decrease the level or effect of tipranavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tivozanibSerious - Use Alternative (1)amobarbital will decrease the level or effect of tivozanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.tizanidineSerious - Use Alternative (1)amobarbital will decrease the level or effect of tizanidine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.tolbutamideMinor (1)amobarbital will decrease the level or effect of tolbutamide by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.tolterodineMonitor Closely (1)amobarbital will decrease the level or effect of tolterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tolvaptanSerious - Use Alternative (1)amobarbital will decrease the level or effect of tolvaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.topiramateMonitor Closely (1)amobarbital and topiramate both increase sedation. Modify Therapy/Monitor Closely.Minor (1)amobarbital decreases levels of topiramate by increasing metabolism. Minor/Significance Unknown.tramadolMonitor Closely (1)amobarbital and tramadol both increase sedation. Use Caution/Monitor.tranylcypromineMinor (1)tranylcypromine increases levels of amobarbital by decreasing metabolism. Minor/Significance Unknown. Theoretical interaction.trazodoneMonitor Closely (2)amobarbital will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. amobarbital and trazodone both increase sedation. Use Caution/Monitor.Minor (1)amobarbital, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.triamcinolone acetonide injectable suspensionMonitor Closely (1)amobarbital will decrease the level or effect of triamcinolone acetonide injectable suspension by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.triazolamMonitor Closely (2)amobarbital will decrease the level or effect of triazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. amobarbital and triazolam both increase sedation. Use Caution/Monitor.triclofosMonitor Closely (1)amobarbital and triclofos both increase sedation. Use Caution/Monitor.trifluoperazineMonitor Closely (1)amobarbital and trifluoperazine both increase sedation. Use Caution/Monitor.trimipramineMonitor Closely (1)amobarbital and trimipramine both increase sedation. Use Caution/Monitor.Minor (1)amobarbital, trimipramine. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.triprolidineMonitor Closely (1)triprolidine and amobarbital both increase sedation. Use Caution/Monitor.tucatinibSerious - Use Alternative (1)amobarbital will decrease the level or effect of tucatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.ubrogepantMonitor Closely (1)amobarbital will decrease the level or effect of ubrogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.upadacitinibSerious - Use Alternative (1)amobarbital will decrease the level or effect of upadacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid upadacitinib coadministration with strong CYP3A4 inducers.valbenazineMonitor Closely (1)amobarbital will decrease the level or effect of valbenazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.valerianSerious - Use Alternative (2)valerian increases effects of amobarbital by pharmacodynamic synergism. Avoid or Use Alternate Drug. May enhance CNS depression. valerian and amobarbital both increase sedation. Avoid or Use Alternate Drug.vardenafilMonitor Closely (1)amobarbital will decrease the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.verapamilMonitor Closely (1)amobarbital will decrease the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.vinblastineMinor (1)amobarbital will decrease the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.vincristineMinor (1)amobarbital will decrease the level or effect of vincristine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.vincristine liposomalMinor (1)amobarbital will decrease the level or effect of vincristine liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.vinorelbineMinor (1)amobarbital will decrease the level or effect of vinorelbine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.voclosporinSerious - Use Alternative (1)amobarbital will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.vonoprazanSerious - Use Alternative (1)amobarbital will decrease the level or effect of vonoprazan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.voxelotorSerious - Use Alternative (1)amobarbital will decrease the level or effect of voxelotor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor is primarily metabolized by CYP3A4. Avoid coadministration with moderate or strong CYP3A4 inducers. If unable to avoid coadministration, increase voxelotor dose (see Dosage Modifications).warfarinMonitor Closely (1)amobarbital will decrease the level or effect of warfarin by Other (see comment). Use Caution/Monitor. Warfarin's less potent R-enantiomer is metabolized in part by CYP3A4 (and also CYP1A2 and CYP2C19). Monitor INR more frequently if coadministered with inducers of these isoenzymes and adjust warfarin dose if needed. xylometazolineMonitor Closely (1)amobarbital increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.yohimbineMonitor Closely (1)amobarbital increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.zaleplonMinor (1)amobarbital will decrease the level or effect of zaleplon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.zanubrutinibSerious - Use Alternative (1)amobarbital will decrease the level or effect of zanubrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of zanubrutinib (a CYP3A4 substrate) with moderate CYP3A4 inhibitors. If unavoidable, increase zanubrutinib dose to 320 mg PO BID. After discontinuing the CYP3A4 inhibitor, resume previous dose of zanubrutinib. ziconotideMonitor Closely (1)amobarbital and ziconotide both increase sedation. Use Caution/Monitor.ziprasidoneMonitor Closely (1)amobarbital and ziprasidone both increase sedation. Use Caution/Monitor.Minor (1)amobarbital will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.zolpidemMinor (1)amobarbital will decrease the level or effect of zolpidem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.zonisamideMinor (1)amobarbital will decrease the level or effect of zonisamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.zotepineMonitor Closely (1)amobarbital and zotepine both increase sedation. Use Caution/Monitor. 1-10% Somnolence <1% Nervous system: agitation, confusion, hyperkinesia, ataxia, CNS depression, nightmares, nervousness, psychiatric disturbance, hallucinations, insomnia, anxiety, dizziness, abnormality in thinking Cardiovascular system: Bradycardia, hypotension, syncope Respiratory system: apnea, hypoventilation, postoperative atelectasis Digestive system: Constipation, vomiting, nausea Other adverse effects: Headache, injection site reactions, hypersensitivity reactions, fever, liver damage, megaloblastic anemia following chronic phenobarbital use Contraindications Hypersensitivity Patients with history of manifest or latent porphyria Significant impairment of liver function Respiratory disease in which dyspnea or obstruction is evident Cautions Habit forming; tolerance and psychological dependence may occur with continued use Caution in patients that are mentally depressed, have suicide ideation or history of drug abuse and hepatic damage Rapid administration may cause respiratory depression, apnea, laryngospasm, or vasodilatation with decrease in blood pressure Parenteral solutions of barbiturates are highly alkaline; care should be taken to avoid perivascular extravasation or intra-arterial injection Amobarbital may diminish systemic effects of exogenous and endogenous corticosteroids. Administer with caution to patients with borderline hypoadrenal function, regardless of whether it is of pituitary or of primary adrenal origin Possible impairment of mental and/or physical abilities required for the performance of potentially hazardous tasks, such as driving a car or operating machinery Concurrent use of barbiturates with other CNS depressants (eg, alcohol, narcotics, tranquilizers, antihistamines) may result in increased CNS-depressant effects Extravascular injection may cause local tissue damage with subsequent necrosis; consequences of intra-arterial injection may vary from transient pain to gangrene of the limb; any complaint of pain in the limb warrants stopping the injection Pregnancy Category: D Lactation: small amounts of barbiturates are excreted in the milk; use cautionPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Depress the sensory cortex by interfering with transmission of impulses from thalamus. This results in decreased motor activity, altered cerebellar function, drowsiness, sedation, and hypnosis Absorption Onset: Within 5 minutes Metabolism Primarily hepatic via microsomal enzymes Elimination Half-life: 15-40 hours in adults (mean 25 hours) Excretion: Feces, urine IV Administration Slow IV injection is essential; observe patients carefully during administration Blood pressure, respiration, and cardiac function must be maintained, vital signs be recorded and equipment for resuscitation and artificial ventilation be available The rate of IV injection for adults should not exceed 50 mg/min to prevent sleep or sudden respiratory depression Final dosage is determined largely by the patient’s reaction to the slow administration of the drug IM Administration IM injection of the sodium salts of barbiturates should be made deeply into a large muscle Average IM dose ranges from 65 mg-500 mg; volume of 5 mL (irrespective of concentration) should not be exceeded at any one site because of possible tissue irritation Twenty percent solutions may be used so that a small volume can contain a large dose; monitor vital signs after IM injection of hypnotic dose Superficial IM or subcutaneous injections may be painful and may produce sterile abscesses or sloughs No images available for this drug. No images available for this drug.Print Patient Educationamobarbital injection NO MONOGRAPH AVAILABLE AT THIS TIME USES: Consult your pharmacist. HOW TO USE: Consult your pharmacist. SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. PRECAUTIONS: Consult your pharmacist. DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. NOTES: No monograph available at this time. MISSED DOSE: Consult your pharmacist. STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product. Information last revised July 2016. Copyright(c) 2023 First Databank, Inc. IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs. FormularyPatient DiscountsAdding plans allows you to compare formulary status to other drugs in the same class.To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.Create Your List of PlansAdding plans allows you to:View the formulary and any restrictions for each plan.Manage and view all your plans together – even plans in different states.Compare formulary status to other drugs in the same class.Access your plan list on any device – mobile or desktop. The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. View explanations for tiers and restrictions Tier Description 1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs. 2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs. 3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs. 4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. 5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. 6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. NC NOT COVERED – Drugs that are not covered by the plan. Code Definition PA Prior Authorization Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription. QL Quantity Limits Drugs that