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Drugs & Medications

Phenobarbital/Ergotamine/Bell

Uses

This medication is used to relieve symptoms related to nervousness and tension. This includes unpleasant menopausal signs (such as hot flashes or flushes, sweats, restlessness, trouble sleeping), heart/blood vessel disorders (such as fast/pounding heartbeat), stomach/intestinal disorders (such as spasms), and throbbing headaches that occur often. Ergotamine and belladonna work by blocking certain chemicals (e.g., acetylcholine) in the nervous system to help relieve these symptoms. Phenobarbital helps to calm and relax the body.

How to use Phenobarbital/Ergotamine/Bell

Take this medication by mouth with or without food, usually twice daily (once in the morning and once in the evening) or as directed by your doctor.

Dosage is based on your medical condition and response to therapy.

This medication should be taken only as needed. It is not meant for long-term daily use. The maximum dose is 16 tablets in any 7-day period.

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 nausea/vomiting, mental/mood changes, muscle twitching, seizures) may occur if you suddenly stop using this medication. 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.

Rarely, abnormal drug-seeking behavior (addiction) is possible with this medication. Do not increase your dose, take it more frequently, or use it for a longer time than prescribed. Properly stop the medication when so directed.

When used for an extended period, this medication may not work as well and may require different dosing. Talk with your doctor if this medication stops working well.

Inform your doctor if your condition persists or worsens.

Side Effects

Dizziness, drowsiness, blurred vision, dry mouth, constipation, nausea/vomiting, and decreased sweating may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.

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: slow/fast/irregular heartbeat, signs of infection (e.g., fever, persistent sore throat), easy bruising/bleeding, difficulty urinating, mental/mood changes, tingling/pain/coldness in the fingers/toes, whitish fingers/toes/nails, loss of feeling in the fingers/toes, bluish hands/feet, muscle pain/weakness, severe stomach/abdominal pain, lower back pain, eye pain/redness.

Seek immediate medical attention if any of these rare but very serious side effects occur: chest pain, vision changes, confusion, slurred speech.

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: 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.

Precautions

Before taking this medication, tell your doctor or pharmacist if you are allergic to phenobarbital, ergotamine, or belladonna; or to other ergot alkaloids (e.g., dihydroergotamine); or to other barbiturates (e.g., pentobarbital); or to other belladonna alkaloids (e.g., atropine); or to primidone; 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.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: blood circulation disease (e.g., peripheral vascular disease such as arteriosclerosis, thrombophlebitis, Raynaud's disease), uncontrolled high blood pressure, nutrient deficiency (malnutrition), heart/blood vessel disease (e.g., coronary artery disease, stroke, recent heart attack), liver disease, kidney disease, severe infection, severe itching, severe breathing problems, a certain eye disease (glaucoma), a certain enzyme disorder (porphyria).

Before using this medication, tell your doctor or pharmacist your medical history, especially of: smoking/tobacco use, diabetes, high blood pressure (controlled), trouble urinating, lung disease (e.g., asthma), drug/alcohol abuse, mental/mood disorders (e.g., depression, history of suicide attempt), uncontrolled pain, myasthenia gravis, stomach/esophagus problems (e.g., ulcers, GERD), seizures, bowel disease/infection (e.g., paralytic ileus), overactive thyroid (hyperthyroidism).

This drug may make you dizzy or drowsy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Avoid alcoholic beverages.

This medication can decrease sweating. To prevent heatstroke, avoid becoming overheated in hot weather, in saunas, and during exercise/other strenuous activities.

Using tobacco/nicotine products while using this medication can increase the risk of serious side effects such as heart problems (including chest pain, fast/slow/irregular heartbeat) and decreased blood flow to the brain/hands/feet. Do not use tobacco while taking this medication. If you smoke, talk to your doctor about how to stop smoking.

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 side effects of this drug, especially drowsiness, confusion, unusual excitement, constipation, and urination problems. Drowsiness and confusion can increase the risk of falling.

This medication may harm an unborn baby. Therefore, it must not be used during pregnancy. It is recommended that men and women use two effective forms of birth control (e.g., condoms, diaphragms with spermicide) while taking this medication. If you become pregnant or think you may be pregnant, inform your doctor immediately. Consult your doctor for more details and to discuss reliable forms of birth control. (See also Drug Interactions.)

This medication passes into breast milk and may have undesirable effects on a nursing infant. This medication may also slow or stop milk production. Do not breast-feed while using this drug.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: antispasmodics (e.g., atropine, dicyclomine), certain antiarrhythmic drugs (e.g., quinidine, procainamide), certain beta blockers (e.g., propranolol), certain drugs for Parkinson's disease (e.g., levodopa, benztropine, trihexyphenidyl), cyclosporine, disulfiram, dopamine, MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine), other ergot alkaloids (e.g., methysergide), potassium tablets/capsules, pramlintide, sodium oxybate, valproic acid, warfarin.

If you also take "triptan" migraine drugs (e.g., sumatriptan, rizatriptan), you will need to separate your "triptan" dose from your dose of this medication to reduce the risk of serious side effects. Ask your doctor how long you should wait between your doses of these drugs.

This medication can speed up the removal of other medications from your body, which may affect how they work. Examples of affected drugs include certain calcium channel blockers (such as felodipine, nimodipine), certain cancer drugs (such as erlotinib, sunitinib), griseofulvin, theophylline, corticosteroids (such as prednisone), estrogens, doxycycline, exemestane, voriconazole, among others.

Other medications can affect the removal of ergotamine from your body, which may affect how ergotamine works. Examples include boceprevir, mifepristone, telaprevir, St John's wort, certain antidepressants (such as nefazodone, SSRIs such as fluoxetine/paroxetine, tricyclic antidepressants such as amitriptyline), azole antifungals (such as itraconazole, ketoconazole), macrolide antibiotics (such as erythromycin, clarithromycin), HIV protease inhibitors (such as lopinavir, ritonavir), HIV NNRTI's (such as delavirdine, efavirenz), a certain combination HIV medication (elvitegravir/cobicistat/emtricitabine/tenofovir), rifamycins (such as rifampin, rifabutin), among others.

Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: antihistamines (such as diphenhydramine, meclizine), anti-seizure drugs (e.g., phenytoin), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (such as chlorpromazine, haloperidol, risperidone, trazodone).

Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients or ingredients that could increase your heart rate or blood pressure. Ask your pharmacist about the safe use of those products.

This medication may decrease the effectiveness of hormonal birth control such as pills, patch, or ring. This could cause pregnancy. Discuss with your doctor or pharmacist if you should use additional reliable birth control methods while using this medication. Also tell your doctor if you have any new spotting or breakthrough bleeding, because these may be signs that your birth control is not working well.

Phenobarbital is very similar to primidone. Do not use medications containing primidone while using phenobarbital.

Overdose

If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include severe dizziness/drowsiness, loss of feeling in the fingers/toes, bluish hands/feet, slow/fast/irregular heartbeat, mental/mood changes, hot/dry skin, seizures.

Notes

Do not share this medication with others.

Missed Dose

If you 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.

Storage

Store at room temperature between 59-86 degrees F (15-30 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.

Information last revised April 2014. Copyright(c) 2014 First Databank, Inc.

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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