Meprobamate
MILTOWN
What it isCarbamate anxiolytic; anxiety.
Why this oneHistorically the first widely used anxiolytic, and still occasionally prescribed.
What limits itBarbiturate-like dependence, withdrawal seizures and lethality in overdose. It is the active metabolite of carisoprodol; largely obsolete.
FDA-approved for
- anxiety (1955)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Anxiety | Adults | 1200–1600 mg/day divided TID–QID | 1200–1600 mg/day divided | 2400 mg/day |
| Anxiety | Children 6–12 yr | 200–600 mg/day divided BID–TID | 200–600 mg/day divided | 600 mg/day |
Renal Undefined
Hepatic Undefined
Instructions
- Not recommended for children under 6 years
Contraindications
- Acute intermittent porphyria
- Allergic/idiosyncratic reactions to meprobamate or related compounds (carisoprodol, mebutamate, tybamate, carbromal)
Cautions
- Allergic/idiosyncratic reactions, usually within first to fourth dose
- Severe hypersensitivity reactions (angioedema, bronchospasm, Stevens-Johnson syndrome, bullous dermatitis)
- Blood dyscrasias (agranulocytosis, aplastic anemia, thrombocytopenic purpura)
- Exacerbation of porphyric symptoms
Adverse reactions
- Drowsiness
- Ataxia
- Dizziness
- Nausea/vomiting
- Palpitation/tachycardia
- Hypotension
Pregnancy Undefined
Lactation Undefined
NO BOXED WARNINGS
Principal riskBarbiturate-like dependence and lethality in overdose
Cost, est. cash$10–$300/month
Generic entry1982
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilitySedation, falls, dependence and additive respiratory depression with opioids or other CNS depressants.
Mechanism of action: Meprobamate ballicule
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Memory aids: mascots and interaction avatars
