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  Butalbital
Drug Uses
Butalbital is a non-narcotic, sedative barbiturate; in combination with aspirin+caffeine it’s called Fiorinal, helps to treat different kinds of pain including headaches. It’s also a muscle relaxant prescribed to the ones suffering from pain the reason for which may be stress as well as muscle contraction. It’s more effective as a pain-killer than when they are taken alone. Fiorinal with codeine has got the same generic ingredients including codeine. This medicine serves for the same purpose, though it’s a narcotic pain-killer. The use, doses, precautions, side effects, symptoms of overdose and storage is the same as for Fiorinal. Butalbital as a barbiturate acts in the CNS decreasing its activity and intensifying the action of alcohol, that’s why when taking any medicine containing it, one is not to drink alcohol beverages. Butalbital+acetaminophen+caffeine+codeine combination is called Fioricet, acts both as a relaxant and a pain-killer. It’s also used for different kinds of headaches and pain the reason for which are muscle contractions in the shoulder area, head and neck.
How Taken
Taken in prescribed doses in capsules and tablets to relieve pain.
One needs prescription for these medications. One should take the medicine strictly following the doctor’s directions even if the pain doesn’t stop occurring. Tablets and capsules are taken orally with food or, in order to reduce the irritation of the stomach, with a glass of water.
If taken as soon as the headache or a migraine begins it works best. To make it even better, having taken a pill, one should lie for some time in a quiet, dark place.
The dosage will vary from patient to patient. One is to follow either the directions on the label or the doctor’s ones. The patient is not to change the dosage him/herself until the doctor says so.
Fiorinal is NOT to be taken if it has the smell of vinegar.
Average dosage:
Kids prescribed by the doctor
Adults 1-2 every 4hrs if necessary, but no more than 6 per day.
One is not to stop taking this medicine suddenly, the doctor may advise to reduce the dosage gradually to avoid side effects.

Missed Dose
If the patient is to take the medicine regularly, according to a definite schedule and has missed a dose, there’s no way that one should double the dose. It should be taken as soon as possible but if it’s time for the next dose, one should skip this one and follow the schedule.
Overdose
Any excessive use of any medicine may lead to serious consequences. If anyone has taken an overdose, the emergency is to be called immediately.
An overdose of the medicine may lead to fatal end as well as its combination with alcohol or CNS depressants. Some side effects may occur while the patient’s body adjusts to the medicine; nevertheless, one should consult with the doctor if the following has occurred.
Signs of overdose:
Most common signs of butalbital overdose: hard breathing, breathlessness, dizziness, confusion, slow heartbeat, shock, and coma. Also:
buzzing noise in the ears, seizures, confusion, dizziness, hearing loss, weakness, severe excitement, hard breathing, irritation, sleep disturbance, anxiety, hallucinations, lightheadedness, low blood pressure, nausea, stomach pain, drowsiness, tremor, vision problems, irregular heartbeat, uncontrolled movements, urine with blood, sallow complexion, itching, unusual bruising, swollen glands.
Less common:
Blue/red complexion, face rash and itching, cough, breathlessness, wheezing, swellings on eyelids, lips, face, bloody, tarry stool.
Rare:
Bleeding sores on lips, red skin and its peeling, fever, sore throat, chest pain.
There may occur some other unwanted symptoms that may need medical attention including serious allergic reaction. On the other hand, some side effects may not need medical help but if they are worrying, troublesome and continued, one should consult with the doctor.
Precautions
1 When using the medicine for a long time, it may be addictive, and the patient becomes dependent on it both mentally and physically, it may cause stomach, liver problems and any other medical problems, and he/she need a larger dose to make it work.
2 Before taking the medicine, one should consult with your doctor and weigh the risks. As for the medications mentioned above the following points should be considered:
Allergies:
Fiorinal can not be prescribed to the patient in case he/she ever had any allergies to sedatives, pain-killers or generic ingredients both medicines.
One should inform the doctor if he/she’s got any allergies to any substances (food, etc.) or to salicylates (including wintergreen oil-methyl salicylate), any generic ingredients of the medicines or any of the following ones:
Diclofenac
Etodolac
Fenoprofen
Ibuprofen
Ketoprofen
Mefenamic Acid
Diflunisal
Meclofenamate
Flurbiprofen
Indomethacin
Nabumetone
Floctafenine
Ketorolac
Phenylbutazone
Naproxen
Oxyphenbutazone
Oxaprozin
Zomepirac
Piroxicam
Tolmetin
Tiaprofenic acid
Suprofen
Sulindac
Tenoxicam
3 If one takes any medications together with the one prescribed, the doctor should be definitely informed, because their effects may be different. The doctor should know if the patient is taking any of the following:
Probenecid
Nalterxone
Vancomycin
Methotrexate
Corticotrophin (butalbital makes it less effective)
Valproic acid
Corticosteroids
Divalproex
Antidepressants
Heparin
Anticoagulants (butalbital makes it less effective)
Contraceptives that contain estrogens
CNS depressants (influence butalbital side effects)
Antacids
Carbamazepine
Medications that make the urine not so acid
Acetozalamide
Sulfinpyrazone
Contraceptives taken orally
Narcotic pain-killers
Insulin
Diabetes drugs taken orally
Beta-blocking blood-pressure drugs
Sleeping pills
Tranquilizers
Steroid medications
Blood-thinning drugs
Non-steroidal anti-inflammatory drugs

4 The doctor should also know if one’s got any of the following conditions otherwise butalbital can make them even worse:
Porphyria
Drug or alcohol addiction
Diabetes
Hyperactivity
Colitis
Bleeding problems
Asthma (in particular when accompanied by nasal polyps and allergies)
Overactive thyroid
Head injuries
Stomach problems
Heart disease Chickenpox or influenza (it may cause a neurological disease)
Difficulties with blood clotting
Stomach ulcer
Problems with intestines, kidneys or liver, thyroid gland
Head injury
Enlarged prostate gland or problems with urination
Seizures
Gout
Gallstones or gallbladder diseases
Kidney, liver or chronic lung diseases
Deficiency of vitamin K
Mental depression
Problems with urination or enlarged prostate
5 One is not to increase the dose if the medication stops working as it may mean that the patient becomes addicted to it.
6 If there are even more frequent headaches than before, it may also mean that the patient has become addicted to the medicine. The doctor is to advise the patient how to reduce this as further use of the medicine may cause even more headaches.
7 One is to check the labels of the medications being taken at the moment. In case they contain barbiturates, narcotics, aspirin, salicylates, they may cause an overdose.
8 One should make sure he/she knows how to react to side effect the medicine may produce(dizziness, drowsiness, excitement),especially before anything that may be life-threatening under such circumstances. Such symptoms may occur when changing the position suddenly; lying for some time, getting up and down slowly may be the option in this case. The same may be advised in case of sickness and vomiting that may occur at the beginning.
9 When having an appointment with any other doctor or having any kind of medical treatment, one should definitely inform the doctor about the medicine being taken as the treatment may cause side effects.
10 These medicines are not to be used 5 days before any kind of operation including a visit to the dentist’s.
11 One should inform medical staff about the medicine being taken before doing any medical
tests as it may influence the results.
12 The doctor should also know if the patient is pregnant or is planning to have a baby as taking the medicine may cause bleeding either in the mother or in the baby or lead to the delivery delay. 13 The generic ingredients also get into mother’s milk that’s why if the medicine is needed for further treatment, the doctor may advise to stop breast-feeding until the treatment finishes.
14 All appointments should be kept with the patient’s doctor.
15 The medicine is not to be used be anyone except the patient.
16 Perhaps, for the ones who suffer from constant headaches another medication is needed instead. Medicine preventing headaches may start working only in some weeks but even after that time it may not cure completely, though they will not be so frequent and severe as they used to be.
Side Effects
The medicine may cause a stomach problem, that’s why it is to be taken with food or milk.
Inborn defects tend to appear in case when a pregnant woman takes barbiturates. The investigations proved that a barbiturate (butalbital) may be the cause for brain tumors and problems with breathing in the babies if it’s taken by a pregnant woman.
The babies are vulnerable during lactation period as a barbiturate gets into the milk and causes dizziness, breathlessness or breathing problems, slow heartbeat.
Though butalbital as a barbiturate often causes dizziness, children may feel excitement as well.
Adults may feel at ease, depressed and excited, especially elderly people that are more subject to the effects produced by a barbiturate.
Other side effects: abdominal pain, nausea and vomiting.
Storage
  • Keep away from kids
  • Store in a cool and dark place
  • Store away from damp places (kitchen, bathroom, etc.)
  • Do not keep outdated medicine
  • Keep it tightly closed
  • Store in its light-resistant container