Pregnancy Category D

Uses. Mephobarbital has both sedative and anticonvulsant effects. Anticonvulsant properties make the drug a standard treatment for epilepsy. When used for that condition, stoppage of the drug must be handled carefully lest a person start having a streak of seizures one after another (a potentially fatal condition called status epilepticus). Sedative qualities make mephobarbital an effective tranquilizer, with users feeling lighthearted and mellow without getting very sleepy. Men metabolize the drug faster than women do, meaning a dose will last longer in women. After ingestion the drug metabolizes into phenobarbital, which seems to be a more potent sedative. Health care practitioners sometimes administer those two drugs together.

Drawbacks. In an experiment comparing mephobarbital to phenobarbital in epileptic children, parents reported fewer unwanted behavioral effects with mephobarbital, and some pediatricians agree with that observation. The most typical behavior problem in such children is hyperactivity. A formal test comparing the two drugs, however, found no difference in either unwanted conduct or therapeutic power.

Mephobarbital is to be avoided if a person has porphyria, a disease reflecting a body chemistry disorder and in which a person may be harmed by exposure to light. The drug should also be avoided if a person has a muscle-weakening disease called myasthenia gravis, or a thyroid deficiency causing an affliction called myxedema.

Persons using this drug may need extra vitamin D, due to possible deficiency that might be caused by faster metabolism of the vitamin.

Abuse factors. Not enough scientific information to report on tolerance, dependence, withdrawal, and addiction.

Drug interactions. Taking mephobarbital with acetaminophen (Tylenol and similar products) may promote liver injury. Mephobarbital can interfere with effectiveness of birth control pills and with actions of medicines used to control epilepsy and blood clotting. Drugs used to treat asthma, blood pressure, and heart ailment may not work as well if a person also takes mephobarbital. Cancer. Not enough scientific information to report.

Pregnancy. Additional vitamin K is recommended for pregnant women using mephobarbital as childbirth approaches, in order to reduce bleeding in the women and offspring. Mephobarbital can help reduce fetal pulse rate irregularity but has been found to cause birth defects, with the risk malformations increasing if other antiepileptic drugs are also used. The drug is found in breast milk of nursing mothers who use the substance. Additional scientific information may be found in:

De Haan, J., and L. Stolte. "Drugs and the Fetal Heart Rate." British Medical Journal 4

(October 16, 1971): 171. Willis, J., et al. "Barbiturate Anticonvulsants: A Neuropsychological and Quantitative

Electroencephalographic Study." Journal of Child Neurology 12 (1997): 169-71. Young, R.S., et al. "A Randomized, Double-Blind, Crossover Study of Phenobarbital and Mephobarbital." Journal of Child Neurology 1 (1986): 361-63.

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