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Meprobamate (Equanil, Miltown 200, 400 and 600)
(meh-proh- BAM-ayt) Apo-Meprobamate Equanil Equanil Wyseals Miltown 200, 400 and 600 Neuramate Novo-Mepro (C-IV) (Rx)

Classification: Nonbenzodiazepine antianxiety agent

See Also: See also Tranquilizers, Antimanic Drugs, and Hypnotics .

Action/Kinetics: Also possesses muscle relaxant and anticonvulsant effects. Acts on the limbic system and the thalamus, as well as inhibits polysynaptic spinal reflexes. Onset: 1 hr. Blood levels, chronic therapy: 5-20 mcg/mL. t 1/2: 6-24 hr. Extensively metabolized in liver and inactive metabolites and some unchanged drug (8%-19%) are excreted in the urine.

Uses: Short-term treatment (no more than 4 months) of anxiety.

Contraindications: Hypersensitivity to meprobamate or carisoprodol. Porphyria. Children less than 6 years of age.

Special Concerns: Use with caution in pregnancy, lactation, epilepsy, liver and kidney disease. Geriatric clients may be more sensitive to the depressant effects of meprobamate; also, due to age-related impaired renal function, the dose of meprobamate may have to be reduced.

Side Effects: CNS: Ataxia, drowsiness, dizziness, weakness headache, paradoxical excitement, euphoria, slurred speech, vertigo. GI: N&V, diarrhea. Miscellaneous: Visual disturbances, allergic reactions including hematologic and dermatologic symptoms, paresthesias.

Laboratory Test Alterations: With test methods: 17-Hydroxycorticosteroids, 17-ketogenic steroids, and 17-ketosteroids. Pharmacologic effects: Alkaline phosphatase, bilirubin, serum transaminase, urinary estriol (calorimetric tests), porphobilinogen. PT in clients on Coumarin.

Overdose Management: Symptoms: Drowsiness, stupor, lethargy, ataxia, shock, coma, respiratory collapse, death. Also, arrhythmias, tachycardia or bradycardia, reduced venous return, profound hypotension, CV collapse. Excessive oronasal secretions, relaxation of pharyngeal wall leading to obstruction of airway. Treatment: Induction of vomiting or gastric lavage if detected shortly after ingestion. It is imperative that gastric lavage be continued or gastroscopy be performed as incomplete gastric emptying can cause relapse and death. Give fluids to treat hypotension. Avoid fluid overload. Institute artificial respiration. Use care in treating seizures due to combined CNS depressant effects. Use forced diuresis and vasopressors followed by hemodialysis or hemoperfusion if condition deteriorates.

Drug Interactions: Additive depressant effects when used with CNS depressants, MAO inhibitors, and tricyclic antidepressants.

How Supplied: Tablet: 200 mg, 400 mg

?Tablets Anxiety.
Adults, initial: 400 mg t.i.d.-q.i.d. (or 600 mg b.i.d.). May be increased, if necessary, up to maximum of 2.4 g/day. Pediatric, 6-12 years of age: 100-200 mg b.i.d.-t.i.d. (the 600-mg tablet is not recommended for use in children).

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