Pentobarbital sodium 50 mg/mL is available in 20- and 50-mL multiple-dose vials.3654 Each mL of solution also contains propylene glycol 40% (v/v), alcohol 10%, and hydrochloric acid and/or sodium hydroxide to adjust pH in water for injection.3654
pH
The pH of pentobarbital sodium injection is adjusted to approximately 9.53654 with a range of 9 to 10.5.3866
Trade Name(s)
Nembutal
Pentobarbital sodium may be administered by deep intramuscular injection into a large muscle or by slow intravenous injection.3654 For intramuscular administration, no more than 5 mL of solution (250 mg) should be injected at any one site because of possible tissue irritation.3654 For slow intravenous injection, the rate of administration should not exceed 50 mg/min.3654
Extreme care should be taken to avoid perivascular extravasation or intra-arterial injection.3654 Extravascular injection may cause local tissue damage with subsequent necrosis.3654 Potential consequences of intra-arterial injection vary from transient pain to limb gangrene.3654 Any complaint of limb pain during pentobarbital sodium administration warrants stopping the injection.3654
Intact vials of pentobarbital sodium should be stored at controlled room temperature.3654 Excessive heat should be avoided and vials should be protected from freezing.3654
Pentobarbital sodium may raise the pH of admixtures to the alkaline range and, therefore, the drug should not be mixed with alkali-labile drugs.47 Solutions showing evidence of precipitation should not be used.3654
Syringes
Pentobarbital sodium 50 mg/mL was packaged in 1-mL glass and polypropylene syringes and 3-mL polypropylene syringes (Becton Dickinson) and stored at 25°C. No loss occurred in 31 days.2429
Pentobarbital sodium (Akorn) 50 mg/mL was packaged as 5 mL in 10-mL polypropylene syringes (Becton Dickinson) and stored at ambient room temperature protected from light.3887 The solutions remained clear and colorless with no loss of drug in 100 days.3887
Sorption
Pentobarbital sodium did not undergo sorption to a polyvinyl chloride (PVC) plastic test strip or PVC infusion solution bag.12; 770
Plasticizer Leaching
Pentobarbital sodium 2 mg/mL in dextrose 5% did not leach diethylhexyl phthalate (DEHP) plasticizer from 50-mL PVC bags in 24 hours at 24°C.1683
Filtration
Pentobarbital sodium 600 mg/L and 1.25 g/L in dextrose 5% and also sodium chloride 0.9% was filtered through a 0.45-µm filter. The delivered concentration did not decrease.754
Standardize 4 Safety
One or more standardized concentrations for this drug have been established through Standardize 4 Safety (S4S), a national patient safety initiative to reduce medication errors, especially during transitions of care. (See Standardize 4 Safety in Users Guide.) Recommendations developed to date through this initiative are available at www.ashp.org/pharmacy-practice/standardize-4-safety-initiative.
Table 1: Standardize 4 Safety Continuous IV Infusion Standard Concentrations for Pentobarbital3635
| Patient Population | Concentration Standards | Dosing Units |
|---|---|---|
| Pediatric patients (50 kg) | 8 mg/mL 50 mg/mL | mg/kg/hour |
For a list of references cited in the text of this monograph, search the monograph titled References.