Barbiturates

CNS depressants; refer to WARNINGS section for detailed guidance.

CNS-depressant action of clonazepam may be potentiated by barbiturates, increasing risk of sedation and respiratory depression.

Clonidine may potentiate CNS-depressive effects. Avoid concomitant use.

Actions of benzodiazepines may be potentiated by barbiturates.

Cyclobenzaprine may enhance the effects of barbiturates and other CNS depressants.

Diazepam injection has produced hypotension or muscular weakness when used with barbiturates. May potentiate diazepam action.

Barbiturate administration causes folate deficiency through increased loss or metabolic interference.

CYP3A4 inducers that decrease ivabradine plasma concentrations; avoid concomitant use.

Increase metabolism of contraceptive steroids, reducing contraceptive effectiveness and potentially resulting in unintended pregnancy or unscheduled bleeding.

Produces increased CNS-depressant effects including respiratory depression and sedation.

May reduce contraceptive effectiveness and result in unintended pregnancy or breakthrough bleeding by increasing metabolism of contraceptive steroids.

May decrease contraceptive effectiveness and increase breakthrough bleeding through CYP3A4 induction.

May decrease plasma concentrations of COCs and potentially diminish effectiveness or increase breakthrough bleeding.

CYP 3A4 inducers enhance metabolism of prednisolone, requiring increased dosage of corticosteroid.

Promethazine increases sedative action; dose of barbiturates should be reduced by at least one-half.

Promethazine may increase, prolong, or intensify sedative action. Dose should be reduced by at least one-half when given concomitantly.

May increase anesthetic/sedative effects and cardiorespiratory depression; can result in pronounced decreases in blood pressure and cardiac output.

In combination with opioids, may reduce induction dose requirements and increase anesthetic/sedative effects with pronounced decreases in blood pressure and cardiac output.

Produces additive CNS-depressant effects when co-administered with temazepam.

Hepatic enzyme inducers that increase corticosteroid clearance, reducing their effect.

Strong CYP3A4 inducer expected to cause loss of ubrogepant efficacy. Concomitant use should be avoided.

Induce hepatic microsomal enzymes, increasing potential for acetaminophen hepatotoxicity.

Potentiation of orthostatic hypotension may occur when given concurrently with hydrochlorothiazide.

Amoxapine may enhance the effects of barbiturates and other CNS depressants.

Possibility of additive or potentiating effect with CNS depressants.

Atropine may potentiate the effect of barbiturates. Barbiturates should be used cautiously in treating convulsions from atropine exposure.

Atropine may potentiate the effect of barbiturates. Barbiturates should be used cautiously in treating convulsions from atropine exposure.

Hepatic enzyme induction may enhance corticosteroid metabolism, requiring increased corticosteroid dosage.

Possibility of additive or potentiating CNS depressant effect with brimonidine.

CNS depressant with potential for additive or potentiating effect when used with brimonidine tartrate ophthalmic solution.

CNS depressant with possibility of additive or potentiating effect on central nervous system depression.

CNS depressant; may result in additive or potentiating effect with brimonidine on the central nervous system.

Potential additive or potentiating effect with CNS depressants. Specific interaction studies not conducted.

Potentiation of orthostatic hypotension may occur with hydrochlorothiazide component.

Barbiturates may result in additive or potentiating CNS depressant effects with YUVEZZI.

Potentiation of orthostatic hypotension may occur when barbiturates are given concurrently with chlorothiazide.

Potentiation of orthostatic hypotension may occur when barbiturates are given concurrently with chlorothiazide sodium.

Additive CNS depression may occur when antihistamines are administered concomitantly with barbiturates.

Barbiturates decrease plasma levels of clomipramine.

Barbiturates may decrease plasma levels of clomipramine; dosage adjustment may be needed.

Clonidine may potentiate the CNS-depressive effects of barbiturates.

Clonidine may potentiate CNS-depressive effects of barbiturates.

Cyclobenzaprine may enhance the effects of barbiturates and CNS depression.

Cyclobenzaprine may enhance the effects of barbiturates.

Barbiturates induce CYP3A4 enzyme activity, enhancing corticosteroid metabolism and requiring dose increases.

Similar association with reduced efficacy and breakthrough bleeding suggested, though less marked than with rifampin.

CYP 3A4 inducers may enhance metabolism of dexamethasone, requiring dosage increase.

Barbiturates induce CYP 3A4 enzyme activity, enhancing dexamethasone metabolism and requiring dosage increase.

Barbiturates induce CYP 3A4 and enhance dexamethasone metabolism, requiring dosage increase.

MOTOFEN may potentiate the action of barbiturates; patient should be closely monitored.

May potentiate CNS depressant effects of diphenoxylate hydrochloride and atropine sulfate. Monitor for CNS adverse reactions.

Barbiturates shorten the half-life of doxycycline, thereby lowering doxycycline concentration in the body.

Barbiturates decrease the half-life of doxycycline.

Additive or potentiating CNS depressant effects; droperidol dose should be reduced when used concomitantly.

May decrease systemic concentrations of hormonal contraceptives and diminish effectiveness or increase breakthrough bleeding.

Induce CYP3A4 enzyme, may decrease effectiveness of COCs or increase breakthrough bleeding.

May decrease the effectiveness of hormonal contraceptives or increase breakthrough bleeding through CYP3A4 enzyme induction.

Enzyme inducers that may decrease effectiveness of COCs or increase breakthrough bleeding. Use back-up contraception.

Potent CYP3A inducers expected to decrease estazolam concentrations; also produce CNS depression that may potentiate benzodiazepine action.

CYP3A4 enzyme inducer that may decrease the effectiveness of the contraceptive or increase breakthrough bleeding.

Similar association with reduced efficacy, though less marked than rifampin.

May decrease plasma concentrations of etonogestrel and diminish contraceptive effectiveness or increase breakthrough bleeding.

CYP3A4 enzyme inducer that may decrease plasma concentrations of etonogestrel and ethinyl estradiol, potentially diminishing contraceptive effectiveness or increasing breakthrough bleeding.

Induce CYP3A4, may decrease plasma concentrations of CHCs and potentially diminish effectiveness or increase breakthrough bleeding.

Increased metabolic clearance of fludrocortisone acetate due to hepatic enzyme induction. May require increased steroid dosage.

May reduce glucose-lowering effect of glimepiride, leading to worsening glycemic control.

Barbiturates usually depress griseofulvin activity by decreasing plasma levels, requiring dosage adjustment of griseofulvin.

Potentiation of orthostatic hypotension may occur.

Barbiturates induce hepatic enzyme activity, enhancing corticosteroid metabolism and may require dosage increase.

Barbiturates induce cytochrome P450 3A4 enzyme activity, enhancing corticosteroid metabolism and requiring increased corticosteroid dosage.

Hepatic enzyme inducers that decrease imipramine plasma concentration. Dose adjustment of imipramine may be necessary.

Hepatic enzyme inducers that decrease imipramine plasma concentrations. Dosage adjustment of imipramine may be necessary.

Potentiation of orthostatic hypotension may occur.

Hepatic enzyme inducers may increase corticosteroid metabolism and reduce efficacy.

Barbiturates induce CYP3A4 and may decrease plasma concentrations of COCs, potentially diminishing contraceptive effectiveness or increasing breakthrough bleeding.

Barbiturates induce CYP3A4 enzymes, potentially decreasing contraceptive effectiveness and increasing breakthrough bleeding.

Lofexidine may potentiate CNS depressant effects of barbiturates.

Lofexidine may potentiate CNS depressant effects of barbiturates.

Additive CNS depressant effects when used with magnesium; dosage should be adjusted with caution.

Additive CNS depressant effects may occur; dosage adjustment needed when used concomitantly with magnesium sulfate.

Hepatic enzyme inducers may increase corticosteroid clearance.

May decrease effectiveness of medroxyprogesterone acetate through enzyme induction. Counsel use of back-up or alternative contraception.

Hepatic enzyme inducers may enhance metabolism of corticosteroids, requiring dosage increase of the corticosteroid.

Barbiturates induce cytochrome P450 3A4 and may enhance corticosteroid metabolism, requiring dosage increase.

Barbiturates induce CYP3A4 enzyme activity, enhancing corticosteroid metabolism and may require dosage increase.

Hepatic enzyme inducers that enhance corticosteroid metabolism and may require increased corticosteroid dosage.

Hypotensive effects may be potentiated by volume contraction associated with metolazone therapy.

Additive drowsiness and CNS depression reported with concurrent use. Caution advised.

Enzyme inducers that may decrease plasma concentrations of CHCs and potentially diminish effectiveness or increase breakthrough bleeding.

CYP3A4 inducer that may decrease the effectiveness of COCs or increase breakthrough bleeding.

Enzyme inducers that may decrease plasma concentrations of norethindrone and ethinyl estradiol, potentially diminishing contraceptive effectiveness or increasing breakthrough bleeding.

May decrease plasma concentrations and efficacy of contraceptive; may increase breakthrough bleeding.

CNS depressants that may increase CNS depression when used with FYCOMPA. Patients should limit activity until experienced with concomitant use.

Concomitant use may potentiate CNS depression including dizziness and cognitive adverse reactions.

Concomitant use with CNS depressants may potentiate CNS depression such as dizziness or cognitive adverse reactions.

CYP 3A4 enzyme inducers enhance metabolism of corticosteroids, requiring increased prednisone dosage.

Promethazine may increase, prolong, or intensify sedative action; dose of barbiturates should be reduced by at least one-half.

Protriptyline may enhance the effects of barbiturates.

CYP3A4 and CYP2C8 inducers. Repaglinide dose increase and increased glucose monitoring may be required during concomitant use.

Metabolic enzyme inducers that may decrease systemic concentrations of estrogen and/or progestin, potentially diminishing contraceptive effectiveness.

Administration should be adjusted with caution in patients receiving magnesium-containing solutions due to additive central depressive effect.

Renal clearance of acidic drugs like barbiturates may be increased due to alkalinizing action of lactate.

Potentiation of orthostatic hypotension may occur.

Potentiation of orthostatic hypotension may occur.

Trazodone may enhance effects of barbiturates and other CNS depressants.

CYP 3A4 inducers enhance metabolism of corticosteroids and may require dosage increase.

Additive effects with trihexyphenidyl; abuse potential exists with concurrent use.

CYP3A4 inducers decrease plasma concentrations of ulipristal acetate and may decrease its effectiveness as emergency contraception.

Sevoflurane administration is compatible with barbiturates and other commonly used intravenous anesthetics.