Phenobarbital interactions

Food & lifestyle

• alcohol

  Major

  Metabolism

  Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.

  What to do: The combination of ethanol and barbiturates should be avoided.

  5 sources

  1. Gupta RC, Kofoed J "Toxological statistics for barbiturates, other sedatives, and tranquilizers in Ontario: a 10-year survey." Can Med Assoc J 94 (1966): 863-5
  2. Misra PS, Lefevre A, Ishii H, Rubin E, Lieber CS "Increase of ethanol, meprobamate and pentobarbital metabolism after chronic ethanol administration in man and in rats." Am J Med 51 (1971): 346-51
  3. Saario I, Linnoila M "Effect of subacute treatment with hypnotics, alone or in combination with alcohol, on psychomotor skills related to driving." Acta Pharmacol Toxicol (Copenh) 38 (1976): 382-92
  4. Stead AH, Moffat AC "Quantification of the interaction between barbiturates and alcohol and interpretation of fatal blood concentrations." Hum Toxicol 2 (1983): 5-14
  5. Seixas FA "Drug/alcohol interactions: avert potential dangers." Geriatrics 34 (1979): 89-102

Conditions

Conditions in which Phenobarbital needs care, as documented in this source.

• Alcoholic Intoxication

  Major

  The use of barbiturates is contraindicated in patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of barbiturates may be additive with those of alcohol. Severe respiratory depression and death may occur. Therapy with barbiturates should be administered cautiously in patients who might be prone to acute alcohol intake.

  8 sources

  1. Plaa GL "Acute toxicity of antiepileptic drugs." Epilepsia 16 (1975): 183-91
  2. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company (2001):
  3. "Multum Information Services, Inc. Expert Review Panel"
  4. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company (2001):
  5. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical (2001):
  6. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company (2001):
  7. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals (2001):
  8. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories (2001):

• Cardiovascular Diseases

  Major

  The intravenous administration of barbiturates may produce severe cardiovascular reactions such as bradycardia, hypertension, or vasodilation with fall in blood pressure, particularly during rapid infusion. Parenteral therapy with barbiturates should be administered cautiously in patients with hypertension, hypotension, or cardiac disease. The intravenous administration of barbiturates should be reserved for emergency treatment of acute seizures or for anesthesia.

  5 sources

  1. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company (2001):
  2. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  3. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company (2001):
  4. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical (2001):
  5. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company (2001):

• Exanthema

  Major

  Skin eruptions may precede rare but potentially fatal barbiturate-induced reactions such as systemic lupus erythematosus and exfoliative dermatitis, the latter of which may be accompanied by hepatitis and jaundice. Therapy with barbiturates should be administered cautiously in patients with preexisting drug-induced dermatitis, since it may delay the recognition of a potential reaction to barbiturates. Barbiturate therapy should be withdrawn promptly at the first sign of a dermatologic adverse effect. However, cutaneous reactions may proceed to an irreversible stage even after cessation of medication due to the slow rate of metabolism and excretion of barbiturates. Patients should be advised to promptly report signs that may indicate impending development of barbiturate-related cutaneous lesions, including high fever, severe headache, stomatitis, conjunctivitis, rhinitis, urethritis, and balanitis. Rashes may be more likely to occur with phenobarbital and mephobarbital.

  12 sources

  1. Pelekanos J, Camfield P, Camfield C, Gordon K "Allergic rash due to antiepileptic drugs: clinical features and management." Epilepsia 32 (1991): 554-9
  2. Pagliaro L, Campesi G, Aguglia F "Barbiturate jaundice. Report of a case due to a barbital-containing drug, with positive rechallenge to phenobarbital." Gastroenterology 56 (1969): 938-43
  3. Shear NH, Spielberg SP "Anticonvulsant hypersensitivity syndrome. In vitro assessment of risk." J Clin Invest 82 (1988): 1826-32
  4. Stuttgen G "Toxic epidermal necrolysis provoked by barbiturates." Br J Dermatol 88 (1973): 291-3
  5. Fernandez de Corres L, Leanizbarrutia I, Munoz D "Eczematous drug reaction from phenobarbitone." Contact Dermatitis 11 (1984): 319
  6. Dourmishev AL, Rahman MA "Phenobarbital-induced pemphigus vulgaris." Dermatologica 173 (1986): 256-8
  7. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company (2001):
  8. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company (2001):

  Show all 12 sourcesShow fewer sources

  9. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical (2001):
  10. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company (2001):
  11. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals (2001):
  12. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories (2001):

• Hypotension

  Major

  Barbiturates should not be administered by injection to patients in shock or coma or who have recently received another respiratory depressant. The hypnotic and hypotensive effects of these agents may be prolonged and intensified in such patients.

  5 sources

  1. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company (2001):
  2. "Multum Information Services, Inc. Expert Review Panel"
  3. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company (2001):
  4. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical (2001):
  5. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company (2001):

• Kidney Diseases

  Major

  The long-acting barbiturate, phenobarbital, is partially eliminated by the kidney. The plasma clearance of phenobarbital may be decreased and the half-life prolonged in patients with impaired renal function. Therapy with phenobarbital should be administered cautiously and initiated at reduced dosages in patients with renal impairment. Since approximately 75% of a mephobarbital dose is metabolized to phenobarbital, the same precaution should be observed with mephobarbital. The remaining barbiturates, which are short- and intermediate-acting, are all negligibly excreted in the urine and may be appropriate alternatives in these patients.

  3 sources

  1. Turk JW, Ladenson JH "Phenytoin and phenobarbital concentrations in renal insufficiency ." Ann Intern Med 101 (1984): 569
  2. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company (2001):
  3. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals (2001):

• Liver Diseases

  Major

  Barbiturates are extensively metabolized by the liver. The plasma clearance of barbiturates may be decreased and the half-lives prolonged in patients with impaired hepatic function. Therapy with barbiturates should be administered cautiously and initiated at reduced dosages in patients with liver disease. Barbiturates are not recommended for use in patients with cirrhosis, hepatic failure, hepatic coma, or other severe hepatic impairment.

  9 sources

  1. Alvin J, McHorse T, Hoyumpa A, et al. "The effect of liver disease in man on the disposition of phenobarbital." J Pharmacol Exp Ther 192 (1975): 224-35
  2. Kallberg N, Agurell S, Ericsson O, et al. "Quantitation of phenobarbital and its main metabolites in human urine." Eur J Clin Pharmacol 9 (1975): 161-8
  3. Whyte MP, Dekaban "Metabolic fate of phenobarbital: a quantitative study of p-hydroxyphenobarbital elimination in man." Drug Metab Dispos 5 (1977): 63-9
  4. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company (2001):
  5. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company (2001):
  6. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical (2001):
  7. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company (2001):
  8. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals (2001):

  Show all 9 sourcesShow fewer sources

  9. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories (2001):

• Porphyrias

  Major

  The use of barbiturates is contraindicated in patients with a history of porphyria. Barbiturates may exacerbate acute intermittent porphyria or porphyria variegata by inducing the enzymes responsible for porphyrin synthesis.

  8 sources

  1. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company (2001):
  2. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  3. Braunwald E, Hauser SL, Kasper DL, Fauci AS, Isselbacher KJ, Longo DL, Martin JB, eds., Wilson JD "Harrison's Principles of Internal Medicine." New York, NY: McGraw-Hill Health Professionals Division (1998):
  4. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company (2001):
  5. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical (2001):
  6. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company (2001):
  7. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals (2001):
  8. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories (2001):

• Respiratory Insufficiency

  Major

  Barbiturates may produce severe respiratory depression, apnea, laryngospasm, bronchospasm and cough, particularly during rapid intravenous administration. In usual hypnotic dosages, the degree of respiratory depression produced is similar to that which occurs during physiologic sleep, while at higher dosages, the rate, depth and volume of respiration may be markedly decreased. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with barbiturates should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are particularly important, and equipment for resuscitation should be immediately available if the parenteral route is used. Barbiturates, especially injectable formulations, should generally be avoided in patients with sleep apnea, hypoxia, or severe pulmonary diseases in which dyspnea or obstruction is evident.

  9 sources

  1. Plaa GL "Acute toxicity of antiepileptic drugs." Epilepsia 16 (1975): 183-91
  2. Lund A, Gormsen H "The role of antiepileptics in sudden death in epilepsy." Acta Neurol Scand 72 (1985): 444-6
  3. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company (2001):
  4. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  5. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company (2001):
  6. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical (2001):
  7. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company (2001):
  8. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals (2001):

  Show all 9 sourcesShow fewer sources

  9. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories (2001):

• Substance-Related Disorders

  Major

  Barbiturates have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages. Abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance to a barbiturate, overdosage can still produce respiratory depression and death, and cross-tolerance usually will occur with other agents in the class. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with barbiturates. It may be prudent to refrain from dispensing large quantities of medication to these patients. After prolonged use or if dependency is suspected, withdrawal of barbiturates should be undertaken gradually using a dosage-tapering schedule.

  9 sources

  1. Boisse NR, Okamoto M "Physical dependence to barbital compared to pentobarbital. II. Tolerance characteristics." J Pharmacol Exp Ther 204 (1978): 507-13
  2. Gersema LM, Alexander B, Kunze KE "Major withdrawal symptoms after abrupt discontinuation of phenobarbital." Clin Pharm 6 (1987): 420-2
  3. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company (2001):
  4. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  5. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company (2001):
  6. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical (2001):
  7. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company (2001):
  8. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals (2001):

  Show all 9 sourcesShow fewer sources

  9. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories (2001):

• Adrenal Insufficiency

  Moderate

  Barbiturates, especially phenobarbital, secobarbital and butabarbital, may diminish the systemic effects of exogenous and endogenous corticosteroids via induction of hepatic microsomal enzymes, thereby accelerating the metabolism of corticosteroids. In addition, barbiturates may interfere with pituitary corticotropin production. Therapy with barbiturates should be administered cautiously in patients with adrenal insufficiency. Patients with borderline hypoadrenalism should be monitored closely, and patients receiving steroid supplementation may require an adjustment in dosage when barbiturates are added to or withdrawn from their medication regimen.

  6 sources

  1. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company (2001):
  2. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company (2001):
  3. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical (2001):
  4. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company (2001):
  5. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals (2001):
  6. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories (2001):

• Depressive Disorder

  Moderate

  Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.

  16 sources

  1. "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals (2002):
  2. "Product Information. Klonopin (clonazepam)." Roche Laboratories (2001):
  3. "Product Information. Dilantin (phenytoin)." Parke-Davis (2001):
  4. "Product Information. Cerebyx (fosphenytoin)." Parke-Davis (2001):
  5. "Product Information. Mysoline (primidone)." Elan Pharmaceuticals (2001):
  6. "Product Information. Lyrica (pregabalin)." Pfizer U.S. Pharmaceuticals Group (2005):
  7. "Product Information. Sabril (vigabatrin)." Lundbeck Inc (2009):
  8. "Product Information. Potiga (ezogabine)." GlaxoSmithKline (2011):

  Show all 16 sourcesShow fewer sources

  9. "Product Information. Qsymia (phentermine-topiramate)." Vivus Inc (2012):
  10. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  11. "Product Information. Briviact (brivaracetam)." UCB Pharma Inc (2016):
  12. "Product Information. Diacomit (stiripentol)." Biocodex USA (2018):
  13. "Product Information. Epidiolex (cannabidiol)." Greenwich Biosciences LLC (2018):
  14. "Product Information. Xcopri (cenobamate)." SK Life Science, Inc. (2020):
  15. "Product Information. Fintepla (fenfluramine)." Zogenix, Inc (2020):
  16. "Product Information. Ztalmy (ganaxolone)." Marinus Pharmaceuticals, Inc (2022):

• Depressive Disorder

  Moderate

  Barbiturates depress the central nervous system and may cause or exacerbate mental depression. Therapy with barbiturates should be administered cautiously in patients with a history of depression or suicidal tendencies. It may be prudent to refrain from dispensing large quantities of medication to these patients.

  7 sources

  1. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company (2001):
  2. "Multum Information Services, Inc. Expert Review Panel"
  3. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company (2001):
  4. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical (2001):
  5. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company (2001):
  6. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals (2001):
  7. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories (2001):

• Hematologic Diseases

  Moderate

  Hematologic toxicity, including agranulocytosis, thrombocytopenic purpura and megaloblastic anemia, has been reported rarely during use of barbiturates. Therapy with barbiturates should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow suppression. Blood counts are recommended prior to and periodically during long-term therapy, and patients should be instructed to immediately report any signs or symptoms suggestive of blood dyscrasia such as fever, sore throat, local infection, easy bruising, petechiae, bleeding, pallor, dizziness, or jaundice. Barbiturate therapy should be discontinued if blood dyscrasias occur.

  9 sources

  1. Van Hoof A, Chamone DA, Vermylen J "Platelet aggregation and anaesthesia." Lancet 2 (1980): 373
  2. Kiorboe E, Plum CM "Megaloblastic anaemia developing during treatment of epilepsy." Acta Med Scand Suppl 445 (1966): 349-57
  3. Iivanainen M, Savolainen H "Side effects of phenobarbital and phenytoin during long-term treatment of epilepsy." Acta Neurol Scand Suppl 97 (1983): 49-67
  4. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company (2001):
  5. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company (2001):
  6. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical (2001):
  7. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company (2001):
  8. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals (2001):

  Show all 9 sourcesShow fewer sources

  9. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories (2001):

• Osteomalacia

  Moderate

  Rickets and osteomalacia have rarely been reported following prolonged use of barbiturates, possibly due to increased metabolism of vitamin D as a result of enzyme induction by barbiturates. Long-term therapy with barbiturates should be administered cautiously in patients with vitamin D deficiency.

  6 sources

  1. Sotaniemi EA, Hakkarainen HK, Puranen JA, Lahti RO "Radiologic bone changes and hypocalcemia with anticonvulsant therapy in epilepsy." Ann Intern Med 77 (1972): 389-94
  2. Zerwekh JE, Homan R, Tindall R, Pak CY "Decreased serum 24,25-dihydroxyvitamin D concentration during long- term anticonvulsant therapy in adult epileptics." Ann Neurol 12 (1982): 184-6
  3. Marsden CD, Reynolds EH, Parsons V, Harris R, Duchen L "Myopathy associated with anticonvulsant osteomalacia." Br Med J 4 (1973): 526-7
  4. Iivanainen M, Savolainen H "Side effects of phenobarbital and phenytoin during long-term treatment of epilepsy." Acta Neurol Scand Suppl 97 (1983): 49-67
  5. Doriguzzi C, Mongini T, Jeantet A, Monga G "Tubular aggregates in a case of osteomalacic myopathy due to anticonvulsant drugs." Clin Neuropathol 3 (1984): 42-5
  6. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company (2001):

• Psychotic Disorders

  Moderate

  Paradoxical reactions characterized by excitability and restlessness may occur in pediatric patients with hyperactive aggressive disorders. Such patients should be monitored for signs of paradoxical stimulation during therapy with barbiturates.

  9 sources

  1. Mayhew LA, Hanzel TE, Ferron FR, Kalachnik JE, Harder SR "Phenobarbital exacerbation of self-injurious behavior." J Nerv Ment Dis 180 (1992): 732-3
  2. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company (2001):
  3. Sylvester CE, Marchlewski A, Manaligod JM "Primidone or phenobarbital use complicating disruptive behavior disorders." Clin Pediatr (Phila) 33 (1994): 252-3
  4. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  5. "Product Information. Amytal Sodium (amobarbital)." Lilly, Eli and Company (2001):
  6. "Product Information. Nembutal Sodium (pentobarbital)." Abbott Pharmaceutical (2001):
  7. "Product Information. Seconal Sodium (secobarbital)." Lilly, Eli and Company (2001):
  8. "Product Information. Mebaral (mephobarbital)." Sanofi Winthrop Pharmaceuticals (2001):

  Show all 9 sourcesShow fewer sources

  9. "Product Information. Butisol Sodium (butabarbital)." Wallace Laboratories (2001):

Therapeutic duplication

Drug classes that overlap with Phenobarbital, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• barbiturates

  The recommended maximum number of medicines in the 'barbiturates' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'barbiturates' category.

  Example product in the source data (US market): Phrenilin with caffeine and codeine

• barbiturates

  The recommended maximum number of medicines in the 'barbiturates' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'barbiturates' category.

  Example product in the source data (US market): Phrenilin

• barbiturates

  The recommended maximum number of medicines in the 'barbiturates' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'barbiturates' category.

  Example product in the source data (US market): Butabarbital/hyoscyamine/phenazopyridine

• barbiturates

  The recommended maximum number of medicines in the 'barbiturates' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'barbiturates' category.

  Example product in the source data (US market): Aspirin/butalbital/caffeine/codeine

• barbiturates

  The recommended maximum number of medicines in the 'barbiturates' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'barbiturates' category.

  Example product in the source data (US market): Laniroif

• barbiturates

  The recommended maximum number of medicines in the 'barbiturates' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'barbiturates' category.

  Example product in the source data (US market): Nonbac

• tranquilizers

  The recommended maximum number of medicines in the 'tranquilizers' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'tranquilizers' category.

  Example product in the source data (US market): Librax

• tranquilizers

  The recommended maximum number of medicines in the 'tranquilizers' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'tranquilizers' category.

  Example product in the source data (US market): Limbitrol ds

• tranquilizers

  The recommended maximum number of medicines in the 'tranquilizers' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'tranquilizers' category.

  Example product in the source data (US market): Micrainin

• tranquilizers

  The recommended maximum number of medicines in the 'tranquilizers' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'tranquilizers' category.

  Example product in the source data (US market): Nodolor