Butalbital is a medication within the drug classification known as barbiturates. It is taken orally to treat a variety of mild to moderate conditions. Barbiturates act primarily on the central nervous system (CNS) and have an intermediate duration of action compared to common over-the-counter medications.
Butalbital is most commonly combined with acetaminophen and caffeine to achieve the most desirable effects.
Butalbital, acetaminophen, and caffeine is a combination drug available in tablet, capsule, and solution form.
Acetaminophen is a commonly used pain reliever and fever reducer, and caffeine is a stimulant that increases the effect of pain relievers.
Both butalbital and caffeine use can lead to low, moderate, or high physical dependence, though caffeine withdrawal is typically a milder and less serious issue. Acetaminophen is not a habit-forming substance, but it can have serious effects, such as liver damage, when taken in high doses.
The combination drug butalbital, acetaminophen, and caffeine is only available with a doctor’s prescription.
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Butalbital is used primarily in treating tension headaches, also known as stress headaches. These are classified as attacks that:
Butalbital should not be used for the treatment of migraine headaches. It is a prescription drug that should only be used on the professional medical advice of a licensed healthcare provider.
Though used mainly for treating headaches, butalbital can also be used as a sedative to treat anxiety, seizures, and, in some cases, insomnia.
There are several common and infrequent side effects of butalbital, including:
Rare side effects of butalbital include:
Butalbital has a high potential for addiction and physical dependence on the drug. Tolerance to this medication, as well as other barbiturates, can occur in a relatively short time span, often leading to higher dosage and more potential for misuse.
Some signs of butalbital addiction include:
Behavioral treatments are often necessary to change the patient’s mindset and avoid relapse for butalbital. Cognitive behavioral therapies can be done as both outpatient (from home) and inpatient (from a medical facility) treatments.
Inpatient treatment is generally more effective as the patient will have access to constant medical and professional care.
Outpatient treatment can also be problematic due to a lack of supervision and potential home factors (such as social environment) that may have contributed to butalbital abuse in the first place.
Butalbital is a barbiturate drug, which is a class of CNS depressants. This class of medication acts on the central nervous system as a depressant. They are effective as anticonvulsants, but they also carry habit-forming potential. Benzodiazepines have replaced barbiturates in recent years for several types of treatment.
Fioricet is not the same as butalbital, but it does contain this barbiturate compound. Fioricet is a brand name drug containing butalbital, acetaminophen, and caffeine in one oral tablet or capsule. This medication is very similar to esgic, fiorinal, orbivan, repan, margesic, phrenilin, and phenobarbital, all of which contain butalbital and some form of pain reliever.
Though it is used primarily to treat tension headaches, butalbital can also be prescribed to treat anxiety. This was once used as a common medication to treat this condition, but it has become less prescribed in favor of benzodiazepines, which are more widely used today.
In addition to those listed above, possible adverse effects of the combination drug of acetaminophen, butalbital, and caffeine include:
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U.S. Food and Drug Administration. “Butalbital, Acetaminophen, Caffeine, and Codeine Phosphate Capsules for Oral Use.” FDA. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020232s041lbl.pdf
National Library of Medicine. “Butalbital.” NLM. https://pubchem.ncbi.nlm.nih.gov/compound/Butalbital
National Institute of Health. “Harmful Drug Interactions.” NIH https://www.niaaa.nih.gov/sites/default/files/publications/Harmful_Interactions.pdf
National Highway Traffic Safety Administration. “2013–2014 National Roadside Study of Alcohol and Drug Use by Drivers.” NHTSA https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/documents/13013-nrs_drug_092917_v6_tag.pdf