methohexital (Rx)

Brand and Other Names:Brevital
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for injection: Schedule IV

  • 500mg
  • 2.5g
more...

Anesthesia

Induction: 50-120 mg (70 mg average) IV push at 10 mg ( 1 mL of 1% solution) over 5 seconds, depending on patient response

Maintenance: 20-40 mg (2-4 mL of 1% soluiton) IV push q4-7min PRN, OR 4-6 mg/min IV drip

Dosage Forms & Strengths

powder for injection: Schedule IV

  • 500mg
  • 2.5g
more...

>1 Month Old

6.6-10 mg/kg IM administered as a 5% (50 mg/mL) solution OR 

25 mg/kg PR administered as a 1% (10 mg/mL) solution

Next:

Interactions

Interaction Checker

and methohexital

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 
            Previous
            Next:

            Adverse Effects

            Frequency Not Defined

            Hiccups, coughing, muscle twitching & laryngospasm, which may impair pulmonary ventilation

            Respiratory depression, apnea, dyspnea, cardiorespiratory arrest (which may occur in association with seizures), or hypotension may occur

            Circulatory depression, peripheral vasculatory collapse, bronchospasm, postanesthetic shivering, salivation, skeletal muscle hyperactivity (twitching to convulsive-like movements), seizures, restlessness, anxiety (especially in the presence of postop pain), headache, nausea, vomiting, abd pain, & emergence delirium may also occur

            Acute allergic reactions including erythema, pruritus, urticaria, rhinitis, hypotension, dyspnea, anxiety, restlessness, abdominal pain & peripheral vascular collapse have been reported

            Thrombophlebitis, injection site pain, & injury to nerves adjacent to injection site

            Extravasation may cause local irritation manifested as pain, swelling, ulceration, & necrosis

            Previous
            Next:

            Warnings

            Black Box Warnings

            Methohexital should be used in hospital or ambulatory care settings that can provide continuous monitoring of respiratory (eg, pulse oximetry) and cardiac function

            Resuscitative drugs and age- and size-appropriate equipment for bag valve mask ventilation and intubation and personnel trained in their use and skilled in airway management should be readily available

            For deeply sedated patients, a designated individual other than the practitioner performing the procedure should be present to continuously monitor the patient

            Contraindications

            Porphyria

            Known hypersensitivity to barbiturates

            Relative: cardiovascular disease, hypotension, respiratory disease

            Cautions

            Severe anemia, extreme obesity, debilitated patients

            Renal/hepatic/endocrine/circulatory dysfunction, obstructive pulmonary dz, severe HTN, status asthmaticus

            Rapid bolus doses will increase cardiorespiratory effects including laryngospasm, apnea, hypotension, myocardial depression, cardiovascular collapse

            Mild sedation may persist 8-12 hr

            Patients should be instructed on discharge not to drive or operate heavy machinery

            General anesthetics and sedation drugs in young children and pregnant women

            • Brain development
              • Prolonged or repeated exposure may result in negative effects on fetal or young children’s brain development
              • Caution with use during surgeries or procedures in children younger than 3 yr or in pregnant women during their third trimester
              • Assess the risk:benefit ratio in these populations, especially for prolonged procedures (ie, >3 hr) or multiple procedures
            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: excreted in breast milk; use by nursing mothers should be evaluated carefully

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
            Previous
            Next:

            Pharmacology

            Mechanism of Action

            Ultra short-acting anesthetic barbiturate; no muscle relaxant activity

            Pharmacokinetics

            Half-Life: 3-6 hr

            Onset: Immediate (IV); 2-10 min (IM); 5-15 min (PR)

            Duration: 10-20 min (IV); 45 min (PR)

            Metabolism: Hepatically conjugated to inactive metabolites; slow

            Excretion: Urine; trace amounts of drug &/or metabolites also excreted in feces & sweat

            Previous
            Next:

            Administration

            IV Compatibilities

            Solution: D5/LR, D5W in NS, D5W, LR, NS

            Additive: chlorpromazine, hydralazine, kanamycin, lidocaine, mechlorethamine, methyldopate, prochlorperazine, promazine, promethazine, streptomycin

            Syringe: glycopyrrolate

            IV Administration

            Do not use diluents containing bacteriostats

            Soln should be clear or colorless or it should not be used

            Administer by injection or infusion, in concentration no higher than 1%

            Avoid intraarterial injection & extravasation

            Storage

            Store at controlled room temp

            Previous
            Next:

            Images

            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous