18 . July , 2019 - Thursday
Check todays hot topics or new products

Find a Drug: Advanced

Please Sign in or Register

All about: Butalbital/Acetaminophen/Caffeine/Codeine Phosphate

Big Image Pronouncation: (BYOO-TAL-bih-tuhl/uh-seet-uh-MIN-oh-fen/kaff-EEN/KOE-deen FOSS-fate)
Class: Narcotic analgesic

Trade Names:
Fioricet with Codeine
- Capsules 30 mg codeine phosphate/325 mg acetaminophen/40 mg caffeine/50 mg butalbital

Mechanism of Action


Butalbital has generalized depressant effect on CNS and, in very high doses, has peripheral effects. Acetaminophen has analgesic and antipyretic effects; its analgesic effects may be mediated through inhibition of prostaglandin synthetase enzyme complex. Caffeine is thought to produce constriction of cerebral blood vessels. Codeine binds to opiate receptors in the CNS, causing inhibition of ascending pain pathways and altering perception of and response to pain.

Indications and Usage

Relief of symptom complex of tension (or muscle contraction) headache.


Hypersensitivity to acetaminophen, caffeine, opiates, or barbiturates; porphyria.

Dosage and Administration

Adults and Children 12 yr of age and older

PO 1 to 2 tablets or capsules every 4 h; max, 6 tablets or capsules/day.


Store in airtight, light-resistant container at room temperature.

Drug Interactions

Beta-blockers (eg, propranolol), corticosteroids, doxycycline, estrogens (including oral contraceptives), felodipine, griseofulvin, nifedipine, phenylbutazone, quinidine, theophylline, warfarin

Effects of these drugs may be decreased.

Carbamazepine, sulfinpyrazone

May increase risk of hepatotoxicity.


May increase CNS effects.

Other CNS depressants (eg, ethanol, narcotics, general anesthetics, tranquilizers, sedative-hypnotics)

Increased drowsiness, dizziness and other CNS depressive effects may occur.

Tricyclic antidepressants

Antidepressant effects may decrease.

Laboratory Test Interactions

With Chemstrip bG and Dextrostix home blood glucose systems, may cause false decrease in mean glucose values; may increase serum amylase; may give false-positive urinary 5-hydroxyindoleacetic acid test results.

Adverse Reactions




Drowsiness; dizziness; lightheadedness; confusion; intoxicated feeling.




Nausea; vomiting; flatulence; constipation.


Shortness of breath.



Category C .




Safety and efficacy in children younger than 12 yr of age not established.

Labor and Delivery

Delivery may be prolonged and newborn may experience respiratory depression or withdrawal.

Drug dependency

Prolonged use may produce drug tolerance and dependency (psychologic and physical).

Head injury

Respiratory depressant effects may be enhanced and CSF pressure may be increased.



Blood dyscrasias, respiratory depression, hepatic damage, drowsiness, confusion, coma, hypotension, hypovolemic shock, nausea, tremor, vomiting, tachycardia, insomnia, restlessness.

Patient Information

  • Caution patient that dependency/tolerance may result from long-term use.
  • Remind patient to take medication with full glass of water.
  • Instruct patient not to discontinue drug abruptly after long-term regular use.
  • Caution patient to avoid intake of alcoholic beverages and other CNS depressants without health care provider approval.
  • Caution patient to avoid any hazardous activity (eg, driving, operating heavy machinery) if dizziness, drowsiness, or a decrease in mental acuity occurs.
  • Warn patient that orthostatic hypotension may occur. Instruct patient to change positions slowly and to sit or lie down if symptoms occur.
  • Warn patient that constipation could occur. Advise patient to increase dietary fiber and fluids unless contraindicated.
  • Instruct patient to report these symptoms to health care provider: persistent or recurrent pain occurs before next scheduled dose, difficulty breathing, blurred vision, increased drowsiness, vomiting, constipation, urinary retention, yellowing of skin or gums.

Recent Drug Updates at DrugIndexOnline:

Aloxi Aloxi
Generic Name: palonosetron (pa low NO seh tron) Brand Names: Aloxi What is palonosetron? Palonosetron blocks the actions of chemicals in the body that may cause nausea and vomiting. Palonosetron is used to prevent nausea and vomiting associated with cancer chemotherapy. Palonosetron may more...

Co-Gesic Co-Gesic
Generic name: Hydrocodone bitartrate, Acetaminophen Brand names: Norco, Zydone, Maxidone, Lortab, Lorcet, Hydrocet, Co-Gesic, Anexsia, Vicodin Why is Co-Gesic prescribed? Vicodin combines a narcotic analgesic (painkiller) and cough reliever with a non-narcotic analgesic for the relief of moderat more...

Eligard Eligard
Generic Name: leuprolide (LOO pro lide) Brand Names: Eligard, Lupron, Viadur What is leuprolide? Leuprolide is related to a naturally occurring hormone called gonadotropin-releasing hormone (GnRH). GnRH influences the release of the hormones testosterone and estrogen in the body. Leuprol more...

Ethosuximide Ethosuximide
Pronouncation: (ETH-oh-SUX-ih-mide) Class: Succinimide Trade Names: Zarontin - Capsules 250 mg - Syrup 250 mg/5 mL Mechanism of Action Pharmacology Elevates seizure threshold and suppresses paroxysmal spike and wave activity associated with lapses of consciousness common in absence (p more...

Hectorol Capsules Hectorol Capsules
Generic Name: Doxercalciferol Capsules (dox-ehr-kal-SIFF-eh-role) Brand Name: HectorolHectorol Capsules is used for:Lowering elevated parathyroid hormone levels in patients who have chronic kidney disease, including those undergoing kidney dialysis. Hectorol Capsules is a synthetic form of vitam more...

Methadone Methadone
Generic Name: Methadone hydrochloride Dosage Form: Tablets, usp CII Rx only. CONDITIONS FOR DISTRIBUTION AND USE OF Methadone PRODUCTS: Code of Federal Regulations, Title 21, Sec. 291.505 Methadone PRODUCTS, WHEN USED FOR TREATMENT OF NARCOTIC ADDICTION IN DETOXIFICATION OR MAINTENANCE PROGRAMS more...

Original Tegrin Medicated Shampoo Original Tegrin Medicated Shampoo
Generic Name: Allantoin/Coal Tar Shampoo (a-LAN-toyn/kohl tar) Brand Name: Original Tegrin MedicatedOriginal Tegrin Medicated Shampoo is used for:Relieving itching, scaling, dryness, and flaking of the skin due to dandruff, eczema, psoriasis, and seborrhea. It may also be used for other conditio more...

Propoxyphene Compound-65 Propoxyphene Compound-65
Some commonly used brand names are: In the U.S.— Damason-P 5 Darvon Compound-65 9 Empirin with Codeine No.3 2 Empirin with Codeine No.4 2 Endodan 6 Lortab ASA 5 Panasal 5/500 5 PC-Cap 9 Percodan 6 Percodan-Demi 6 Propoxyphene Compound-65 9 Roxiprin 6 Synalgos-DC 1 Talwin Compound 7 In Ca more...