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Combination of
Febarbamate Carbamate
Difebarbamate Carbamate
Phenobarbital Barbiturate
Clinical data
Legal status
ATC code ?

Tetrabamate (Atrium, G Tril, Sevrium) is a combination drug formulation of febarbamate, difebarbamate, and phenobarbital which was marketed in France and Spain and was used to treat anxiety and alcohol withdrawal-associated muscle tremors, agitation, and depression.[1][2][3][4] It was largely, but not completely discontinued on April 4, 1997 after over 30 years of use due to reports of hepatitis and acute liver failure.[3][4][5][6] The decision to restrict the use of the drug had been long-awaited.[6]


  1. ^ Index nominum 2000: international drug directory. Taylor & Francis US. 2000. pp. 333 & 427.  
  2. ^ Eugene R. Schiff; Willis C. Maddrey; Michael F. Sorrell (19 October 2011). Schiff's Diseases of the Liver. John Wiley and Sons. p. 2276.  
  3. ^ a b Binder D, Jost R, Flury R, Salomon F (May 1995). "[Acute liver failure following tetrabamate]". Schweizerische Medizinische Wochenschrift (in German) 125 (19): 965–9.  
  4. ^ a b Consolidated list of products whose consumption and/or sale have been banned, withdrawn, severely restricted or not approved by governments. United Nations Publications. 2003. p. 259.  
  5. ^ Horsmans Y, Lannes D, Pessayre D, Larrey D (December 1994). "Possible association between poor metabolism of mephenytoin and hepatotoxicity caused by Atrium, a fixed combination preparation containing phenobarbital, febarbamate and difebarbamate". Journal of Hepatology 21 (6): 1075–9.  
  6. ^ a b "Severe hepatitis due to Atrium". Prescrire International 10 (55): 150. October 2001.  

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