Indications and Usage
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INDICATIONS AND USAGE
Based on a review of this drug by the National Academy of Sciences-National Research Council and/or other information, FDA has classified the indications as follows: "Possibly" effective: For use as adjunctive therapy in the treatment of irritable bowel syndrome (irritable colon, spastic colon, mucous colitis) and acute enterocolitis. May also be useful as adjunctive therapy in the treatment of duodenal ulcer. Final classification of the less-than-effective indications requires further investigation. IT HAS NOT BEEN SHOWN CONCLUSIVELY WHETHER ANTICHOLINERGIC/ANTISPASMODIC DRUGS AID IN THE HEALING OF A DUODENAL ULCER, DECREASE THE RATE OF RECURRENCES OR PREVENT COMPLICATIONS. |
Dosage and Administration
The dosage of Donnatal® Tablets should be adjusted to the needs of the individual patient to assure symptomatic control with a minimum of adverse effects.
Donnatal® Tablets - Adults: One or two Donnatal® Tablets three or four times a day according to condition and severity of symptoms.
Contraindications
- glaucoma;
- obstructive uropathy (for example, bladder neck obstruction due to prostatic hypertrophy);
- obstructive disease of the gastrointestinal tract (as in achalasia, pyloroduodenal stenosis, etc.);
- paralytic ileus, intestinal atony of the elderly or debilitated patient;
- unstable cardiovascular status in acute hemorrhage;
- severe ulcerative colitis especially if complicated by toxic megacolon;
- myasthenia gravis;
- hiatal hernia associated with reflux esophagitis;
- in patients with known hypersensitivity to any of the ingredients.
Phenobarbital is contraindicated in acute intermittent porphyria and in those patients in whom phenobarbital produces restlessness and/or excitement.
Adverse Reactions
Adverse reactions may include xerostomia; urinary hesitancy and retention; blurred vision; tachycardia; palpitation; mydriasis; cycloplegia; increased ocular tension; loss of taste sense; headache; nervousness; drowsiness; weakness; dizziness; insomnia; nausea; vomiting; impotence; suppression of lactation; constipation; bloated feeling; musculoskeletal pain; severe allergic reaction or drug idiosyncrasies, including anaphylaxis, urticaria, and other dermal manifestations; and decreased sweating.
Acquired hypersensitivity to barbiturates consists chiefly in allergic reactions that occur especially in persons who tend to have asthma, urticaria, angioedema, and similar conditions. Hypersensitivity reactions in this category include localized swelling, particularly of the eyelids, cheeks, or lips, and erythematous dermatitis. Rarely, exfoliative dermatitis (e.g. Stevens-Johnson syndrome and toxic epidermal necrolysis) may be caused by phenobarbital and can prove fatal. The skin eruption may be associated with fever, delirium, and marked degenerative changes in the liver and other parenchymatous organs. In a few cases, megaloblastic anemia has been associated with the chronic use of phenobarbital.
Phenobarbital may produce excitement in some patients, rather than a sedative effect.
To report SUSPECTED ADVERSE REACTIONS, contact Advanz Pharma (US) Corp. at 1-877-370-1142 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Drug Interactions
Phenobarbital may decrease the effect of anticoagulants, and necessitate larger doses of the anticoagulant for optimal effect. When the phenobarbital is discontinued, the dose of the anticoagulant may have to be decreased.
Drug Abuse and Dependence
Abuse
Phenobarbital may be habit forming and should not be administered to individuals known to be addiction prone or to those with a history of physical and/or psychological dependence upon drugs (see WARNINGS ).
Dependence
In patients habituated to barbiturates, abrupt withdrawal may produce delirium or convulsions.
Overdosage
The signs and symptoms of overdose are headache, nausea, vomiting, blurred vision, dilated pupils, hot and dry skin, dizziness, dryness of the mouth, difficulty in swallowing, and CNS stimulation. Treatment should consist of gastric lavage, emetics, and activated charcoal. If indicated, parenteral cholinergic agents such as physostigmine or bethanechol chloride should be used.
Description
Donnatal® Tablets
Each Donnatal® Tablet contains:
Phenobarbital, USP..................................... 16.2 mg
Hyoscyamine Sulfate, USP...................... 0.1037 mg
Atropine Sulfate, USP .............................0.0194 mg
Scopolamine Hydrobromide, USP ...........0.0065 mg
Clinical Pharmacology
This drug combination provides natural belladonna alkaloids in a specific, fixed ratio combined with phenobarbital to provide peripheral anticholinergic/antispasmodic action and mild sedation.
How Supplied / Storage and Handling
Donnatal® Tablets are supplied as: white, D-shaped, flat faced beveled edge tablets embossed "D" on one side and debossed "Donnatal" on the other side.
- Bottles of 100 tablets - NDC 59212-425-10.
- Bottles of 4 tablets - NDC 59212-425-04.
Store at 20°-25°C (68°-77°F) [See USP Controlled Room Temperature]. Protect from light and moisture.
Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.
DEA EXEMPT PRODUCT
Manufactured for:
Advanz Pharma (US) Corp.
Bannockburn, IL 60015
DONNATAL® is a registered trademark of Mercury Pharma Group Limited.
Distributed by Advanz Pharma (US) Corp. under license
Revised: 11/23
Patient Counseling Information
Donnatal® Tablets may produce drowsiness or blurred vision. The patient should be warned, should these occur, not to engage in activities requiring mental alertness, such as operating a motor vehicle or other machinery, and not to perform hazardous work.