Methohexital

Methohexital  is a prescription medication used as an anesthesia

• Methohexital is available under the following different brand names: Brevital

Adult dosage

Powder for injection: Schedule IV

• 500mg
• 2.5g

Anesthesia

Adult dosage

• 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% solution) IV push every 4-7 mins or as needed, OR 4-6 mg/min IV drip

Pediatric dosage

• Children above 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

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of the Methohexital include:

• drowsiness,
• nausea,
• vomiting,
• stomach pain,
• chills or shivering,
• coughing,
• hiccups,
• muscle twitching, or
• mild skin rash or itching.

Serious side effects of the Methohexital include:

• severe burning or swelling at the injection site,
• seizures (convulsions),
• numbness or tingly feeling,
• a light-headed feeling,
• fast heart rate,
• weak or shallow breathing,
• confusion,
• anxiety, or
• restlessness when coming out of anesthesia.

Rare side effects of the Methohexital include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Methohexital has severe interactions with no other drugs.
• Methohexital has serious interactions with the following drugs:
  • abemaciclib
  • benzhydrocodone/acetaminophen
  • fentanyl
  • fentanyl intranasal
  • fentanyl transdermal
  • fentanyl transmucosal
  • hydrocodone
  • isocarboxazid
  • metoclopramide intranasal
  • ropeginterferon alfa 2b
  • selinexor
  • sufentanil SL
• Methohexital has moderate interactions with the following drugs:
  • abiraterone
  • amifostine
  • benazepril
  • brexanolone
  • bupivacaine implant
  • buprenorphine, long-acting injection
  • captopril
  • daridorexant
  • deutetrabenazine
  • difelikefalin
  • ganaxolone
  • lasmiditan
  • lemborexant
  • lurasidone
  • midazolam intranasal
  • remimazolam
  • stiripentol
  • suvorexant
• Methohexital has minor interactions with the following drugs:
  • probenecid
  • sulfisoxazole

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Porphyria
• Known hypersensitivity to barbiturates
• Relative: cardiovascular disease, hypotension, respiratory disease

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Methohexital?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Methohexital?”

Cautions

• Severe anemia, extreme obesity, debilitated patients
• Renal/hepatic/endocrine/circulatory dysfunction, obstructive pulmonary disease, 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 hours
• 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 yrs or in pregnant women during their third trimester
    • Administration of anesthetic and sedation drugs that block NMDA receptors and/or potentiate GABA activity increase neuronal apoptosis in the developing brain and result in long-term cognitive deficits when used for longer than 3 hours; assess the risk: benefit ratio in these populations, especially for prolonged procedures (ie, above 3 hrs) or multiple procedures

Pregnancy and Lactation

• There are no adequate and well-controlled studies in pregnant women; published studies in pregnant primates demonstrate that administration of anesthetic and sedation drugs that block NMDA receptors and/or potentiate GABA activity during the period of peak brain development increases neuronal apoptosis in the developing brain of the offspring when used for longer than 3 hours; clinical significance not clear; however, studies in juvenile animals suggest neuroapoptosis correlates with long-term cognitive deficits
• Lactation
  • Excreted in breast milk; use by nursing mothers should be evaluated carefully