Thiopental

Generic name
Thiopental
Brand name
ATC Code
N01AF03
Compare …

Thiopental

Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Pharmacokinetics in children

Rapid distribution. Only for short-term treatment in IC. The slow elimination becomes relevant as the length of treatment increases.

dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

Available formulations

No information is present at this moment.

Dosages

Status epilepticus
  • Intravenous
    • 1 month up to 18 years
      • Initial dose: 5 mg/kg/dose, bolus.
      • Maintenance dose: 5 mg/kg/hour, continuous infusion. Max: 10 mg/kg/hour.
        • Loading: Preferably with EEG monitoring. Repeat the loading dose every 20 minutes until a burst suppression of 30 seconds is obtained or the epileptiform activity has disappeared.
        • Maintenance: raise the dosage as necessary in steps of 1-2 mg/kg/hour to a maximum of 10 mg/kg/hour.
        • Reduce: Once the status is under control (both clinically and on the EEG), cut back the thiopental gradually over 12-24 hours (e.g. 25% of the initial rate every 6 hours)
        • Relapses: repeat the loading dose and revert to the old infusion rate for 24-72 hours.
Anaesthesia: induction
  • Intravenous
    • 2 years up to 18 years
      • Initial dose: 2 - 8 mg/kg/dose, bolus. Further titrate dose according to effect..

      • The effect of thiopental in children is variable and individual. Younger patients generally need a higher dose per kg bodyweight than older patients.

    • 1 month up to 2 years
      • Initial dose: 5 - 8 mg/kg/dose, bolus. Further titrate dose according to effect..

      • The effect of thiopental in children is variable and individual. Younger patients generally need a higher dose per kg bodyweight than older patients.

    • Term neonate
      • Initial dose: 3 - 4 mg/kg/dose, bolus. Further titrate dose according to effect..

      • The effect of thiopental in children is variable and individual. Younger patients generally need a higher dose per kg bodyweight than older patients.
Thiopental coma: refractory intracranial hypertension
  • Intravenous
    • 1 month up to 18 years
      • Initial dose: 12.5 mg/kg/hour, continuous infusion. Over 6 hours.
      • Maintenance dose: First 5 mg/kg/hour, then 3 mg/kg/hour, continuous infusion.

      • Loading dose depends on the EEG and the plasma concentration.

Renal impaiment in children > 3 months

GFR ≥10 ml/min/1.73m2: Dose adjustment not required.

GFR <10 ml/min/1.73m2: A general recommendation on dose adjustment cannot be provided.

The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects in children

Depression of respiration and cardiac output. Skin reactions because of histamine release. Tissue necrosis on extravasation.

The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications in children

Absolute contraindication: Porphyria.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

Watch out for blood pressure drops, reduced resistance, fever and (on prolonged used) impaired liver function.

Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

ANESTHETICS, GENERAL

This pages provides a list of drugs from the same ATC class for comparison. This does not necessarily mean that these drugs are interchangeable.

Halogenated hydrocarbons
N01AB07
N01AB06
N01AB08
Opioid anesthetics
N01AH02
N01AH01
N01AH06
N01AH03
Other general anesthetics
N01AX01
N01AX14
N01AX07
N01AX10

References

  1. Rademaker C.M.A. et al, Geneesmiddelen-Formularium voor Kinderen, 2007
  2. Werkgroep Richtlijnen Epilepsie, Epilepsie. Richtlijnen voor diagnostiek en behandeling, Nederlandse Vereniging voor Neurologie en de Nederlandse Liga tegen Epilepsie, Herziene, tweede versie, januari 2006
  3. Waardenburg van DA, et al, Richtlijn status epilepticus kinderen ouder dan één maand., Nederlandse Vereniging voor Kindergeneeskunde, Augustus 2005
  4. Hospira Benelex BVBA, SPC Pentothal (RVG 11772), 05/17, Geraadpleegd 19 jan 2022, https://www.geneesmiddeleninformatiebank.nl/smpc/h11772_smpc.pdf
  5. Panpharma GMBH, SmPC Thiopental Pulver zur Herstellung einer Injektionslösung (43552.00.00) , Jan 2020
  6. Panpharma GMBH, SmPC Thiopental Pulver zur Herstellung einer Injektionslösung (43552.00.00), Jan 2020

Changes

Therapeutic Drug Monitoring


Overdose