Butabarbital Indications and Dosage
- anxiety
- insomnia
- sedation induction
- sedation maintenance
Butabarbital Indications and Dosage
For preprocedure sedation induction and relief of preoperative anxiety:
Oral dosage:
Adults: 50 - 100 mg PO given 60 - 90 minutes before surgery.
Elderly or debilitated patients: May require reduction of regular adult dose. NOTE: According to OBRA regulations, butabarbital is not to be used in a nursing home patient, unless previously started before admission to the nursing home, or given as a single dose for a medical or dental procedure.
Children: 2 - 6 mg/kg PO, up to a maximum of 100 mg/dose.
For sedation maintenance (routine daytime sedation), to relieve anxiety, tension, and/or apprehension:
Oral dosage:
Adults: 15 - 30 mg PO 3 - 4 times daily.
Elderly or debilitated adult patients: May require reduction of regular adult dose. NOTE: According to OBRA regulations, butabarbital is not to be used in a nursing home patient, unless previously started before admission to the nursing home, or given as a single dose for a medical or dental procedure.
Children: 2 mg/kg/dose PO three times daily.
For the short term treatment of insomnia:
NOTE: This is no longer an accepted use for this drug. Barbiturates should be prescribed for <= 14 days for insomnia; they generally lose effectiveness after this time.
Oral dosage:
Adults: 50 - 100 mg PO at bedtime.
Elderly or debilitated adult patients: May require reduction of regular adult dose. Federal OBRA guidelines state that the maximum single dose of butabarbital as a hypnotic in the elderly nursing home patient is 100 mg PO. It is recommended to avoid use of this drug in the elderly for insomnia. Treatment for insomnia should not extend past 10 continuous days without documentation. NOTE: According to OBRA regulations, butabarbital is not to be used in a nursing home patient, unless previously started before admission to the nursing home, or given as a single dose for a medical or dental procedure.
Children: Dosage must be individualized; Not a generally accepted use in children.
Maximum Dosage Limits:
- Adults: 200 mg/day PO.
- Elderly: OBRA guidelines recommend 100 mg/day PO for insomnia; use not recommended.
- Adolescents: Safe and effective use has not been established.
- Children: Safe and effective use has not been established.
Patients with hepatic impairment:
Reduced dosage is needed; avoid in those with hepatic coma/encephalopathy.
Patients with renal impairment:
Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.
[ Last revised: 12/5/2003 11:20:00 AM ]
References
. Gurvich T, Cunningham JA. Appropriate Use of Psychotropic Drugs in Nursing Homes. Am Fam Physician 2000;61:1437 - 46.
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