{"id":4623,"date":"2025-03-31T18:12:14","date_gmt":"2025-03-31T18:12:14","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/phenobarbital-txt\/"},"modified":"2025-03-31T18:12:14","modified_gmt":"2025-03-31T18:12:14","slug":"phenobarbital-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/phenobarbital-txt\/","title":{"rendered":"phenobarbital.txt"},"content":{"rendered":"

CLINICAL USE <\/H3>
\nAnti-epileptic agent

DOSE IN NORMAL RENAL FUNCTION <\/H3>Oral: 60\u2013180 mg at nightStatus epilepticus: 10 mg\/kg, max 1 g IV

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :232.2 (254.2 as sodium salt) <\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :45\u201360<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 25<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :1<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :75\u2013120\/Unchanged

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function, but avoid very large doses
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Reduce dose by 25\u201350% and avoid very large single doses

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • HDF\/high flux &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR=10\u201320 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Antibacterials: reduced concentration of chloramphenicol, doxycycline, metronidazole, telithromycin and possibly rifampicin \u2013 avoid with telithromycin\n
  • Anticoagulants: increased metabolism of coumarins (reduced effect)\n
  • Antidepressants: antagonise anticonvulsant effect; reduces concentration of paroxetine, mianserin and tricyclics; concentration reduced by St John\u2019s wort \u2013 avoid concomitant use\n
  • Antifungals: possibly reduced concentration of itraconazole, posaconazole and voriconazole \u2013 avoid concomitant use with voriconazole; reduced absorption of griseofulvin (reduced effect)\n
  • Antipsychotics: antagonise anticonvulsant effect; metabolism of haloperidol increased; possibly reduces aripiprazole concentration \u2013 increase aripiprazole dose; concentration of both drugs reduced with chlorpromazine\n
  • Antivirals: concentration of abacavir, amprenavir, darunavir, indinavir, lopinavir, nelfinavir and saquinavir possibly reduced\n
  • Calcium-channel blockers: effect of felodipine, isradipine and probably dihydropyridines, diltiazem and verapamil reduced\n
  • Ciclosporin: reduced ciclosporin levels Corticosteroids: metabolism of corticosteroids accelerated, reduced effect\n
  • Diuretics: concentration of eplerenone reduced \u2013 avoid concomitant use; increased risk of osteomalacia with carbonic anhydrase inhibitorsOestrogens and progestogens: metabolism accelerated, reduced contraceptive effectSodium oxybate: enhanced effects of sodium oxybate \u2013 avoid\n
  • Tacrolimus: concentration of tacrolimus reduced

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>IV, oral

    Rate of Administration <\/H4>Not more than 100 mg\/minute

    Comments<\/H4>For IV administration, dilute 1 in 10 with water for injectionPhenobarbital (phenobarbitone).578 PhEnoBArBiTAL (PhEnoBArBiTonE)

    OTHER INFORMATION <\/H4>Aim for plasma concentration of 15\u2013 40 mg\/L (65\u2013170 \u00b5mol\/L) for optimum responseMay cause excessive sedation and increased osteomalacia in ERFCharcoal haemoperfusion and haemodialysis more effective than peritoneal dialysis for poisoningUp to 50% unchanged drug excreted in urine with alkaline diuresis.
    \n","protected":false},"excerpt":{"rendered":"

    CLINICAL USE Anti-epileptic agent DOSE IN NORMAL RENAL FUNCTION Oral:<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4623","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4623","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4623"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4623\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4623"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4623"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4623"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}