b.b.s.

If you are taking this medication on a regular schedule (such as for anxiety) and miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

For sleep, take this medication by mouth, immediately before you go to bed or as directed by your doctor. Only take this medication if you have time for a full night's sleep. For anxiety, take this medication usually 3 to 4 times daily or as directed by your doctor. For use before surgery, take as directed by your doctor. Dosage is based on your medical condition and response to treatment. If you are taking the liquid form, carefully measure your dose using a medication-measuring device or spoon. Do not use a household spoon because you may not get the correct dose. If you are taking this medication for sleep, take it only when you need help falling asleep. Taking it regularly will make the drug work less well over time. Do not take more of this medication than prescribed. Doing so may increase side effects. This medication may cause withdrawal reactions, especially if it has been used regularly for a long time or in high doses. In such cases, withdrawal symptoms (such as anxiety, vivid dreams, shaking hands/fingers, twitching, trouble sleeping) may occur if you suddenly stop using this medication. Withdrawal from butabarbital can be severe and include hallucinations, seizures and (rarely) death. To prevent withdrawal reactions, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details, and report any withdrawal reactions immediately. Along with its benefits, this medication may rarely cause abnormal drug-seeking behavior (addiction). This risk may be increased if you have abused alcohol or drugs in the past. Take this medication exactly as prescribed to lessen the risk of addiction. When this medication is used for a long time for anxiety or to help you sleep, it may not work as well. Butabarbital should only be used for a short time for anxiety or sleep. Talk with your doctor if this medication stops working well. Tell your doctor if your condition persists or worsens (such as continued anxiety or difficulty falling asleep) after 7 to 10 days.

The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring. To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval. Some products that may interact with this drug include: darunavir, felbamate, lopinavir, MAO inhibitors (furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine). Other medications can affect the removal of butabarbital from your body, which may affect how butabarbital works. Examples include disulfiram, phenytoin, valproic acid, St. John's wort, among others. This medication can speed up the removal of other medications from your body, which may affect how they work. Examples of affected drugs include cyclosporine, doxycycline, estrogens, griseofulvin, metronidazole, ranolazine, "blood thinners" such as warfarin, corticosteroids such as prednisone, calcium channel blockers such as felodipine/nimodipine, among others. This medication may decrease the effectiveness of hormonal birth control products (such as pills, patch, ring). This effect can result in pregnancy. Ask your doctor or pharmacist for details. Discuss whether you should use additional reliable birth control methods while using any of these drugs. The risk of serious side effects (such as slow/shallow breathing, severe drowsiness/dizziness) may be increased if this medication is taken with other products that may also affect breathing or cause drowsiness. Therefore, tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, antihistamines (such as cetirizine, diphenhydramine), tricyclic antidepressants (such as amitriptyline), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine). Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely. This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Do not share this medication with others. It is against the law. Keep all medical appointments so that your doctor can monitor your progress or check for side effects. For long-term use, laboratory and/or medical tests (such as blood counts, liver/kidney tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe tiredness/dizziness, inability to wake up, very slow breathing rate.

Before taking butabarbital, tell your doctor or pharmacist if you are allergic to it; or to other barbiturates (such as phenobarbital); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: certain hormone problems (adrenal disease such as Addison's disease), liver problems, kidney problems, lung disease (such as sleep apnea, chronic obstructive pulmonary disease-COPD), mental/mood disorders (such as depression, thoughts of suicide), history of alcohol/substance abuse, personal/family history of a certain blood disorder (porphyria). This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages. The liquid form of this product may contain alcohol. Caution is advised if you have diabetes, alcohol dependence, liver disease, or any other condition that requires you to limit/avoid alcohol in your diet. Ask your doctor or pharmacist about using this product safely. Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Older adults may be more sensitive to the effects of this drug, especially drowsiness and dizziness. However, this drug can often cause excitement or confusion instead of drowsiness in older adults. This medication is not recommended for use during pregnancy. It may harm an unborn baby. Consult your doctor for more details. Since birth control pills may not be effective if taken with this medication (see also Drug Interactions section), discuss reliable forms of birth control with your doctor. If you become pregnant while taking this medication, notify your doctor immediately. This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Store at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Unwanted sleepiness, trouble waking up, dizziness, excitation, headache, tiredness, loss of appetite, nausea, or vomiting may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor immediately if any of these unlikely but serious side effects occur: mental/mood changes (such as agitation, confusion, depression, hallucinations, thoughts of suicide, nightmares), slurred speech, staggering walk/clumsiness, double vision, memory problems. Rarely, after taking this drug, people have gotten out of bed and driven vehicles while not fully awake ("sleep-driving"). People have also sleepwalked, or have prepared/eaten food, made phone calls, or had sex while not fully awake. Often these people do not remember these events. If you discover that you have done any of these things, tell your doctor immediately. Drinking alcohol, taking other medications that cause drowsiness, or taking higher doses of butabarbital may increase your risk for this effect. Do not drink alcohol while using this medication. Tell your doctor immediately if any of these rare but very serious side effects occur: slow/shallow breathing, fainting, slow heartbeat. A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.