Secobarbital

Mechanism of Action

Depress reticular activating system & cerebellar function

Pharmacokinetics

Half-life elimination: 28 hr

Duration: 3-4 hr

Vd: 1.5 L/kg

Onset: 15-30 min (hypnosis)

Excretion: Urine

Protein Bound: 45-60%

Metabolism: hepatic microsomal enzymes, glucuronidationExcretion: mostly urine as metabolites (<5% unchanged)

Enzymes induced: Primarily CYP2C9/10; CYP2C8,  CYP2C9

Secobarbital is in a group of drugs called barbiturates (bar-BIT-chur-ates). Secobarbital slows the activity of your brain and nervous system.

Secobarbital is used short-term to treat insomnia, or as a sedative before surgery.

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

Secobarbital may cause a severe allergic reaction. Stop taking secobarbital and 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.

Take secobarbital only when you are getting ready for several hours of sleep. You may fall asleep very quickly after taking the medicine.

Some people using this medicine have engaged in activity such as driving, and later having no memory of the activity. If this happens to you, stop taking secobarbital and talk with your doctor about another treatment for your sleep disorder.

Do not use secobarbital without telling your doctor if you are pregnant. It could cause harm to the unborn baby. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.

Secobarbital can make birth control pills less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking secobarbital.

Secobarbital may be habit-forming and should be used only by the person it was prescribed for. Secobarbital should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

Some people using this medicine have engaged in activity such as driving, and later having no memory of the activity. If this happens to you, stop taking secobarbital and talk with your doctor about another treatment for your sleep disorder.

Do not take this medication if you are allergic to secobarbital, or if you have porphyria.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take secobarbital:

• severe asthma, chronic obstructive pulmonary disorder (COPD), or other breathing disorder;
• a blood cell disorder such as anemia (lack of red blood cells);
• epilepsy or other seizure disorder;
• liver disease;
• heart disease;
• overactive thyroid;
• a history of depression, mental illness, or suicide attempt; or
• a history of drug or alcohol addiction.

Secobarbital may be habit-forming and should be used only by the person it was prescribed for. Secobarbital should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not use secobarbital without your doctor's consent if you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective form of birth control while you are using this medication.

Secobarbital can make birth control pills less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking secobarbital.

Secobarbital can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Secobarbital may be found in some form under the following brand names:

• Seconal Sodium

• Tuinal

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• ANISINDIONE/SECOBARBITAL
• ARIPIPRAZOLE/SECOBARBITAL
• CYCLOSPORINE/SECOBARBITAL
• DICUMAROL/SECOBARBITAL
• ESTRADIOL/SECOBARBITAL
• ETHINYL ESTRADIOL/SECOBARBITAL
• ETHYNODIOL DIACETATE/SECOBARBITAL
• EVEROLIMUS/SECOBARBITAL
• MESTRANOL/SECOBARBITAL
• NORELGESTROMIN/SECOBARBITAL
• NORETHINDRONE/SECOBARBITAL
• PHENPROCOUMON/SECOBARBITAL
• QUETIAPINE FUMARATE/SECOBARBITAL
• RISPERIDONE/SECOBARBITAL
• SECOBARBITAL/SIROLIMUS
• SECOBARBITAL/SODIUM OXYBATE
• SECOBARBITAL/TACROLIMUS
• SECOBARBITAL/TEMSIROLIMUS
• SECOBARBITAL/WARFARIN

This is not a complete list of Secobarbitaldrug interactions. Ask your doctor or pharmacist for more information.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Secobarbital falls into category D:

It has been shown that use of Secobarbital in pregnant women caused some babies to be born with problems. However, in some serious situations, the benefit of using this medication may be greater than the risk of harm to the baby.

Do not take this medicine if you have consumed alcohol during the day or just before bed.

Avoid taking cold or allergy medicine that contains an antihistamine.

Secobarbital may impair your thinking or reactions. You may still feel sleepy the morning after taking secobarbital. Wait until you are fully awake before you drive, operate machinery, or do anything that requires you to be awake and alert.

• Quinalbarbitone Sodium
• Secobarbital Sodium

Store at controlled room temperature of 20°C to 25°C (68°F to 77°F).

Concerns related to adverse effects:

• CNS depression: May cause CNS depression, which may impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness (eg, operating machinery or driving).

• Hypersensitivity reactions: Postmarketing studies have indicated that the use of hypnotic/sedative agents for sleep has been associated with hypersensitivity reactions including anaphylaxis as well as angioedema.

• Paradoxical responses: May cause paradoxical responses, including agitation and hyperactivity, particularly in acute pain, chronic pain and pediatric patients.

• Sleep-related activities: An increased risk for hazardous sleep-related activities such as sleep-driving; cooking and eating food, and making phone calls while asleep have also been noted. Discontinue treatment in patients who report a sleep-driving episode.

Disease-related concerns:

• Cardiovascular disease: Use with caution in patients with cardiovascular disease; may cause hypotension.

• Depression: Use with caution in patients with depression or suicidal tendencies.

• Drug abuse: Use with caution in patients with a history of drug abuse or acute alcoholism; potential for drug dependency exists. Tolerance, psychological and physical dependence may occur with prolonged use.

• Hepatic impairment: Use with caution in patients with hepatic impairment.

• Renal impairment: Use with caution in patients with renal impairment.

• Respiratory disease: Use with caution in patients with respiratory disease; may cause respiratory depression.

Concurrent drug therapy issues:

• Sedatives: Effects may be potentiated when used with other sedative drugs or ethanol.

Special populations:

• Pediatric: Use with caution in children.

Other warnings/precautions:

• Appropriate use: Symptomatic treatment of insomnia should be initiated only after careful evaluation of potential causes of sleep disturbance. Failure of sleep disturbance to resolve after 7-10 days may indicate psychiatric and/or medical illness.

• Withdrawal: Abrupt cessation may precipitate withdrawal, including status epilepticus in epileptic patients.

Barbiturates can be detected in the placenta, fetal liver, and fetal brain. Fetal and maternal blood concentrations may be similar following parenteral administration. An increased incidence of fetal abnormalities may occur following maternal use. When used during the third trimester of pregnancy, withdrawal symptoms may occur in the neonate including seizures and hyperirritability; symptoms may be delayed up to 14 days. Use during labor does not impair uterine activity; however, respiratory depression may occur in the newborn; resuscitation equipment should be available, especially for premature infants.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Feeling sleepy.
• Feeling sleepy the next day.
• Dizziness.
• Headache.
• Feeling tired or weak.
• Dry mouth.
• Upset stomach.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.