acetaminophen/butalbital/caffeine (Fioricet, Esgic)
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Introduction
325 mg acetaminophen + 50 mg butalbital + 40 mg caffeine.
Indications
- relief of symptomatic complex of tension or muscle contraction headache
Contraindications
- patients with porphyria
Dosage
1-2 tabs PO every 4 hours; max 6 tabs/day
Tabs:
- new tablets (2014) with 300 mg of acetaminophen (rather than 325 mg)[3]
Pharmacokinetics
elimination: liver > kidney
Adverse effects
- dizziness, drowsiness, nausea, dyspepsia, mental depression, paradoxical excitement, anemia, dyspnea, anaphylaxis, hypotension, hallucinations, hepatotoxicity, thrombocytopenia, leukopenia, anemia, respiratory depression
Drug interactions
- decreased effect of:
- increased effect of:
- drug interaction(s) of acetaminophen in combination with GLP1-agonist
- drug interaction(s) of acetaminophen in combination with phenylephrine
- drug interaction(s) of alcoholic beverage with acetaminophen
- drug interaction(s) of ethanol with acetaminophen
- drug interaction(s) of MAO inhibitor with caffeine
- drug interaction(s) of methotrexate with caffeine
Mechanism of action
- similar to other barbiturates: generalized CNS depression
More general terms
Components
- acetaminophen (Tylenol, Paracematol, Panadol, Tempra, Datril, APAP, non-Aspirin)
- butalbital; allylbarbital (Profundol, Sandoptal)
- caffeine (NoDoz, Vivarin)
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998. - not on National VA formulary
- ↑ 3.0 3.1 Prescriber's Letter 21(3): 2014 (subscription needed) http://www.prescribersletter.com