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Sample Hospital (Level 4) Protocol for Phenobarbital Taper
Disclaimer: This is an example protocol that is currently used in a
hospital setting for tapering with phenobarbital. It should not be
interpreted as an exact recommended protocol.
Administer a test dose of 64.8 mg oral phenobarbital.
Assess patients 1 hour after administering the test dose to ensure
they are not oversedated or intoxicated.
If patient tolerates the test dose, continue with the following
phenobarbital taper schedule:
• 129.6 mg oral phenobarbital every 4 hours for a daily total of 6 doses
• 129.6 mg oral phenobarbital every 6 hours for a daily total of 4 doses
• 129.6 mg oral phenobarbital every 8 hours for a daily total of 3 doses
If patient exhibits any signs or symptoms of oversedation or
intoxication, hold the next scheduled dose.
After 72 hours, patient should be safe for discharge (or, for patients
with SUD, transitioned to a less intensive level of addiction care)
without additional phenobarbital or BZD doses.
Management of Severe or
Complicated Withdrawal
