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Bac

Butalbital-Acetaminophen-Caffeine is a combination medication used primarily to treat tension headaches. Tension headaches are often characterized by a constant, dull pain, typically described as a tight band around the head. This medication combines three active ingredients: butalbital, a barbiturate that helps to relax muscle contractions involved in a tension headache; acetaminophen, a pain reliever and fever reducer; and caffeine, which enhances the pain-relieving effects of acetaminophen and constricts blood vessels to improve blood flow and reduce headache symptoms.


Drug Availability and Controlled Substance Status


Butalbital-Acetaminophen-Caffeine is available by prescription only. It is not classified as a controlled substance on its own, but due to the presence of butalbital, a barbiturate, it is considered to have some potential for abuse or dependence. The medication is typically supplied in tablet or capsule form.



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Frequently Asked Questions

How long does it take for Butalbital-Acetaminophen-Caffeine to start working?
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This medication typically begins to relieve headache symptoms within 30 minutes to 1 hour after taking it. The effects can last for several hours.

Can I take Butalbital-Acetaminophen-Caffeine with other headache medications?
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You should avoid taking other medications containing acetaminophen to prevent exceeding the daily recommended dose, which could lead to liver damage. Always consult your healthcare provider before combining medications.

What should I do if I miss a dose?
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Since this medication is taken as needed for headaches, there is no regular dosing schedule. If you miss a dose, take it as soon as you remember, but do not double up to make up for a missed dose.

Is it safe to use Butalbital-Acetaminophen-Caffeine during pregnancy?
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This medication is generally not recommended during pregnancy, particularly in the third trimester, due to the potential risks to the fetus. Pregnant women should consult their healthcare provider for alternative treatment options.

Can I drive after taking Butalbital-Acetaminophen-Caffeine?
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Butalbital can cause drowsiness or dizziness. You should avoid driving or operating heavy machinery until you know how the medication affects you.

Comprehensive Drug Guide

How Does Bac Work?

Mechanism of Action

  • Butalbital: Works as a central nervous system depressant, helping to relax muscle contractions involved in tension headaches. It also has sedative properties that can help reduce anxiety and stress, which may contribute to headache relief.
  • Acetaminophen: Reduces pain by inhibiting the synthesis of prostaglandins in the brain, which are chemicals that can cause pain and inflammation. It also works as a fever reducer.
  • Caffeine: Constricts blood vessels in the brain, which can reduce headache pain. It also enhances the effectiveness of acetaminophen and helps increase alertness.

Common Dosages

The typical dosage for adults is one to two tablets or capsules taken every 4 hours as needed for headache relief. The maximum recommended daily dose is usually limited to six tablets or capsules per day to reduce the risk of liver damage from acetaminophen and other side effects.


Typical Dosing


  • Adults: One or two tablets or capsules every 4 hours as needed, not to exceed six doses in 24 hours.
  • Pediatric: Not typically recommended for children under 12 years of age without specific medical advice.

Typical Dosing

FDA Approved Indications

Butalbital-Acetaminophen-Caffeine is FDA-approved for the treatment of tension headaches. It is not intended for the treatment of other types of headaches, such as migraines, nor is it recommended for prolonged or frequent use due to the risk of dependence and overuse headaches.

Who Shouldn't Take Bac?

Butalbital-Acetaminophen-Caffeine is contraindicated in patients with:

  • A history of hypersensitivity to any of the components.
  • Porphyria (a rare genetic disorder).
  • Severe hepatic impairment.
  • Those taking other central nervous system depressants, alcohol, or sedatives due to the increased risk of side effects.
  • It should be used with caution in patients with a history of drug or alcohol dependence.


Advice From The Pharmacist

Patients should take Butalbital-Acetaminophen-Caffeine exactly as prescribed and avoid exceeding the recommended dose due to the risk of liver damage from acetaminophen and the potential for dependence on butalbital. Patients should also be advised not to consume alcohol while taking this medication, as it can increase the risk of liver damage and enhance the sedative effects of butalbital. If the medication is used frequently or over an extended period, there is a risk of developing medication overuse headaches, so patients should be advised to use it only as needed for headache relief.

Side Effects of Bac

Common Side Effects

Common side effects may include:

  • Drowsiness or dizziness
  • Lightheadedness
  • Nausea or vomiting
  • Abdominal pain


Uncommon/Severe Side Effects

Serious side effects can include:

  • Respiratory depression (especially in overdose)
  • Hepatotoxicity (liver damage) due to acetaminophen overdose
  • Dependence or withdrawal symptoms with prolonged use of butalbital

Patients should seek immediate medical attention if they experience symptoms of an allergic reaction (such as rash, itching, swelling, severe dizziness, or trouble breathing), or signs of liver damage (such as dark urine, persistent nausea or vomiting, yellowing of the skin or eyes).



Risks and Warnings of Bac

  • Liver Damage: Acetaminophen is associated with a risk of severe liver damage, especially at higher doses or with alcohol consumption. Patients should be cautious about using other products containing acetaminophen.
  • Dependency and Abuse: Butalbital can be habit-forming, leading to physical or psychological dependence, especially with prolonged use.
  • Overuse Headache: Frequent use of Butalbital-Acetaminophen-Caffeine can lead to rebound headaches, also known as medication overuse headaches.
  • Sedation: The sedative effects of butalbital can impair the ability to drive or operate machinery.

Interactions with Bac

Common Drug Interactions

  • Alcohol: Increases the risk of liver damage and enhances the sedative effects of butalbital.
  • Other CNS Depressants: Combining with other sedatives, tranquilizers, or alcohol can increase the risk of sedation and respiratory depression.
  • Anticoagulants: Caffeine may interact with anticoagulants like warfarin, affecting their efficacy.
  • Certain Antidepressants and Anxiolytics: These may increase the sedative effects of butalbital.

Patients should inform their healthcare provider about all medications they are taking, including over-the-counter drugs and supplements.



Alternatives to Bac

Alternatives to Butalbital-Acetaminophen-Caffeine for treating tension headaches include:

  • Over-the-counter NSAIDs: Such as ibuprofen (Advil) or naproxen (Aleve).
  • Other prescription medications: Such as muscle relaxants or different types of analgesics depending on the patient's condition.
  • Non-pharmacological treatments: Such as stress management techniques, physical therapy, or acupuncture.