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Description
Butalbital and acetaminophen (byoo-TAL-bi-tal and a-seat-a-MIN-oh-fen) combination is a pain reliever and relaxant. It is used to treat tension headaches. Butalbital belongs to the group of medicines called barbiturates (bar-BI-tyoo-rates) . Barbiturates act in the central nervous system (CNS) to produce their effects.

When you take butalbital for a long time, your body may get used to i t so that larger amounts are needed to produce the same effects. This is called tolerance to the medicine. Also, butalbital may become habit-forming (causing mental or physical dependence) when it is used for a long time or in large doses. Physical dependence may lead to withdrawal side effects when you stop taking the medicine.

Other medical problems
ChildrenˇX

- For butalbital: Although barbiturates such as butalbital often cause drowsiness, some children become excited after taking them.
- For acetaminophen: Acetaminophen has been tested in children and, in effective doses, has not been shown to cause different side effects or problems than it does in adults.
- For caffeine: There is no specific information comparing use o f caffeine in children up to 12 years of age with use in other age groups. However, caffeine is not expected to cause different side effects or problems in children than it does in adults.

Possible food and drug interactions when taking this medication
Do not take acetamino phenbutalbital caffeine - Esgic if you have taken monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the las t 14 days. Dangerous side effects could result. Acetaminophen and butalbital may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedative s (used to treat insomnia), other pain relievers, anxiety medicines, and muscle relaxants.

Overdose
Seek emergency medical attention. Symptoms of an acetamino phenbutalbita lcaffeine - Esgic overdose include insomnia, restlessness, tremor, nausea, vomiting, diarrhea, abdominal pain, sweating, seizur es, drowsiness, decreased breathing,

What side effects may occur?
If you experience any of the following serious side effects, stop taking acetaminophenbutalbitalcaffeine and seek emergency medical attention: an allergic reaction (difficulty breathing; closing of yo ur throat; swelling of your lips, tongue, or face; or hives); slow, weak breathing; liver damage (yellowing of the skin or eyes, nausea, abdominal pain or discomfort, unusual bleeding or bruising, sev ere fatigue); blood problems (easy or unusual bleeding or bruising); or low blood sugar (fatigue, increased hunger or thirst,

What special precautions should I follow?
If you think you or anyone else may have taken an overdose of this medicine, get emergency help at once. Taking an overdose of this medicine or taking alcohol or CNS depressants with this medicine may lead to unconsciousness or possibly death. Signs of butalbital overdose include severe drowsiness, confusion, severe weakness, shortness of breath or unusually slow or troubled breathing, slurred spe ech, staggering, and unusually slow heartbeat. Signs of severe acetaminophen poisoning may not occur until 2 to 4 days after the overdose is taken, but treatment to prevent liver damage or death must be started within 24 hours or less after the overdose is taken.


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