butalbital/acetaminophen/caffeine (Alagesic LQ, Capacet, Dolgic Plus, Esgic, Fioricet, and Others)

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GENERIC NAME: butalbital/acetaminophen/caffeine

BRAND NAME: Alagesic LQ, Capacet, Dolgic Plus, Esgic, Esgic-Plus, Fioricet, Dolgic LQ, Ezol, Geone, Margesic, Nonbac, Orbivan, Repan, Zebutal

DRUG CLASS AND MECHANISM: Butalbital/acetaminophen/caffeine is a combination product used for treating headache.

Butalbital is a narcotic that depresses the central nervous system.

Acetaminophen is a pain reliever and fever reducer. It is the active compound in Tylenol. Acetaminophen relieves pain by elevating the pain threshold, that is, by requiring a greater amount of pain to develop before a person feels it. It reduces fever through its action on the heat-regulating center of the brain. Specifically, it tells the center to lower the body's temperature when the temperature is elevated.

Caffeine has pain relieving properties and may boost the action of other pain relievers by mechanisms that are not well understood. It may reduce the activity of pain sensing nerves in the brain. The FDA approved butalbital/acetaminophen/caffeine in November 1984.

Patients taking combination drugs of butalbital, acetaminophen, and caffeine should review the patient safety information such as specific side effects, drug interactions, and pregnancy safety for each of these drugs.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS:

  • Alagesic LQ is available in tropical fruit punch flavor, oral solution form. It contains 50 mg butalbital, 325 mg acetaminophen, and 40 mg caffeine per 15 ml of solution. It contains 7.368% alcohol. It is available in 16 fluid ounce containers.
  • Capacet, Esgic, Fioricet, Margesic, Orbivan, and generic capsules contain butalbital/ acetaminophen/caffeine in 50 mg/325 mg/40 mg strengths.
  • Esgic, Fioricet, Nonbac, Repan and generic tablets are available in 50 mg/325 mg/40 mg strengths.
  • Esgic-Plus, Zebutal, and generic tablets are available in 50 mg/500 mg/40 mg strengths.
  • Dolgic Plus tablets are available in 50 mg/750 mg/40 mg strength.
  • Generic tablets are also available in reformulated strengths, which contain 300 mg acetaminophen.

STORAGE: Alagesic LQ is stored at room temperature between 20 C to 25 C (68 F to 77 F). Butalbital / acetaminophen / caffeine containing tablets and capsules should be stored between 15 C to to30 to C (59 F to to 86 F).

PRESCRIBED FOR: Butalbital/acetaminophen/caffeine is used for complex of tension or muscle contraction headaches.

DOSING:

Adults and children of 12 years of age and older

  • 50/325/40 mg tablets or capsules: Take 1 to 2 tablets by mouth every 4 hours. Maximum of 6 doses per day. Not to exceed 4000 mg of acetaminophen per day to avoid liver injury.
  • Dolgic Plus (50/750/40 mg): Take 1 tablet by mouth every 4 hours. Maximum of 5 tablets per day.
  • Alagesic LQ: Take 1 to 2 tablespoons (15-30 ml) by mouth every 4 hours. Maximum daily dose of 6 tablespoons (180 ml) per day.
  • Safe and effective use of butalbital/acetaminophen/caffeine is not established in children under 12 years of age.

DRUG INTERACTIONS: Butalbital/acetaminophen/caffeine should not be used with MAOI (monoamine oxidase inhibitors) like phenelzine (Nardil) and selegiline (Emsam) because they can significantly increase central nervous system effects of butalbital and increased blood levels of caffeine.

Butalbital can increase the effects of narcotic pain killers, alcohol, sedative or hypnotic medications, and other medications that depress the central nervous system. Loss of consciousness, troubled breathing, lowered heart rate, coma, and in severe cases death can occur.

PREGNANCY: There are no adequate studies done on butalbital/acetaminophen/caffeine to determine its safe and effective use in pregnant women.

Medically Reviewed by a Doctor on 6/23/2014



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