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What is this medicine
Acetaminophen ispain reliever and fever reducer. Butalbital is inclass of drugs called barbiturates that slow down your central nervous system (brain and nerve impulses) causing relaxation. Caffeine i s believed to constrict dilated blood vessels that may contribute to tension headaches. Together, acetaminophen, butalbital, and caffeine - Esgic is used to relieve complex tension (muscle contraction ) headaches although precisely how it works is unknown. Acetamino phenbutalbital caffeine - Esgic may also be used for purposes other than those listed in this medication guide.

How should you take this medication?
Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. If butalbital and acetaminophen co mbination is taken regularly (for example, every day), it may become habit-forming (causing mental or physical dependence). The caffeine in some butalbital and acetaminophen combinations can also incr ease the chance of dependence. Dependence is especially likely to occur in patients who take these medicines to relieve frequent headaches. Taking too much of this medicine may also lead to liver dama ge or other medical problems.

Symptoms of overdose
Anxiety, confusion, excitement, irritability, nervousness, restlessness, or trouble in sleeping (severe, especially with products containing caffeine) ; convulsions (seizures) (for products containin g caffeine); diarrhea, especially if occurring together with increased sweating, loss of appetite, and stomach cramps or pain; dizziness, lightheadedness, drowsiness, or weakness, (severe) ; freque nt urination (for products containing caffeine) ; hallucinations (seeing, hearing, or feeling things that are not there); increased sensitivity to touch or pain (for products containing caffeine); muscle trembling or twitching (for products containing caffeine); nausea or vomiting, sometimes with blood;

Possible food and drug interactions when taking this medication
It is especially important that your health care professional know if you are taking any of the following:

- Antidepressants, tricyclic (amitriptyline [e.g., Elavil], amoxapine [e.g., Asendi n], clomipramine [e.g., Anafranil], desipramine [e.g., Pertofrane], doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g., Aventyl], protriptyline [e.g., Vivactil], trimipramine [ e.g., Surmontil]) or
- Central nervous system (CNS) depressants (medicines that often cause drowsiness)ˇXThese medicines may add to the effects of butalbital and increase the chance of drowsiness or other side effects
- Divalproex (e.g., Depakote) or
- Valproic acid (e.g., Depakene)ˇXThe chance of side effects may be increased

What side effects may occur?
Although side effects from acetaminophen, butalbital, and caffeine are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:

- drowsiness
- upset stomach
- vomiting
- stomach pain
- depression
- lightheadedness
- confusion

If you experience any of the following symptoms, call your doctor immediately:
- skin rash
- itching
- difficulty breathing

Missed Dose
Take the missed dose as soon as you remember. Do not takedouble dose of Esgic . Wait the prescribed amount of time before taking your next dose.


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