Barbiturates: Precautions

See a physician regularly while taking barbiturates. The physician will check to make sure the medicine is working as it should and will note unwanted side effects.

Because barbiturates work on the central nervous system, they may add to the effects of alcohol and other drugs that slow the central nervous system, such as anti-histamines, cold medicine, allergy medicine, sleep aids, medicine for seizures, tranquilizers, some pain relievers, and muscle relaxants. They may also add to the effects of anesthetics, including those used for dental procedures. The combined effects of barbiturates and alcohol or other CNS depressants (drugs that slow the central nervous system) can be very dangerous, leading to unconsciousness or even death. Anyone taking barbiturates should not drink alcohol and should check with his or her physician before taking any medicines classified as CNS depressants.

Taking an overdose of barbiturates or combining barbiturates with alcohol or other central nervous system depressants can cause unconsciousness and even death. Anyone who shows signs of an overdose or a reaction to combining barbiturates with alcohol or other drugs should get emergency medical help immediately. Signs include:

• severe drowsiness
• breathing problems
• slurred speech
• staggering
• slow heartbeat
• severe confusion
• severe weakness

Barbiturates may change the results of certain medical tests. Before having medical tests, anyone taking this medicine should alert the health care professional in charge.

People may feel drowsy, dizzy, lightheaded, or less alert when using these drugs. These effects may even occur the morning after taking a barbiturate at bedtime. Because of these possible effects, anyone who takes these drugs should not drive, use machines or do anything else that might be dangerous until they have found out how the drugs affect them.

Barbiturates may cause physical or mental dependence when taken over long periods. Anyone who shows these signs of dependence should check with his or her physician right away:

• the need to take larger and larger doses of the medicine to get the same effect
• a strong desire to keep taking the medicine
• withdrawal symptoms, such as anxiety, nausea or vomiting, convulsions, trembling, or sleep problems, when the medicine is stopped

Children may be especially sensitive to barbiturates. This may increase the chance of side effects such as unusual excitement.

Older people may also be more sensitive that others to the effects of this medicine. In older people, barbiturates may be more likely to cause confusion, depression, and unusual excitement. These effects are also more likely in people who are very ill.

People with certain medical conditions or who are taking certain other medicines can have problems if they take barbiturates. Before taking these drugs, be sure to let the physician know about any of these conditions:

ALLERGIES. Anyone who has had unusual reactions to barbiturates in the past should let his or her physician know before taking the drugs again. The physician should also be told about any allergies to foods, dyes, preservatives, or other substances.

PREGNANCY. Taking barbiturates during pregnancy increases the chance of birth defects and may cause other problems such as prolonged labor and withdrawal effects in the baby after birth. Pregnant women who must take barbiturates for serious or life-threatening conditions should thoroughly discuss with their physicians the benefits and risks of taking this medicine.

BREASTFEEDING. Barbiturates pass into breast milk and may cause problems such as drowsiness, breathing problems, or slow heartbeat in nursing babies whose mothers take the medicine. Women who are breastfeeding should check with their physicians before using barbiturates.

OTHER MEDICAL CONDITIONS. Before using barbiturates, people with any of these medical problems should make sure their physicians are aware of their conditions:

• alcohol or drug abuse
• depression
• hyperactivity (in children)
• pain
• kidney disease
• liver disease
• diabetes
• overactive thyroid
• underactive adrenal gland
• chronic lung diseases such as asthma or emphysema
• severe anemia
• porphyria

USE OF CERTAIN MEDICINES. Taking barbiturates with certain other drugs may affect the way the drugs work or may increase the chance of side effects.

— Nancy Ross-Flanigan