More information about Meprobamate
Pronunciation(me proe BA mate)
U.S. Brand NamesMiltown®
Canadian Brand NamesNovo-Mepro
UseManagement of anxiety disorders
Use - DentalTreatment of muscle spasm associated with acute temporomandibular joint pain; management of dental anxiety disorders
Use - Unlabeled/InvestigationalDemonstrated value for muscle contraction, headache, premenstrual tension, external sphincter spasticity, muscle rigidity, opisthotonos-associated with tetanus
Pregnancy Risk FactorD
LactationEnters breast milk/not recommended
ContraindicationsHypersensitivity to meprobamate, related compounds (including carisoprodol), or any component of the formulation; acute intermittent porphyria; pre-existing CNS depression; narrow-angle glaucoma; severe uncontrolled pain; pregnancy
Warnings/PrecautionsPhysical and psychological dependence and abuse may occur; abrupt cessation may precipitate withdrawal. Use with caution in patients with depression or suicidal tendencies, or in patients with a history of drug abuse. May cause CNS depression, which may impair physical or mental abilities. Patients must be cautioned about performing tasks which require mental alertness (eg, operating machinery or driving). Effects with other sedative drugs or ethanol may be potentiated. Not recommended in children <6 years of age; allergic reaction may occur in patients with history of dermatological condition (usually by fourth dose). Use with caution in patients with renal or hepatic impairment, or with a history of seizures. Use caution in the elderly as it may cause confusion, cognitive impairment, or excessive sedation.
Adverse ReactionsFrequency not defined.
Cardiovascular: Syncope, peripheral edema, palpitation, tachycardia, arrhythmia
Central nervous system: Drowsiness, ataxia, dizziness, paradoxical excitement, confusion, slurred speech, headache, euphoria, chills, vertigo, paresthesia, overstimulation
Dermatologic: Rashes, purpura, dermatitis, Stevens-Johnson syndrome, petechiae, ecchymosis
Gastrointestinal: Diarrhea, vomiting, nausea
Hematologic: Leukopenia, eosinophilia, agranulocytosis, aplastic anemia
Neuromuscular & skeletal: Weakness
Ocular: Blurred vision, impairment of accommodation
Renal: Renal failure
Respiratory: Wheezing, dyspnea, bronchospasm, angioneurotic edema
Overdosage/ToxicologySymptoms of overdose include drowsiness, lethargy, ataxia, coma, hypotension, shock, and death. Treatment is supportive following attempts to enhance drug elimination.
Drug InteractionsCNS depressants: Sedative effects may be additive with other CNS depressants; monitor for increased effect; includes barbiturates, benzodiazepines, narcotic analgesics, ethanol, and other sedative agents
Ethanol: Avoid ethanol (may increase CNS depression).
Herb/Nutraceutical: Avoid valerian, St John's wort, kava kava, gotu kola (may increase CNS depression).
Mechanism of ActionAffects the thalamus and limbic system; also appears to inhibit multineuronal spinal reflexes
Onset of action: Sedation: ~1 hour
Distribution: Crosses placenta; enters breast milk
Half-life elimination: 10 hours
Excretion: Urine (8% to 20% as unchanged drug); feces (10% as metabolites)
Children 6-12 years: Anxiety: 100-200 mg 2-3 times/day
Adults: Anxiety: 400 mg 3-4 times/day, up to 2400 mg/day
Dosing interval in renal impairment:
Clcr 10-50 mL/minute: Administer every 9-12 hours
Clcr<10 mL/minute: Administer every 12-18 hours
Hemodialysis: Moderately dialyzable (20% to 50%)
Dosing adjustment in hepatic impairment: Probably necessary in patients with liver disease
Monitoring ParametersMental status
Reference RangeTherapeutic: 6-12 mcg/mL (SI: 28-55
Patient EducationTake exactly as directed; do not increase dose or frequency. Drug may cause physical and/or psychological dependence. Do not use alcohol or other prescription or OTC medications (especially pain medications, sedatives, antihistamines, or hypnotics) without consulting prescriber. Maintain adequate hydration (2-3 L/day of fluids) unless instructed to restrict fluid intake. You may experience drowsiness, lightheadedness, impaired coordination, dizziness, or blurred vision (use caution when driving or engaging in tasks requiring alertness until response to drug is known); nausea, vomiting, or dry mouth (small, frequent meals, frequent mouth care, chewing gum, or sucking lozenges may help); or diarrhea (boiled milk, yogurt, or buttermilk may help). Report persistent CNS effects, skin rash or irritation, changes in urinary pattern, wheezing or respiratory difficulty, or worsening of condition. Pregnancy/breast-feeding precautions: Do not get pregnant while taking this medication; use appropriate contraceptive measures. Breast-feeding is not recommended.
Nursing ImplicationsAssist with ambulation; monitor mental status
Additional InformationWithdrawal should be gradual over 1-2 weeks. Benzodiazepine and buspirone are better choices for treatment of anxiety disorders.
Anesthesia and Critical Care Concerns/Other ConsiderationsWithdrawal should be gradual over 1-2 weeks. Benzodiazepines and buspirone are better choices for treatment of anxiety disorders.
Dental Health: Effects on Dental TreatmentNo significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic PrecautionsNo information available to require special precautions
Dosage FormsTablet: 200 mg, 400 mg
Hassan E, "Treatment of Meprobamate Overdose With Repeated Oral Doses of Activated Charcoal,"Ann Emerg Med, 1986, 15(1):73-6.
Jacobsen D, Wiik-Larsen E, Saltvedt E, et al, "Meprobamate Kinetics During and After Terminated Hemoperfusion in Acute Intoxications,"J Toxicol Clin Toxicol, 1987, 25(4):317-31.
Volturo GA, "Meprobamate and Bezoar Formation,"Ann Emerg Med, 1987, 16(4):472-3.
International Brand NamesAndaxin® (HU); Cyrpon® (AT); Dapaz® (ES); Epikur® (AT); Equanil® (FR, ZA); Meprobamat® (DE, GB, RO); Méprobamate Richard® (FR); Meprobamat-Petrasch® (AT); Meprobamat Pliva® (HR); Mepro® (BE, IL); Meprodil® (CH); Microbamat® (AT); Miltaun® (AT); Novo-Mepro (CA); Oasil® (LU); Pertranquil® (BE, LU); Praol® (GR); Probamyl® (BE); Procalmadiol® (LU); Quaname® (LU); Quanil® (IT); Reposo-Mono® (BE); Sanobamat® (BE); Tranquilin® (LU); Visano® (DE)