Phenobarbital Treatment for Hyperbilirubinemia

Hyperbilirubinemia is a condition, seen most often in newborns, in which excessive amounts of bilirubin are present in the blood. Bilirubin is formed during the breakdown of red blood cells. Phenobarbital therapy has been widely used to treat hyperbilirubinemia.

Cause

• Early neonatal hyperbilirubinemia reflects the limited ability of the newborn's liver to excrete bilirubin, but this generally resolves quickly. Continued hyperbilirubinemia usually indicates the presence of some hemolytic disorder or impaired liver function.

Phenobarbital Treatment

• Phenobarbital was used for decades to treat hyperbilirubinemia and still is used in the treatment of Crigler-Najjar syndrome, type II, a disorder that affects the body's metabolism of bilirubin. Phenobarbital promotes the conversion of bilirubin into a form that can readily be excreted.

Use with Phototherapy

• Beginning in the late 1960s, phototherapy (short bursts of strong light) was often used in combination with phenobarbital to treat hyperbilirubinemia.

Pivotal Study

• A study conducted by Y.K. Wong and B.S.B. Wood, published in the September 1973 issue of Archives of Disease in Childhood, showed that phototherapy by itself was as effective as the combination treatment with phenobarbitone, a phenobarbital derivative.

Crigler-Najjar Syndrome, Type II

• While phenobarbital has little therapeutic effect on bilirubin levels in Crigler-Najjar syndrome, type I, it cuts bilirubin by 60 percent to 70 percent in type II of the syndrome, according to an article by Philippe LaBrune on Orpha.net.