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Butalbital/acetaminophen/caffeine (By mouth)

Acetaminophen (a-seet-a-MIN-oh-fen), Butalbital (bue-TAL-bi-tal), Caffeine (KAF-een)

Treats tension (or muscle contraction) headaches. This medicine contains a barbiturate.

Brand Name(s):

Alagesic LQ, Capacet, Dolgic Plus, Esgic, Esgic-Plus, Fioricet, Margesic, Nonbac, Orbivan, Repan, Zebutal

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

Do not use this medicine if you have had an allergic reaction to acetaminophen, butalbital, or caffeine. Do not use this medicine if you have an enzyme problem called porphyria.

How to Use This Medicine:

Capsule, Liquid, Tablet

  • Take your medicine as directed.
  • This medicine contains acetaminophen. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Do not use more than 4 grams (4,000 milligrams) total of acetaminophen in one day.
  • Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
  • Take this medicine with food or milk if it upsets your stomach.

If a dose is missed:

  • Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you are also using an MAO inhibitor (such as Eldepryl®, Marplan®, Nardil®, or Parnate®) or a tranquilizer (such as chlordiazepoxide or Librium®).
  • Many combination medicines contain acetaminophen, including products with brand names such as Alka-Seltzer Plus®, Comtrex®, Drixoral®, Excedrin Migraine®, Midol®, Sinutab®, Sudafed®, Theraflu®, and Vanquish®. Carefully check the labels of all other medicines you are using to be sure they do not contain acetaminophen.
  • Tell your doctor if you drink alcohol or if you are using any medicine that makes you sleepy, such as allergy medicine or narcotic pain medicine.
  • Do not drink alcohol while you are using this medicine. Large doses of acetaminophen can damage your liver. Alcohol can also increase this risk. Tell your doctor if you drink 3 or more alcoholic drinks a day.

Warnings While Using This Medicine:

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney or liver disease, or a stomach disorder. Tell your doctor if you have a history of alcohol or drug abuse.
  • This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working.
  • Tell your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, or yellow eyes or skin. These could be symptoms of a serious liver problem.
  • This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
  • Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
  • Long-term use of this medicine is not recommended.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Blistering, peeling, or red skin rash
  • Dark-colored urine or pale stools
  • Nausea, vomiting, loss of appetite, or pain in the upper stomach
  • Trouble breathing
  • Unusual bleeding, bruising, or weakness
  • Yellowing of your skin or the whites of your eyes

If you notice these less serious side effects, talk with your doctor:

  • Confusion, trouble concentrating, unsteadiness
  • Mild dizziness, sleepiness, or tiredness
  • Mild nausea, vomiting
  • Rapid heartbeat, irritability, or tremors

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088


Last Updated: 10/4/2014


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