Adverse Effects
Frequency Not Defined
Butalbital
- Dizziness, drowsiness, feeling of intoxication, lightheadedness, sedation
- Abdominal pain, nausea, vomiting
- Shortness of breath
Acetaminophen
- Angioedema, laryngeal edema
- Pruritic maculopapular rash, urticaria
- Agranulocytosis, leukopenia, neutropenia, pancytopenia, thrombocytopenia, thrombocytopenic purpura
- Hepatotoxicity
- Anaphylactoid reaction
Caffeine
- Tachycardia, palpitations (dose dependent)
- Insomnia, irritability, nervousness, restlessness, tinnitus, tremor
- Diarrhea, nausea, vomiting
- Diuresis
Warnings
Black Box Warnings
Contains acetaminophen
Hepatotoxicity may occur with acetaminophen doses that exceed 4 g/day; take into account all acetaminophen-containing products the patient is taking, including PRN doses and OTC products
Acetaminophen has been associated with cases of acute liver failure, at times resulting in liver transplantation or death
New dosage limit allows no more than 325 mg/dosage unit for prescription medications that contain acetaminophen
Healthcare professionals can direct patients to take 1 or 2 tablets, capsules, or other dosage units of a prescription product containing 325 mg of acetaminophen up to 6 times daily (12 dosage units) and still not exceed the maximum daily dose of acetaminophen (ie, 4 g/day)
We do not suggest you to take Fioricet or Gabapentinfor a long time, you need go to your local health professional to treat your pain without prescription. We think exercising is the best way to relieve your pain. Exercising is a very good methods. Exercising can enhance your immune system and increase your muscle strength and make your nerve strong.
You can also take some nutrition from food. We suggest you join USANA Distributor Network and take USANA products to increase your immune system while earning money.
Contraindications
Hypersensitivity
Cautions
Use caution in hepatitis or severe hepatic/renal impairment
Use caution in repeated administration to patients with anemia, or with cardiovascular, pulmonary, or renal disease porphyria
Acetaminophen has been associated with cases of acute liver failure, at times resulting in liver transplantation or death; risk increases in individuals with underlying liver disease, alcohol ingestion, and/or use of more than 1 acetaminophen-containing product (see Black Box Warnings)
Acetaminophen: Risk for rare, but serious skin reactions that can be fatal; these reactions include Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP); symptoms may include skin redness, blisters and rash
Patients with G6PD deficiency
Butalbital may cause sedation; avoid driving a car, operating machinery, or administering with other CNS depressants (eg, alcohol)
Caution with special-risk patients (eg, elderly or debilitated or those with severe renal or hepatic dysfunction or with acute abdominal conditions)
Overuse of barbiturate-containing medications
- Based on the American Academy of Neurology guidelines, limit and carefully monitor use of butalbital-containing agents
- Don’t use opioid or butalbital treatment for migraine except as a last resort
- Any use of barbiturates and opiates was associated with increased risk of transformed migraine after adjusting for covariates
- Limit and carefully monitor their use (butalbital-containing agents) based on overuse, medication overuse headache, and withdrawal concerns
- Butalbital may be habit-forming; for short-term use only
Pregnancy & Lactation
Pregnancy
Case reports of withdrawal seizures in newborns whose mothers had taken butalbital-containing drug during pregnancy
Lactation
Excreted in breast milk in small amounts; not recommended
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.