Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For barbiturates, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to barbiturates. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Barbiturates have been shown to increase the chance of birth defects in humans. However, this medicine may be needed in serious diseases or other situations that threaten the mother's life. Be sure you have discussed this and the following information with your doctor:

• Taking barbiturates regularly during pregnancy may cause bleeding problems in the newborn infant. In addition, taking barbiturates regularly during the last 3 months of pregnancy may cause the baby to become dependent on the medicine. This may lead to withdrawal side effects in the baby after birth.
• One study in humans has suggested that barbiturates taken during pregnancy may increase the chance of brain tumors in the baby.
• Barbiturates taken for anesthesia during labor and delivery may reduce the force and frequency of contractions of the uterus; this may prolong labor and delay delivery.
• Use of barbiturates during labor may cause breathing problems in the newborn infant.

Breast-feeding—Barbiturates pass into the breast milk and may cause drowsiness, slow heartbeat, shortness of breath, or troubled breathing in babies of nursing mothers taking this medicine.

Children—Unusual excitement may be more likely to occur in children, who are usually more sensitive than adults to the effects of barbiturates.

Older adults—Confusion, mental depression, and unusual excitement may be more likely to occur in the elderly, who are usually more sensitive than younger adults to the effects of barbiturates.

Other medicines—Although certain medicines should not be used together at all, in other cases 2 different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking a barbiturate, it is especially important that your health care professional know if you are taking any of the following:

• Adrenocorticoids (cortisone-like medicine) or
• Anticoagulants (blood thinners) or
• Carbamazepine or
• Corticotropin (ACTH)—Barbiturates may decrease the effects of these medicines

• Central nervous system (CNS) depressants (medicines that cause drowsiness)—Using these medicines with barbiturates may result in increased CNS depressant effects

• Divalproex sodium or
• Valproic acid—Using these medicines with barbiturates may change the amount of either medicine that you need to take

• Oral contraceptives (birth control pills) containing estrogens—Barbiturates may decrease the effectiveness of these oral contraceptives, and you may need to change to a different type of birth control

Other medical problems—The presence of other medical problems may affect the use of barbiturates. Make sure you tell your doctor if you have any other medical problems, especially:

• Alcohol abuse (or history of) or
• Drug abuse or dependence (or history of)—Dependence on barbiturates may develop

• Anemia (severe) or
• Asthma (history of), emphysema, or other chronic lung disease or
• Diabetes mellitus (sugar diabetes) or
• Hyperactivity (in children) or
• Mental depression or
• Overactive thyroid or
• Porphyria (or history of)—Barbiturates may make the condition worse

• Kidney disease or
• Liver disease—Higher blood levels of barbiturates may result, increasing the chance of side effects

• Pain—Barbiturates may cause unexpected excitement or mask important symptoms of more serious problems

• Underactive adrenal gland—Barbiturates may interfere with the effects of other medicines needed for this condition