Phenobarbital Dosing for Delirium Tremens - Inpatient

From the gender and height of the patient, dosing of phenobarbital for DTs can be calculated. This site is for the exclusive use of EMMC physicians using the DT PowerPlan. No guarantee or liability is implied to those using this site. Remember that alcoholics may suffer from other serious medical conditions. In other words, use this web site at your own risk. Please make sure that the results on the next web page are sensible for your patient.


Please enter the height in inches or centimeters and the gender of the patient in the form below. Values above 100 are assumed to be cm, and values below 100 are assumed to be in inches. Do not enter fractions, but decimals are acceptable. Do not use this site for extreme values of height.

Use the radio buttons below to select the relative likelihood of DT's as indicated. Definition of high or medium likelihood of DT's is given at the bottom of the page.

The radio buttons below represent weight-based loading doses. They are grouped into six category sets of likelihood of DT's to risk of respiratory complications from phenobarbital. Assumption is recent significant alcohol use. Submit button is at the bottom. At the bottom of the page are definitions of likelihood of DT's and risk of complications from phenobarbital.

Choose one dose schedule
  • High likelihood for DT's
  • Low risk of complications from phenobarbital

  • High likelihood for DT's
  • Some risk of complications from phenobarital

  • High likelihood for DT's
  • High risk of complications from phenobarbital

  • Medium likelihood for DT's
  • No risk factors for complications from phenobarbital

  • Medium likelihood of DT's
  • Some risk of complications from phenobarbital

  • Medium likelihood of DT's
  • High risk of complications from phenobarbital

Factors Favoring High Likelihood of DT's

  • Prior DTs or prior seizures and
    • Heavy alcohol use for past two weeks or
    • Active symptoms of acute alcohol withdrawal
  • Or
    • Heavy alcohol use for past two weeks,
    • Elevation of MCV,
    • Elevated blood alcohol level,
    • Elevated AST:ALT ratio

Factors Favoring Medium Likelihood of DT's

  • Active alcohol dependence plus two of the following:
  • More than two days since drinking
  • Elevated blood alcohol level
  • Autonomic dysfunction related to alcohol
  • Elevated AST:ALT ratio or MCV
  • Unexplained burns or falls
  • Age above 35-years with chronic alcohol use for over three months
  • Liver function abnormalities or elevation of MCV

Risk of Sedation from Phenobarbital

  • Age over 65 years
  • Hepatic dysfunction
  • Narcotics
  • Head injury
  • Recently administered benzodiazepines
  • Current administration of sedatives

Risk of Respiratory Failure from Phenobarbital

  • Pneumonia
  • Rib fractures
  • Chest tubes
  • Pulmonary contusions
  • C-collar and other major neurologic illnesses and injuries
  • Chronic lung disease
  • Decompensated heart failure