SECOBARBITAL

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Created Jan 2021

SECOBARBITAL

  • [SECONAL]
  • [TUINAL]
  • [QUINALBARBITONE]

DEA CODE 2315: Schedule 2

Secobarbital

Secobarbital (Seconal)

Seconal is a type of barbiturate drug that acts as a brain and central nervous system depressant. Also known by the generic name secobarbital, this type of medication is typically used to sedate patients before surgery or to treat insomnia. It relaxes your muscles and entire body by interacting with neurotransmitters in the brain, which results in a slowing down of brain function. This can reduce pain and result in significant drowsiness or even a blackout. Due to the powerful side effects of Seconal, you should only take this medication as prescribed by a doctor.

Seconal is a central nervous system depressant that causes significant drowsiness when it is ingested. Secobarbital is typically prescribed to patients who need to be sedated prior to surgery, and it can also be used as short-term treatment for some cases of insomnia. Because of its direct effects to the central nervous system, this medication should only be taken right before you intend to go to bed or immediately before you enter surgery. Secobarbital is a strong sedative drug, which makes it extremely dangerous when it is not taken at the correct dosage. It is intended to be used only for a short period of time.

Treatment for Insomnia:
Between family lives, careers, educational pursuits, and social obligations, many Americans live busy, harried lives. Sometimes this nonstop lifestyle is so stressful and demanding that our sleep suffers. Nearly three out of ten Americans have experienced insomnia on a short-term basis, while one in ten encounters it on a regular basis.

For this reason, an increasing number of Americans are turning to prescription sleep aids to address this condition. While Seconal isn't the most popular sleep aid by any means, a significant number of people still rely on it for treating short-term insomnia, and another number chooses to abuse it.

As a barbiturate, secobarbital has sedative-hypnotic qualities. In addition to its use as a treatment for insomnia, it's also used to reduce anxiety prior to surgery. When implemented as a short-term treatment for insomnia, Seconal is taken just prior to bed, or if you find you're having trouble falling asleep. Due to their overdose potential, barbiturates today are used on a more limited basis for insomnia, according to the National Institute on Drug Abuse. Seconal is delivered in an orange capsule. For average adults, the dosage is 100 mg, to be taken orally.

Secobarbital sodium, a barbiturate, is FDA approved for the treatment of insomnia and for pre-anesthetic use. This drug binds at a distinct site associated with a Cl-ionopore at the GABAA receptor, increasing the duration of time for which the Cl-ionopore is open. The post-synaptic inhibitory effect of GABA in the thalamus is, therefore, prolonged. Adverse reactions are drowsiness, lethargy, hangover, paradoxical excitement in elderly patients, somnolence. Rifampin may decrease secobarbital levels by increasing metabolism.

How should it be used?
Secobarbital comes as a capsule to take by mouth.

  • When secobarbital is used to treat insomnia, it is usually taken at bedtime as needed for sleep.
    • Your sleep problems should improve within 7 to 10 days after you start taking secobarbital. Call your doctor if your sleep problems do not improve during this time, if they get worse at any time during your treatment, or if you notice any changes in your thoughts or behavior.
  • When secobarbital is used to relieve anxiety before surgery, it is usually taken 1 to 2 hours before surgery.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take secobarbital exactly as directed.

Secobarbital should normally be taken for short periods of time. If you take secobarbital for 2 weeks or longer, secobarbital may not help you sleep as well as it did when you first began to take the medication. If you take secobarbital for a long time, you may also develop dependence ('addiction,' a need to continue taking the medication) on secobarbital. Talk to your doctor about the risks of taking secobarbital for 2 weeks or longer. Do not take a larger dose of secobarbital, take it more often, or take it for a longer time than prescribed by your doctor.

Do not stop taking secobarbital without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking secobarbital, you may develop anxiety, muscle twitching, uncontrollable shaking of your hands or fingers, weakness, dizziness, changes in vision, nausea, vomiting, or difficulty falling asleep or staying asleep, or you may experience more severe withdrawal symptoms such as seizures or extreme confusion.

Seconal Sodium (secobarbital sodium capsules)
Side Effects:
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
RxList
Some people using this medicine have engaged in activity such as driving, eating, walking, making phone calls, or having sex and later having no memory of the activity. If this happens to you, stop taking secobarbital and talk with your doctor about another treatment for your sleep disorder.
Stop using secobarbital and call your doctor at once if you have:
  • unusual thoughts or behavior
  • new or worsening depression
  • confusion, hallucinations
  • anxiety, agitation
  • thoughts of suicide or hurting yourself
The sedative effects of secobarbital may be stronger in older adults.
Common side effects may include:
  • drowsiness, feeling tired
  • "hangover" effect (drowsiness the day after a dose)
  • headache, dizziness
  • memory problems
  • dry mouth
  • upset stomach
  • feeling restless or excited (especially in children)
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Seconal Sodium (secobarbital sodium)
Maximum Dosage:
Prescribers Digital Reference
Adults:300 mg/day PO.
Geriatric:300 mg/day PO.
Adolescents:6 mg/kg/day PO (Max: 100 mg).
Children:6 mg/kg/day PO (Max: 100 mg).
Infants:Safety and efficacy have not been established.
Neonates:Safety and efficacy have not been established.

Prescribed for:
  • Additional local anesthesia
  • Additional agent to induce general anesthesia

Used for:
This medication is used to calm you just before surgery. Secobarbital belongs to a class of drugs known as barbiturate hypnotics. It works by affecting certain parts of the brain to calm you.

Older adults should discuss the risks and benefits of this medication with their doctor or pharmacist, as well as other effective and possibly safer treatments.

Before using:
Tell your doctor or pharmacist your medical history, especially of:

  • certain hormone problems (adrenal disease such as Addison's disease)
  • Liver problems
  • kidney problems
  • lung disease (such as sleep apnea
  • chronic obstructive pulmonary disease-COPD)
  • mental/mood disorders (such as depression, thoughts of suicide)
  • personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol)
  • personal/family history of a certain blood disorder (porphyria)

Precautions:

  • This drug may make you dizzy or drowsy.
  • Alcohol or marijuana (cannabis) can make you more dizzy or drowsy.
  • Do not drive, use machinery, or do anything that needs alertness until you can do it safely.
  • Avoid alcoholic beverages.
  • Talk to your doctor if you are using marijuana (cannabis).
Older adults may be more sensitive to the effects of this drug, especially drowsiness and dizziness.

This drug can often cause excitement or confusion instead of drowsiness in older adults.

Drowsiness, dizziness, and confusion can increase the risk of falling.

Pharmacology:

Mechanism of Action:
Depress reticular activating system & cerebellar function

Pharmacokinetics:

  • Half-life elimination: 28 hr
  • Duration: 3-4 hr
  • Vd: 1.5 L/kg
  • Onset: 15-30 min (hypnosis)
  • Excretion: Urine
  • Protein Bound: 45-60%
  • Metabolism: hepatic microsomal enzymes, glucuronidation
  • Excretion: mostly urine as metabolites (<5% unchanged)
  • Enzymes induced: Primarily CYP2C9/10; CYP2C8, CYP2C9

Secobarbital
Duration:

A Barbiturate derivative that possesses all the classic effects of todays Benzodiazepines, and the old Barbiturates. It's used in the treatment of Epilepsy, short term treatment for insomnia, and a preoperative medication for anaesthesia and anxiolysis for short surgical/diagnostic/therapeutic procedures.

RouteOnsetDurationAfter Effects
Tripsit Factsheets
All ROAs:15-30 minutes6-10 hours1-24 hours
Secobarbital Duration
Avoid:
All other CNS depressants.

Important Information:

You should not use secobarbital if you have severe liver disease, severe breathing problems, or porphyria.

Some people using secobarbital have engaged in activity such as driving, eating, walking, making phone calls, or having sex and later having no memory of the activity.

Do not take secobarbital if you have consumed alcohol during the day or just before bed.

Avoid taking cold or allergy medicine that contains an antihistamine. Secobarbital may impair your thinking or reactions. You may still feel sleepy the morning after taking secobarbital. Wait until you are fully awake before you drive, operate machinery, or do anything that requires you to be awake and alert.

Interactions:

Drug Interactions (550) Alcohol/Food Interactions (2) Disease Interactions (13)


What other drugs will affect Secobarbital?
Taking secobarbital with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures. Other drugs may interact with secobarbital, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

A total of 550 drugs are known to interact with Secobarbital.

  • 31 major drug interactions
  • 498 moderate drug interactions
  • 21 minor drug interactions

Therapeutic Uses:

  • Hypnotic, for the short-term treatment of insomnia, since it appears to lose its effectiveness for sleep induction and sleep maintenance after 2 weeks.
  • The hypnotic effectiveness of this barbiturate is comparable to pentobarbital sodium; secobarbital is not an antianxiety agent
  • It is usually given orally
  • Parenteral routes should be used to induce sleep only when oral admin is impossible or impractical
  • Used more frequently for hypnosis than for sedation but may lose its effectiveness by 2nd wk of continual admin.
  • The failure of insomnia to remit after 7 to 10 days of treatment may indicate the presence of a primary psychiatric and/or medical illness that should be evaluated

Complex behaviors such as "sleep-driving" (ie, driving while not fully awake after ingestion of a sedative-hypnotic, with amnesia for the event) have been reported. These events can occur in sedative-hypnotic-naive as well as in sedative-hypnotic-experienced persons. ... Other complex behaviors (eg, preparing and eating food, making phone calls, or having sex) have been reported in patients who are not fully awake after taking a sedative-hypnotic. As with sleep-driving, patients usually do not remember these events.

What is the most important information I should know about Secobarbital (Seconal Sodium)?
You should not use secobarbital if you are allergic to it, or if you have:
  • Severe liver disease
  • Severe breathing problems
  • Porphyria

To make sure secobarbital is safe for you, tell your doctor if you have:

  • Asthma, chronic obstructive pulmonary disorder (COPD), or other breathing disorder
  • Liver disease
  • Kidney disease
  • A history of depression, mental illness, or suicidal thoughts
  • A history of drug or alcohol addiction
  • If you also use a narcotic (opioid) medication

If you use secobarbital while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.

Secobarbital can make birth control pills less effective. Ask your doctor about using a non-hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy.

Secobarbital can pass into breast milk and may cause side effects in the nursing baby. Tell your doctor if you are breast-feeding.

Do not give this medicine to a child without medical advice.

Breastfeeding:

Summary of Use During Lactation:

Because there is little published experience with secobarbital during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.

Effects on Lactation and Breastmilk:
Secobarbital 200 mg given intravenously during labor 10 minutes to 3 hours before delivery for obstetric sedation reduced the sucking behavior of the newborn infants. The number of sucks, sucking pressure and total consumption of artificial feeding from the testing device were reduced Secobarbital 200 mg given intravenously during labor 10 minutes to 3 hours before delivery for obstetric sedation reduced the sucking behavior of the newborn infants. The number of sucks, sucking pressure and total consumption of artificial feeding from the testing device were reduced substantially.

Alternate Drugs to Consider:

  • Secobarbital, also known as seconal or quinalbarbitone, belongs to the class of organic compounds known as barbituric acid derivatives.
  • Used for the short-term treatment of intractable insomnia for patients habituated to barbiturates
  • A very weakly acidic compound (based on its pKa)
  • A potentially toxic compound
  • Only found in individuals that have used or taken this drug

Symptoms of an overdose typically include sluggishness, incoordination, difficulty in thinking, slowness of speech, faulty judgment, drowsiness or coma, shallow breathing, staggering, and in severe cases coma and death.

Pharmacokinetics:

  • Absorption:
    90% is absorbed rapidly. Levels of 1 to 5 mcg/ml are needed to produce sedation; 5 to 15 mcg/ml are needed for hypnosis.
  • Distribution:
    Distributed rapidly throughout body tissues and fluids; about 30% to 45% is protein-bound
  • Metabolism:
    Oxidized in the liver to inactive metabolites. Duration of action is 3 to 4 hours.
  • Excretion:
    About 95% of a dose is eliminated as glucuronide conjugates and other metabolites in urine. Drug has an elimination half-life of about 30 hours.
Overdose and Treatment:
Signs and symptoms of overdose include unsteady gait, slurred speech, sustained nystagmus, somnolence, confusion, respiratory depression, pulmonary edema, areflexia, and coma. Typical shock syndrome with tachycardia and hypotension, jaundice, hypothermia followed by fever, and oliguria may occur.

Maintain and support ventilation and pulmonary function as needed; support cardiac function and circulation with vasopressors and I.V. fluids as needed. If patient is conscious and gag reflex is intact, induce emesis (if ingestion was recent) by administering ipecac syrup. If emesis is contraindicated, perform gastric lavage while a cuffed endotracheal tube is in place to prevent aspiration. Follow with administration of activated charcoal or sodium chloride cathartic. Measure intake and output, vital signs, and laboratory parameters; maintain body temperature. Roll patient from side to side every 30 minutes to avoid pulmonary congestion. Alkalinization of urine may help remove drug from the body; hemodialysis may be useful in severe overdose.

Secobarbital Overdose Outlook (Prognosis):
How well the person does depends on the severity of the overdose and how quickly treatment is received. With proper treatment, people can recover in 1 to 5 days. If there has been prolonged coma and shock (damage to multiple internal organs), a more serious outcome is possible.

If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Assisted Suicide Drug:

Quickness of secobarbital reduces dying period:
Only a tiny percentage of Canadians who've received medical assistance to end their lives has chosen to self-administer a lethal drug cocktail. But that could change now that secobarbital - the drug most commonly used for assisted suicide in other countries - is available in Canada. Secobarbital is considered the best way for suffering individuals who want to control the manner of their death as much as possible, including administering the medication themselves. "It's kind of the barbiturate of choice because (its) quicker onset and duration is such that the dying period is reduced," said Dr. Stefanie Green, president and co-founder of the Canadian Association of MAID Assessors and Providers. "Much of the other recipes cause an extended dying period to happen, which is not always successful."

2017 Summary of Drugs Used for Doctor-Prescribed Suicide:
According to Oregon's February 2017 official report, deaths occurring during the first 19 years under that state's "Death with Dignity Act" took place after patients took the following drugs:

2017 Drugs Used:
Secobarbital (Seconal)59.3%
Pentobarbital (Nembutal)34.3%
Other6.5%

Secobarbital (Seconal) and Pentobarbital (Nembutal) are barbiturates (sedatives). In recent years, Pentobarbital has become unavailable due to protests about its use in capital punishment. Therefore, Seconal has become the most widely use drug to cause death.

The usual therapeutic dosage for Seconal is:

  • 100 mg. to treat insomnia
  • 200-300 mg. for preoperative sedation
The usual doctor-prescribed suicide dosage for Seconal is:
  • 9000 mg. in capsule form
The capsules are opened and contents mixed with a sweet substance to mask the taste.

Drugs-Forum 2005: Oral use - Seconals? (Secobarbital)

  • Seconol is a fast acting barbituate. Phenobarbital is a slow acting barbituate. Pentobarbital and thiopental are ultra fast acting barbituates and are used as anesthetics. Seconol is recreational because it kicks in fast, has a euphoric peak and a relatively short duration. Phenobarbital takes hours to kick in, has no peak and takes forever to wear off. Great anti-seizure drug, though.

    Seconols were sometimes called reds. They are fantastic but unavailable anywhere anymore. The problem with barbituates is that they are deadly when overdosed and this can be done easily once a solid habit is established, which is also easy if supplies are available. Combined with alcohol they can depress respiration at lower doses. Withdrawals are physical and potentially deadly, and consist of a combination of deleium tremens and GHB withdrawal. In some places at some time in the past, they were cheap as dirt and readily available. Benzos replaced barbituates in medicine as sedative/hypnotics since it is much harder to die from a benzo overdose (less respiratory depression). They are not quite as lethal when combined with alcohol though it is still a dangerous combination. They are a controlled substance almost everywhere.

SWGDRUG Secobarbital Monograph

CaymanChem PDF Secobarbital

Fagron PDF Secobarbital

Two Related Substances:

Found no specific information about either - Both are DEA schedule 3 and both have same DEA Number (2316):


SECOBARBITAL AND NONCONTROLLED ACTIVE INGREDIENT

2316: SECOBARBITAL AND NONCONTROLLED ACTIVE INGREDIENT: Schedule 3


SECOBARBITAL SUPPOSITORY DOSAGE FORM

2316: SECOBARBITAL SUPPOSITORY DOSAGE FORM: Schedule 3

Tuinal:

Tuinal was the brand name of a discontinued combination drug composed of two barbiturate salts (secobarbital sodium and amobarbital sodium) in equal proportions. The combination of a short-acting barbiturate, Secobarbital, with an intermediate-acting barbiturate, Amobarbital, aimed to put users to sleep quickly, and to keep them asleep through the night.

  • Tuinal was introduced as a sedative-hypnotic (sleeping pill) medication in the late 1940s by Eli Lilly.
  • It was produced in brightly colored half-reddish orange and half-turquoise blue gelatin capsule form (bullet-shaped Pulvules) for oral administration.
  • Individual capsules contained 50 mg, 100 mg, or 200 mg of barbiturate salts.
  • Eli Lilly has discontinued the manufacture of Tuinal in the United States due to the diminishing use of barbiturates (replaced by the benzodiazepine family of drugs) in outpatient treatment, and its widespread abuse.
  • Tuinal saw widespread abuse as a recreational drug from the 1960s through the 1980s.

The pill was known colloquially under the street names tuies, tumies, double trouble, blue tips, F-66's (which were the markings on Lilly's capsule), Christmas trees, rainbows, beans, nawls, and jeebs

Secobarbital is the most frequently used drug in physician-assisted suicide within the United States.

  • A short-acting barbiturate derivative drug
  • For the treatment of insomnia
  • Patented in 1934 in the United States.
  • It possesses anaesthetic, anticonvulsant, anxiolytic, sedative, and hypnotic properties
  • Valeant is the sole marketer of Seconal in the United States.
  • Currently there are no companies that manufacture the drug generically in the United States.
  • Secobarbital was widely abused for recreational purposes in the 1960s, 1970s, and 1980s, and accidental overdose was associated with the drug.
  • Known on the street as "red devils" or "reds"
  • Seconal came in a bright orange/red bullet shaped capsule known as a Pulvule.
  • Prescription use of secobarbital decreased beginning in the early 1980s by which time benzodiazepines had become increasingly common.

Secobarbital is considered to be an obsolete sedative-hypnotic (sleeping pill), and as a result, it has largely been replaced by the benzodiazepine family.

  
How to Take Secobarbital and Dose of Secobarbital - Secobarbital(Seconal) generic is a barbiturate, prescribed for insomnia (difficulty falling asleep or staying asleep). It is also used to relieve anxiety before surgery. It works by slowing ...
Friday May 24, 2019 - medindia.net

John Carney: Massachusetts must pass death with dignity legislation - On Jan. 23, 76-year-old Ellen Gilland fatally shot her terminally ill husband while he lay in his hospital bed in Daytona Beach, Florida as part of a murder-suicide pact. Mrs. Gilland was arrested and ...
Monday February 06, 2023 - gazettenet.com

Selected Immunosuppressants/Strong CYP3A4 Inducers Interactions - Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment. Serious. These medicines may interact and cause very harmful effects.
Thursday January 11, 2018 - webmd.com

  
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