Home Drug Guide Meprobamate

Drug Guide

Generic Name

Meprobamate

Brand Names Miltown, Equanil, Meprospan, Neuramate, Mepriam, Tranmep, Bamate, Amosene

Classification

Therapeutic: Anxiolytic, muscle relaxant

Pharmacological: Carbamates, CNS depressants

FDA Approved Indications

Anxiety disorder (though approval has been withdrawn and use is now off-label in many regions)

Mechanism of Action

Meprobamate acts as a central nervous system depressant, binding to GABA receptors and enhancing GABA-mediated inhibitory effects, resulting in anxiolytic and muscle relaxant properties.

Dosage and Administration

Adult: Typically 400-800 mg in divided doses daily, titrated as needed; specific dosing varies based on condition and response.

Pediatric: Use is generally not recommended for children due to risk of dependence and adverse effects.

Geriatric: Lower doses are recommended due to increased sensitivity and risk of CNS depression.

Renal Impairment: Dose reduction may be necessary; monitor for toxicity.

Hepatic Impairment: Use with caution; dose adjustments may be needed.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed throughout body tissues, crosses the blood-brain barrier.

Metabolism: Metabolized in the liver, primarily via hydroxylation and conjugation.

Excretion: Excreted primarily via the kidneys as metabolites.

Half Life: Approximately 8-12 hours.

Contraindications

Hypersensitivity to carbamates or related compounds.
History of hypersensitivity reactions.

Precautions

Use with caution in patients with respiratory depression, acute intermittent porphyria, and in elderly patients due to risk of adverse CNS effects. Potential for dependence and withdrawal.

Adverse Reactions - Common

Sedation, dizziness (Common)
Gastrointestinal upset (Uncommon)

Adverse Reactions - Serious

Dependency, withdrawal symptoms upon discontinuation (Serious)
Respiratory depression (Rare)
Hepatic toxicity (Rare)

Drug-Drug Interactions

Additive CNS depression with alcohol, opioids, antihistamines.
Increased sedative effects with other CNS depressants.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of CNS depression, dependence, and withdrawal symptoms.

Diagnoses:

Risk for injury related to sedation.
Impaired skin integrity related to adverse effects.

Implementation: Administer with food to reduce gastrointestinal upset; monitor respiratory status and level of sedation.

Evaluation: Assess effectiveness in reducing anxiety and muscle tension; monitor for adverse effects and signs of dependence.

Patient/Family Teaching

Do not operate heavy machinery or drive until response is known.
Avoid alcohol and other CNS depressants.
Report signs of allergic reaction, excessive sedation, or withdrawal symptoms.

Special Considerations

Black Box Warnings:

Potential for dependence, misuse, and withdrawal reactions.

Genetic Factors: N/A

Lab Test Interference: N/A

Overdose Management

Signs/Symptoms: Extreme sedation, ataxia, hypotension, coma.

Treatment: Supportive care, Airway management, activated charcoal if within an hour of ingestion, and symptomatic treatment. Hemodialysis may be considered in severe cases.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable under recommended storage conditions.