Phenobarbital

Metabolism/Excretion
Hepatic, 20-50% renal
Plasma Protein Binding %
 
35-50
 
Dose For Normal Renal Function
3-7 mg/kg/day (depending upon age) q12-24h
Adjustment For Renal Function Gfr, Ml/Min/1.73M2 30-50
100%
Adjustment For Renal Function Gfr, Ml/Min/1.73M2 10-29
100%
Adjustment For Renal Function Gfr, Ml/Min/1.73M2 <10
50% q24h
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: 100%, supplemental dose may be needed during and after hemo run depending on individual patient seizure threshold
Supplement For Dialysis [Recommendation Level]: Pd
PD: 40-50% is removed by peritoneal dialysis, amount will differ depending upon the number of cycles
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: 10 mg/kg dose q8h, q6h may be needed for higher levels (i.e., 60-80), monitor serum concentrations, [B]
References
Pasko DA, Annich GM. Phenobarbital pharmokinetics of an infant on ECMO and CVVHD: a case report. Presented to Pediatric CRRT; Orlando, FL; 2004. / Porto I, John EG, Heilliczer J. Removal of phenobarbital during continuous cycling peritoneal dialysis in a child. Pharmacotherapy. 1997; 17: 832-5. [PMID: 9250568]