butalbital; allylbarbital (Profundol, Sandoptal)

Introduction

50 mg used in combination with analgesics, acetaminophen or aspirin +/- caffeine.

Adverse effects

• common (> 10%)
  • dizziness, lightheadedness, drowsiness, "hangover effect", nausea, heartburn, stomach pains, dyspepsia, epigastric discomfort
• less common (1-10%)
  • confusion, mental depression, unusual excitement, nervousness, constipation, faint feeling, headache, vomiting, insomnia, nightmares, weakness, tiredness, hemolytic anemia, skin rash, dyspnea, gastrointestinal ulceration, anaphylactic shock
• uncommon (< 1%)
  • leukopenia, agranulocytosis, thrombocytopenia megaloblastic anemia, iron deficiency anemia occult bleeding, prolongation of bleeding time exfoliative dermatitis, Stevens-Johnson syndrome hypotension, thrombophlebitis respiratory depression, bronchospasm insomnia, nervousness, hallucinations hepatotoxicity, renal insufficiency
• other
  • coma
  • tolerance
  • dependence

• drug adverse effects of psychotropic agents
• drug adverse effects of sedatives

Drug interactions

• barbiturates induce CYP1A2, CYP2C9 & CYP3A4
  • may diminish levels of drugs metabolized by CYP1A2, CYP2C9 & CYP3A4

• drug interaction(s) of beta-adrenergic receptor antagonists with barbiturates
• drug interaction(s) of gabapentinoid with psychotropic agent

Laboratory

• butalbital in specimen
  • butalbital in hair
  • butalbital in gastric fluid
  • butalbital in meconium
  • butalbital in saliva
  • butalbital in serum/plasma/blood
    • butalbital in blood
    • butalbital in serum/plasma
  • butalbital in stool
  • butalbital in urine
  • butalbital in vitreous fluid

More general terms

• barbiturate
• sedative/hypnotic (tranquilizer)

Additional terms

• cytochrome p450 1A2 (cytochrome P3-450, phenacetin deethylase, cytochrome p450-4, CYP1A2)
• cytochrome P450 2C9; cytochrome P450 BP-1; cytochrome P450 MP-4; S-mephenytoin-4-hydroxylase; limonene 6-monooxygenase; limonene 7-monooxygenase (CYP2C9, CYP2C10)
• cytochrome P450 3A4 (cytochrome P450 C3, nifedipine oxidase, P450-PCN1, NF-25, CYP3A4)

Component of

• acetaminophen/butalbital/caffeine/codeine (Fioricet with Codeine)
• aspirin/butalbital/caffeine (Fiorinal)
• aspirin/butalbital/caffeine/codeine (Fiorinal with Codeine)
• acetaminophen/butalbital/caffeine (Fioricet, Esgic)
• acetaminophen/butalbital (Phrenilin)

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=2481
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=8275
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=31986