Typical applications for pentobarbital are sedative, short term hypnotic, preanesthetic, insomnia treatment, and control of convulsions in emergencies. Abbott Pharmaceutical discontinued manufacture of their Nembutal brand of pentobarbital capsules in 1999, largely replaced by the benzodiazepine family of drugs.

Pentobarbital can reduce intracranial pressure in Reye syndrome, treat traumatic brain injury and induce coma in cerebral ischemia patients. Pentobarbital-induced coma has been advocated in patients with acute liver failure refractory to mannitol.

Pentobarbital is also used as a veterinary anesthetic agent and euthanasia drug.

Pentobarbital can cause death when used in high doses. It is used for euthanasia for humans as well as animals. It is taken alone, or in combination with complementary agents such as phenytoin, in commercial animal euthanasia injectable solutions. As of 2021, the sodium salt of pentobarbital was considered the “drug of choice” for animal euthanasia in the United States and Canada.

In the Netherlands, pentobarbital is part of the standard protocol for physician-assisted suicide for self-administration by the patient. It is given in liquid form, in a solution of sugar syrup and alcohol, containing 9 grams of pentobarbital. This is preceded by an antiemetic to prevent vomiting.

It is taken by mouth for physician-assisted death in the United States states of Oregon, Washington, Vermont, and California (as of January 2016). The oral dosage of pentobarbital indicated for physician-assisted suicide in Oregon is typically 10 g of liquid.

Pentobarbital has been publicized as a suicide method by assisted suicide advocacy groups, in particular Exit International. Around 2008, suicide tourists were traveling to Mexico in order to purchase pentobarbital from veterinary pharmacies, a means that is no longer possible owing to tighter controls.^{[citation needed]} Around 2025, prosecutions for its illegal distribution to persons seeking to end their lives have occurred in Australia, France, and the United States.

What are some side effects of Nembutal ?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

For all uses of Nembutal (pentobarbital):

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Trouble breathing, slow breathing, or shallow breathing.
• Very bad dizziness or passing out.
• Feeling nervous and excitable.
• Feeling confused.
• Low mood (depression).

Injection (if given in the muscle):

• Pain and irritation where Nembutal (pentobarbital) goes into the body.

Injection (if given in the vein):

• This medicine may cause tissue damage if the drug leaks from the vein. Tell your nurse if you have any redness, burning, pain, swelling, blisters, skin sores, or leaking of fluid where the drug is going into your body.

Consumer Information Use and Disclaimer

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else’s drugs.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
• Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about Nembutal (pentobarbital), please talk with your doctor, nurse, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.