Typical applications for pentobarbital are sedative, hypnotic for short term, preanesthetic, insomnia, 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 was also widely abused, known on the streets as “yellow jackets”. They were available in 50 and 100 mg. yellow capsules. Pentobarbital in pill form is no longer manufactured.
Pentobarbital can cause death when used in high doses. It is used for euthanasia for humans as well as animals. It is also used by itself, or in combination with complementary agents such as phenytoin, in commercial animal euthanasia injectable solutions.
In the Netherlands, the standard protocol for physician-assisted suicide is to provide 9 grams of pentobarbital sodium along with sugar syrup in a 20% ethanol solution for self-administration by the patient.
The oral dosage of pentobarbital indicated for physician-assisted death in the United States states of Oregon, Washington, Vermont, and California (as of January, 2016) is typically 10 g in liquid form. This is considerably higher than the dose for the management of status epilepticus.
Pentobarbital has been used or considered as a substitute for other drugs traditionally used for capital punishment in the United States when they are in short supply. Such use however is illegal under Danish law, and when this was discovered, after public outcry in Danish media, Lundbeck, the owner of the drug, stopped selling it to US states that impose the death penalty. US distributors of the drug are forbidden by the owner to sell it to any customers, such as several state authorities, that practice or participate in executions of humans.
Texas began using pentobarbital for executing death-row inmates by lethal injection on July 18, 2012. The use of pentobarbital has been considered by several states, including Ohio, Arizona, Idaho, and Washington; those states made the decision to switch following shortages of pancuronium bromide, a muscle paralytic previously used as one component in a three-drug cocktail.
In October 2013, Missouri changed its protocols to allow for a compounded pentobarbital to be used in a lethal dose for executions. On November 20, 2013, Joseph Paul Franklin was executed by the state of Missouri. He was the first inmate executed in three years in the state and the first to die by a single dose of pentobarbital.