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 2021, the combination butalbital/acetaminophen/caffeine was the 232nd most commonly prescribed medication in the United States, with more than 1 million prescriptions.[11][12] In the United States it is a schedule III controlled substance[2] in some states but not federally.[5][13][14] It is banned in a number of European countries.[9]

  1. ^ a b "Butapap- butalbital and acetaminophen tablet". DailyMed. U.S. National Library of Medicine. 17 January 2020. Retrieved 10 April 2020.
  2. ^ a b "Allzital- butalbital and acetaminophen tablet". DailyMed. U.S. National Library of Medicine. 17 December 2019. Retrieved 18 April 2020.
  3. ^ a b "Fioricet- butalbital, acetaminophen, and caffeine capsule". DailyMed. U.S. National Library of Medicine. 27 January 2020. Retrieved 10 April 2020.
  4. ^ a b c d e f "Butalbital and Acetaminophen - FDA prescribing information, side effects and uses". Drugs.com. Retrieved 18 April 2019.
  5. ^ a b "Fioricet Capsules (acetaminophen/butalbital/caffeine)". Prescribers' Digital Reference. Retrieved 18 April 2019.
  6. ^ a b Hamilton RJ (2009). Pharmacopoeia. Jones & Bartlett Learning. p. 3. ISBN 978-0-7637-7419-6.
  7. ^ "Fioricet with Codeine- butalbital, acetaminophen, caffeine, and codeine phosphate capsule". DailyMed. U.S. National Library of Medicine. 7 February 2020. Retrieved 10 April 2020.
  8. ^ Mallick-Searle T (2015). "Headaches". In Woo TM, Robinson MV (eds.). Pharmacotherapeutics for Advanced Practice Nurse Prescribers. F.A. Davis. p. 1057. ISBN 978-0-8036-4581-3.
  9. ^ a b Young WB, Siow HC (April 2002). "Should butalbital-containing analgesics be banned? Yes". Current Pain and Headache Reports. 6 (2): 151–155. doi:10.1007/s11916-002-0012-y. PMID 11872187. S2CID 20095800.
  10. ^ "Acetaminophen / butalbital Use During Pregnancy". Drugs.com. Retrieved 18 April 2019.
  11. ^ "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.
  12. ^ "Acetaminophen; Butalbital; Caffeine - Drug Usage Statistics". ClinCalc. Retrieved 14 January 2024.
  13. ^ "Substances Containing Butalbital Have Long Been Schedule III; What About Fioricet and Fiorinal?" (PDF). West Virginia Board of Pharmacy. September 2014. Retrieved 8 June 2019.
  14. ^ "Butalbital". Drugs Details. Retrieved 18 April 2020.