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Combination of
FebarbamateCarbamate, barbiturate
DifebarbamateCarbamate, barbiturate

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. ISBN 978-3-88763-075-1. Retrieved 26 November 2011.
  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. ISBN 978-1-119-95048-6. Retrieved 26 November 2011.
  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. PMID 7761807.
  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 ^ a b Consolidated list of products whose consumption and/or sale have been banned, withdrawn, severely restricted or not approved by governments.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. ISBN 978-92-1-130230-1. Retrieved 26 November 2011.
  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. doi:10.1016/s0168-8278(05)80620-8. PMID 7699230.
  6. ^ a b "Severe hepatitis due to Atrium". Prescrire International. 10 (55): 150. October 2001. PMID 11824432.