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Butalbital-APAP-Caff-Cod

Butalbital-APAP-Caff-Cod is a combination medication used to treat tension headaches and migraine headaches. This medication contains four active ingredients:

  • Butalbital: A barbiturate that helps relax muscle contractions involved in tension headaches.
  • Acetaminophen (APAP): A pain reliever and fever reducer.
  • Caffeine: A central nervous system stimulant that helps enhance the effectiveness of acetaminophen and butalbital.
  • Codeine: An opioid analgesic that provides additional pain relief by acting on the central nervous system.

This combination is particularly effective in relieving severe headache pain but carries risks associated with its opioid component (codeine) and the barbiturate (butalbital).

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Frequently Asked Questions

How long does it take for Butalbital-APAP-Caff-Cod to start working?
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Butalbital-APAP-Caff-Cod typically begins to relieve headache pain within 30 minutes to an hour after taking the medication.

Can I take Butalbital-APAP-Caff-Cod with other pain relievers?
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You should avoid taking Butalbital-APAP-Caff-Cod with other acetaminophen-containing products to prevent exceeding the maximum daily dose of acetaminophen. Always consult your healthcare provider before combining it with other pain relievers.

What should I do if I miss a dose of Butalbital-APAP-Caff-Cod?
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If you miss a dose, take it as soon as you remember. If it’s close to the time of your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for the missed one.

Is Butalbital-APAP-Caff-Cod safe to use during pregnancy?
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Butalbital-APAP-Caff-Cod should be used during pregnancy only if the potential benefits justify the potential risks to the fetus. Pregnant women should consult their healthcare provider before using this medication.

Can I drive while taking Butalbital-ASA-Caff-Codeine?
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Due to the sedative effects of butalbital and codeine, this medication can impair your ability to drive or operate machinery. Avoid these activities until you know how the medication affects you.

Can Butalbital-APAP-Caff-Cod cause rebound headaches?
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Yes, overuse of Butalbital-APAP-Caff-Cod can lead to medication-overuse headaches, also known as rebound headaches. It’s important to use this medication only as prescribed and not on a regular basis.

Comprehensive Drug Guide

How Does Butalbital-APAP-Caff-Cod Work?

Butalbital: Works by depressing the central nervous system (CNS), leading to relaxation of muscle contractions and sedation, which can help alleviate tension headaches.

Acetaminophen: Reduces the production of prostaglandins in the brain, chemicals that can cause pain and inflammation, thereby relieving headache pain.

Caffeine: Increases the pain-relieving effects of acetaminophen and butalbital by constricting blood vessels and stimulating the CNS.

Codeine: Binds to opioid receptors in the brain and spinal cord to provide additional pain relief.

What is Butalbital-APAP-Caff-Cod Used For?

Tension Headaches: To relieve tension headaches caused by muscle contractions.

Migraine Headaches: Sometimes prescribed off-label for migraine relief.

Common Dosages

Butalbital-APAP-Caff-Cod is available by prescription only. It is classified as a Schedule III controlled substance due to the potential for abuse and dependence associated with the codeine and butalbital components. The medication is available in tablet and capsule forms.

Administration: The medication is taken orally, with or without food. It is important not to exceed the recommended dosage to avoid the risk of serious side effects, including liver damage from acetaminophen, respiratory depression from codeine, and dependency from both codeine and butalbital.

Duration of Use: Butalbital-APAP-Caff-Cod is generally used for short-term relief of severe headache pain. Prolonged use can lead to tolerance, dependence, and rebound headaches.

Typical Dosing

FDA Approved Indications

The typical dosage of Butalbital-APAP-Caff-Cod is:

  • Standard Dose: 1 to 2 tablets or capsules taken every 4 hours as needed for pain relief. The maximum recommended dose is 6 tablets or capsules in 24 hours.

Who Shouldn't Take Butalbital-APAP-Caff-Cod?

Butalbital-APAP-Caff-Cod is contraindicated in patients with:

  • Hypersensitivity to butalbital, acetaminophen, caffeine, codeine, or any other components of the formulation.
  • Porphyria, a rare metabolic disorder, as butalbital can exacerbate this condition.
  • Severe liver disease, due to the risk of acetaminophen-induced hepatotoxicity.
  • Respiratory depression, asthma, or other severe breathing disorders, due to the risk of respiratory depression from codeine.

Advice From The Pharmacist

Patients using Butalbital-APAP-Caff-Cod should be advised to:

  • Take the medication exactly as prescribed and not exceed the recommended dose, especially due to the risk of liver damage from acetaminophen and the potential for addiction from codeine and butalbital.
  • Avoid alcohol and other CNS depressants, as these can enhance the sedative effects of the medication and increase the risk of serious side effects, including respiratory depression.
  • Use the medication only when needed for headache relief and not on a regular basis to avoid dependence and the risk of rebound headaches.
  • Be aware of the symptoms of acetaminophen overdose, such as nausea, vomiting, sweating, and confusion, and seek immediate medical attention if these occur.
  • Report any signs of difficulty breathing, severe drowsiness, or confusion, as these may indicate serious side effects requiring immediate medical attention.


Side Effects of Butalbital-APAP-Caff-Cod

Common Side Effects

  • Drowsiness or dizziness
  • Lightheadedness
  • Nausea or vomiting
  • Constipation
  • Shortness of breath


Uncommon/Severe Side Effects

  • Respiratory Depression: Especially if taken in large amounts or combined with other CNS depressants like alcohol or opioids.
  • Liver Damage: Particularly with excessive use of acetaminophen or in patients with pre-existing liver conditions.
  • Dependency: Due to the butalbital and codeine components, which can lead to tolerance and withdrawal symptoms if the medication is abruptly discontinued.
  • Rebound Headaches: Overuse can lead to medication-overuse headaches, where the headaches become more frequent and severe over time.

Risks and Warnings of Butalbital-APAP-Caff-Cod

Dependency and Withdrawal: Both codeine and butalbital are habit-forming, and prolonged use can lead to dependence, tolerance, and withdrawal symptoms, including anxiety, tremors, and seizures upon abrupt discontinuation.

Hepatotoxicity: High doses of acetaminophen can cause severe liver damage, potentially leading to liver failure, particularly in patients who consume alcohol or have pre-existing liver conditions.

Respiratory Depression: The codeine component can cause serious respiratory depression, particularly in individuals who are opioid-naive or those who take higher doses.

Interactions with Butalbital-APAP-Caff-Cod

Common Drug Interactions

Butalbital-APAP-Caff-Cod may interact with other medications, including:

  • CNS Depressants: Such as benzodiazepines, opioids, and alcohol, which can enhance the sedative effects and increase the risk of respiratory depression.
  • MAO Inhibitors: Which can interact with butalbital and codeine, potentially leading to increased CNS effects.
  • Warfarin: Acetaminophen can increase the effects of warfarin, potentially leading to an increased risk of bleeding.
  • Other Acetaminophen-Containing Products: To avoid exceeding the maximum recommended daily dose of acetaminophen.

Patients should inform their healthcare provider of all medications and supplements they are taking to avoid potential interactions.

Alternatives to Butalbital-APAP-Caff-Cod

Alternative treatments for tension and migraine headaches include:

  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Such as ibuprofen or naproxen, which can be effective in treating headaches without the risk of dependence.
  • Other Analgesics: Such as acetaminophen alone for patients who do not require the sedative effects of butalbital or the opioid effects of codeine.
  • Triptans: For migraines, medications like sumatriptan (Imitrex) can be more specific in targeting the cause of migraine headaches.
  • Relaxation Techniques: Such as stress management, biofeedback, or physical therapy to address the muscle tension that can contribute to headaches.

The choice of treatment depends on the severity of the headaches, patient preferences, and the presence of any co-existing health conditions.