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Butalbital/acetaminophen
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Butalbital/acetaminophen

Butalbital/acetaminophen
Combination of
ButalbitalBarbiturate
AcetaminophenMiscellaneous analgesic
Clinical data
Trade namesAllzital, Butapap, Tencon, others
AHFS/Drugs.comProfessional Drug Facts
License data
Routes of
administration
By mouth
ATC code
Legal status
Legal status
Identifiers
CAS Number
ChemSpider
  • none
KEGG
Butalbital/acetaminophen/caffeine
Combination of
ButalbitalBarbiturate
AcetaminophenMiscellaneous analgesic
CaffeineXanthine
Clinical data
Trade namesAnoquan, Fioricet, Triad, others
AHFS/Drugs.comProfessional Drug Facts
MedlinePlusa601009
License data
Routes of
administration
By mouth
ATC code
  • None
Legal status
Legal status
Identifiers
CAS Number
ChemSpider
  • none
KEGG

Butalbital/acetaminophen, sold under the brand name Butapap among others, is a combination medication used to treat tension headaches and migraine headaches.[1][4][5] It contains butalbital, a barbiturate and paracetamol (acetaminophen), an analgesic.[4] Versions also containing caffeine are sold under the brand name Fioricet among others.[6] It is taken by mouth.[4][3] The combination is also sold with codeine.[7]

The most common side effects include sleepiness, dizziness, trouble breathing, and abdominal pain.[4] Other severe side effects may include liver problems, confusion, addiction, and allergic reactions.[4] Frequent use may result in medication overuse headache.[8] Barbiturate withdrawal may occur if rapidly stopped following long term use.[9] Use is not generally recommended during pregnancy or breastfeeding.[10]

The combination was approved for medical use in the United States in 1984.[4] It is available as a generic medication.[6] In the United States it is a schedule III controlled substance[2] in some states but not federally.[5][11][12] It is banned in a number of European countries.[9]

In 2023, the combination butalbital/acetaminophen/caffeine was the 262nd most commonly prescribed medication in the United States, with more than 1 million prescriptions.[13][14]

Medical uses

[edit]

Butalbital/acetaminophen is indicated for the treatment of tension headaches.[15]

Butalbital/acetaminophen/caffeine is indicated for the treatment of tension headaches.[3]

Side effects

[edit]

Prolonged use can cause rebound headaches.[16]

Rarely, use of barbiturates can lead to Stevens–Johnson syndrome.[17]

Mechanism of action

[edit]

Butalbital has a half-life of about 35 hours. Acetaminophen has a half-life of about 1.25 to 3 hours, but may be increased by liver damage and after an overdose. Caffeine has a half-life of about 2.5 to 4.5 hours.[18]

References

[edit]
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