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Butalbital, Acetaminophen, Caffeine and Codeine Phosphate

BUTALBITAL, ACETAMINOPHEN, CAFFEINE AND CODEINE PHOSPHATE

Manufacturer: Hikma Pharmaceuticals USA Inc.

Score: 144.0

Quick Summary

Butalbital, Acetaminophen, Caffeine, and Codeine Phosphate Capsules are indicated for the management of the symptom complex of tension (or muscle contraction) headache when non-opioid analgesic and alternative treatments are inadequate. The capsules contain butalbital, a barbiturate; acetaminophen; caffeine, a methylxanthine; and codeine phosphate, an opioid agonist. The drug has several warnings and precautions, including addiction, abuse, and misuse; life-threatening respiratory depression; accidental ingestion; and risks from concomitant use with benzodiazepines or other CNS depressants. The recommended dosage is one or two capsules every 4 hours as needed for pain, with a total daily dosage not exceeding 6 capsules.

Key Clinical Findings and Indications

  • Management of tension (or muscle contraction) headache
  • Use when non-opioid analgesic and alternative treatments are inadequate

Important Safety Information

Warning

Addiction, abuse, and misuse; life-threatening respiratory depression; accidental ingestion; risks from concomitant use with benzodiazepines or other CNS depressants

Contraindications

  • All children younger than 12 years of age
  • Post-operative management in children younger than 18 years of age following tonsillectomy and/or adenoidectomy
  • Significant respiratory depression
  • Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment
  • Concurrent use of monoamine oxidase inhibitors (MAOIs) or use of MAOIs within the last 14 days
  • Known or suspected gastrointestinal obstruction, including paralytic ileus
  • Known intolerance or hypersensitivity to acetaminophen, caffeine, butalbital, or codeine or to the components of Butalbital, Acetaminophen, Caffeine, and Codeine Phosphate Capsules
  • Porphyria

Adverse Reactions

  • Drowsiness
  • Lightheadedness
  • Dizziness
  • Sedation
  • Shortness of breath
  • Nausea
  • Vomiting
  • Abdominal pain
  • Intoxicated feeling

Dosing Recommendations

General Guidance

Total daily dosage should not exceed 6 capsules

Tension headache

Adult Dose

One or two capsules every 4 hours as needed for pain

Pediatric Dose

Not recommended for children younger than 12 years of age

Special Population Considerations

Pregnancy

  • Prolonged use of opioid analgesics during pregnancy may cause neonatal opioid withdrawal syndrome
  • Use with caution and only when benefits outweigh risks

Nursing Mothers

  • Butalbital, Acetaminophen, Caffeine, and Codeine Phosphate Capsules are not recommended for use in nursing mothers

Pediatric Use

  • Not recommended for children younger than 12 years of age
  • Contraindicated for post-operative management in pediatric patients younger than 18 years of age following tonsillectomy and/or adenoidectomy

Geriatric Use

  • Use with caution in elderly patients due to increased sensitivity to the drug
  • Monitor closely for signs of respiratory depression