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Butalbital/acetaminophen
Combination medication From Wikipedia, the free encyclopedia
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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 2022, the combination butalbital/acetaminophen/caffeine was the 248th most commonly prescribed medication in the United States, with more than 1 million prescriptions.[13][14]
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Medical uses
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
Prolonged use can cause rebound headaches.[16]
Rarely, use of barbiturates can lead to Stevens–Johnson syndrome.[17]
Mechanism of action
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
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