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What Is It
Some butalbital and acetaminophen combinations also contain caffeine (KAF-een) . Caffeine may help to relieve headaches. However, caffeine can also cause physical dependence when it is used for a long time. This may lead to withdrawal (rebound) headaches when you stop taking it.

Butalbital and acetaminophen combination may also be used for other kinds of headaches or other kinds of pain a s determined by your doctor.

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

Special warnings about this medication
The butalbital in this medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressant s are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; other prescription pain medicine; narcotics; other barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Also, drinking large amounts of alcoholic beverages regularly while taking this medicine may increase the chance of live r damage, especially if you take more of this medicine than your doctor ordered or if you take it regularly for a long time.

Proper Use of This Medicine
The combination of acetaminophen, butalbital, and caffeine comes as a capsule and tablet to take by mouth. It usually is taken every 4 hours as needed. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take acetaminophen, butalbital, and caffeine exactly as directed. Do not take more than six tablets or capsules in 1 day. If you think that you need more to relieve your symptoms, call your doctor.

This medication can be habit-forming. Do not take a larger dose, take it more often, or for a longer per iod than your doctor tells you to.

Other Medicines
When you are taking a butalbital and acetaminophen combination, it is especially important that your health care professional know if you are taking any of the following:

- Anticoagulants (b lood thinners), or
- Carbamazepine (e.g., Tegretol) or
- Contraceptives, oral (birth control pills) containing estrogen, or
- Corticosteroids (cortisone-like medicines) or
- Cortic otropin (e.g., ACTH)ˇXButalbital may make these medicines less effective

What special precautions should I follow?
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For butalbital and acetaminophen combinat ions, the following should be considered:

AllergiesˇXTell your doctor if you have ever had any unusual or allergic reaction to butalbital or other barbiturates, or to acetaminophen, aspirin, r caffeine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.


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