medical condition. A healthcare provider must determine the appropriate dose for pediatric patients.

What should I do if I miss a dose of the Phenobarbital suppository?

If you miss a dose, administer it as soon as you remember. However, if it's nearly time for your next dose, skip the missed dose, and resume your regular dosing schedule. Do not double up on the dose to catch up.

Can I drink alcohol while using Phenobarbital Rectal Suppositories?

Alcohol should be avoided while using Phenobarbital suppositories, as it can increase the risk of side effects such as excessive sedation or respiratory depression. Always check with your healthcare provider for specific guidance.

How should I store the Phenobarbital suppositories?

The suppositories should be stored at room temperature away from moisture and direct light. Do not store it in a bathroom and make sure it's kept out of reach of children and pets.

Can I use Phenobarbital rectal suppositories during pregnancy?

Phenobarbital may cause harm to an unborn baby if used during pregnancy, especially in the first trimester. Use only if clearly needed and prescribed by your healthcare provider who will help weigh the risks and benefits.

Is it safe to operate machinery or drive while using phenobarbital suppositories?

No, Phenobarbital can cause drowsiness or dizziness, impacting your ability to perform tasks requiring alertness such as driving a car or operating machinery. It is recommended to avoid these activities until you know how the medication affects you.

Will my diet affect the efficacy of the Phenobarbital suppository?

There are no specific dietary restrictions while using Phenobarbital suppositories, but it is always wise to discuss with your healthcare provider if any foods or beverages may interact with your medication.

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Formulas and/or material listed are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The information contained herein is not intended to replace or substitute for conventional medical care, or encourage its abandonment. Every patient is unique, and formulas should be adjusted to meet their individual needs.

No compounded medications are reviewed by the FDA for safety or efficacy.