phenobarbital

Adult Dosing .

Dosage forms:  TAB: 15 mg, 16.2 mg, 30 mg, 32.4 mg, 60 mg, 64.8 mg, 97.2 mg, 100 mg; SOL: 20 mg per 5 mL; ELIX: 20 mg per 5 mL; INJ: various

status epilepticus

[15-20 mg/kg/dose IV x1]

Info: may give up to 15 mg/kg/dose IV x1 at least 15min after 1st dose if seizure persists; decr. dose in elderly or debilitated pts

seizure disorder

[50-100 mg PO bid-tid]

Alt: 60-200 mg/day PO; Info: adjust dose based on tx response and serum levels; decr. dose in elderly or debilitated pts; taper dose gradually to D/C

sedation

[30-120 mg/day PO/IM/IV divided bid-tid]

Max: 400 mg/day; Info: decr. dose in elderly or debilitated pts; taper dose gradually to D/C if long-term use

sedation, procedural

[100-200 mg IM x1]

Start: 60-90min preop; Info: decr. dose in elderly or debilitated pts

acute alcohol withdrawal, adjunct tx (off-label)

[260 mg IM/IV x1, then 130 mg IM/IV q30min prn]

Alt: 10 mg/kg/dose IV x1; Info: refer to institutional protocol

renal dosing

[if usual regimen bid-tid]

CrCl <15: give usual dose q12-16h

HD: give usual dose q12-16h; may give additional pre-dialysis dose; give 50% usual dose as supplement after dialysis if next maint. dose not due right after dialysis; PD: give 50% usual dose q12-16h; consider supplement

[all other regimens]

renal impairment: not defined

HD/PD: not defined

hepatic dosing

[see below]

mild-moderate impairment: decr. usual dose, amount not defined; severe impairment: contraindicated

Peds Dosing .

Dosage forms:  TAB: 15 mg, 16.2 mg, 30 mg, 32.4 mg, 60 mg, 64.8 mg, 97.2 mg, 100 mg; SOL: 20 mg per 5 mL; ELIX: 20 mg per 5 mL; INJ: various

status epilepticus

[15-20 mg/kg/dose IV x1, then 5-10 mg/kg/dose IV q15-30min prn]

Max: 1000 mg/loading dose, 40 mg/kg/total dose

seizure disorder

[neonates]

Dose: 3-5 mg/kg/day PO/IV divided qd-bid; Info: adjust dose based on tx response and serum levels; taper dose gradually to D/C

[infants]

Dose: 5-6 mg/kg/day PO/IV divided qd-bid; Info: adjust dose based on tx response and serum levels; taper dose gradually to D/C

[1-5 yo]

Dose: 6-8 mg/kg/day PO/IV divided qd-bid; Info: adjust dose based on tx response and serum levels; taper dose gradually to D/C

[6-12 yo]

Dose: 4-6 mg/kg/day PO/IV divided qd-bid; Info: adjust dose based on tx response and serum levels; taper dose gradually to D/C

[>12 yo]

Dose: 1-3 mg/kg/day PO/IV divided qd-bid; Info: adjust dose based on tx response and serum levels; taper dose gradually to D/C

neonatal opioid withdrawal syndrome, adjunct tx (off-label)

[3-4 mg/kg/day PO divided qd-bid]

Start: 16-20 mg/kg/dose PO x1; Info: refer to institutional protocol

renal dosing

[status epilepticus]

renal impairment: not defined

HD/PD: not defined

[all other indications]

CrCl <10: give usual dose q24h

HD: give usual dose q24h; may give additional pre-dialysis dose; give usual dose as supplement after dialysis if next maint. dose not due right after dialysis; PD: give usual dose q24h; consider supplement

hepatic dosing

[see below]

mild-moderate impairment: decr. usual dose, amount not defined; severe impairment: contraindicated