What drugs interact with barbiturates?
Barbiturates should be used with caution with some medications because they accelerate the breakdown of these medications leading to decreased effectiveness. Examples of these medications that interact with barbiturates include:
- atazanavir (Reyataz),
- boceprevir (Victrelis),
- lurasidone (Latuda),
- ranolazine (Ranexa),
- telaprevir (Incivek),
- voriconazole, (Vfend), and
- ritonavir (Norvir).
Concomitant use of barbiturates and other central nervous system depressant medications should be used with caution because concomitant use can lead to excessive sedation, lethargy, and in severe cases coma and death. Examples of these medications that should be used with caution with other central nervous system depressant medications such as:
- alprazolam (Xanax),
- clonazepam (Klonopin),
- diazepam (Valium),
- zolpidem (Ambien), and
- zaleplon (Sonata).
What formulations of are available barbiturates?
- Amobarbital and pentobarbital are available as injections.
- Butabarbital, phenobarbital, belladonna and phenobarbital, butalbital/aspirin/caffeine, and butalbital/acetaminophen/caffeine are available as tablets.
- Butalbital/acetaminophen/caffeine, butalbital/aspirin/caffeine, and secobarbital are available as capsules.
- Butabarbital, phenobarbital, belladonna and phenobarbital, and butalbital/acetaminophen/caffeine are available as oral liquids.
What about taking barbiturates during pregnancy or while breastfeeding?
FDA has listed amobarbital, phenobarbital, pentobarbital, secobarbital as Pregnancy Category D. This means they should not be used during pregnancy. FDA has listed belladonna and phenobarbital, butabarbital, butalbital/acetaminophen/caffeine, and butalbital/acetaminophen/caffeine as Pregnancy Category C. Pregnancy Category C classification means that there is no evidence of safe and effective use of barbiturates established for pregnant women. Therefore, risk to the infant cannot be ruled out. It is not known whether barbiturates enter breast milk; however, barbiturates should be avoided in nursing mothers to avoid harm to the infant.
Medically reviewed by Eni Williams, PharmD, PhD
REFERENCE: Medscape. Anticonvulsants, Barbiturates.
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