$Unique_ID{BRK01833}
$Pretitle{}
$Title{ASPIRIN, CAFFEINE, AND BUTALBITAL COMBINATION}
$Subject{B-A-C (Mayrand)
butalbital with aspirin and caffeine (various manufacturers)
Fiorgen PF (Goldline)
Fiorinal (Sandoz)
Isollyl Improved (Rugby)
Lanorinal (Lannett)
Marnal (Vortech)}
$Volume{}
$Log{}

Copyright (C) 1991 Publications International, Ltd.


ASPIRIN, CAFFEINE, AND BUTALBITAL COMBINATION
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BRAND NAMES (Manufacturers):
     B-A-C (Mayrand)
     butalbital with aspirin and caffeine (various manufacturers)
     Fiorgen PF (Goldline)
     Fiorinal (Sandoz)
     Isollyl Improved (Rugby)
     Lanorinal (Lannett)
     Marnal (Vortech)
TYPE OF DRUG:
     Analgesic combination and sedative
INGREDIENTS:
     aspirin, caffeine, and butalbital
DOSAGE FORMS:
     Tablets (325 mg aspirin, 40 mg caffeine, and 50 mg butalbital; 650 mg
       aspirin, 40 mg caffeine, and 50 mg butalbital)
     Capsules (325 mg aspirin, 40 mg caffeine, and 50 mg butalbital)
STORAGE:
     Aspirin, caffeine, and butalbital combination tablets and capsules should
       be stored at room temperature in tightly closed containers.  Moisture
       causes the aspirin in this product to decompose.

USES

     This combination medication is used to relieve tension headaches and mild
to moderate pain.  Butalbital belongs to a group of drugs known as
barbiturates.  The barbiturates act on the central nervous system (brain and
spinal cord) to produce relaxation.  Caffeine is a central nervous system
stimulant.  It constricts blood vessels in the head, which may help to relieve
headaches.

TREATMENT

     In order to avoid stomach upset, you can take this medication with food
or milk.
     This drug works most effectively if you take it at the onset of pain,
rather than waiting until the pain is intense.
     If you are taking this medication on a regular schedule and you miss a
dose, take the missed dose as soon as possible, unless it is almost time for
your next dose.  In that case, don't take the missed dose at all; just return
to your regular dosing schedule.  Do not double the next dose.

SIDE EFFECTS

     Minor.

     Dizziness, drowsiness, gas, loss of appetite, nausea, nervousness,
sleeping disorders, or vomiting.  These side effects should disappear as your
body adjusts to the medication.
     If you feel dizzy or light-headed, sit or lie down for a while; get up
from a sitting or lying position slowly, and be careful on stairs.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
bloody or black, tarry stools; chest tightness; confusion; difficult or
painful urination; light-headedness; loss of coordination; palpitations; rash;
ringing in the ears; shortness of breath; severe abdominal pain; sore throat
and fever; or yellowing of the eyes or skin.

INTERACTIONS

     This medication interacts with several other types of drugs:
     1. Concurrent use of this medication with other central nervous system
depressants (such as alcohol, antihistamines, barbiturates, benzodiazepine
tranquilizers, muscle relaxants, and phenothiazine tranquilizers) or with
tricyclic antidepressants can cause extreme drowsiness.
     2. Alcohol and anti-inflammatory medications can increase the
gastrointestinal side effects of this medication.
     3. The side effects of anticoagulants (blood thinners, such as warfarin),
oral antidiabetic agents, phenytoin, and methotrexate may be increased by the
aspirin in this product.
     4. Large doses of antacids increase the elimination of the aspirin
portion of this medication from the body and decrease its effectiveness.
     5. Aspirin may decrease the antigout effects of probenecid and
sulfinpyrazone.
     6. Butalbital can increase the elimination from the body of oral
contraceptives (birth control pills), carbamazepine, adrenocorticosteroids
(cortisone-like drugs), digoxin, doxycycline, tricyclic antidepressants,
griseofulvin, metronidazole, theophylline, aminophylline, and quinidine,
thereby decreasing the effectiveness of these medications.
     7. The side effects of cyclophosphamide may be increased by butalbital.
     BE SURE TO TELL YOUR DOCTOR about any medications you are currently
taking, especially any of those listed above.

WARNINGS

     * Tell your doctor about unusual or allergic reactions you have had to
medications, especially to aspirin, methyl salicylate (oil of wintergreen),
diclofenac, diflunisal, flurbiprofen, fenoprofen, ibuprofen, indomethacin,
ketoprofen, meclofenamate, mefenamic acid, naproxen, piroxicam, sulindac, or
tolmetin; to caffeine; or to butalbital or other barbiturates (such as
phenobarbital, pentobarbital, or secobarbital).
     * Tell your doctor if you now have or if you have ever had bleeding
problems, blood disorders, diabetes mellitus, heart disease, hemophilia,
hyperactivity, kidney disease, liver disease, mental depression, peptic
ulcers, or thyroid disease.
     * If this drug makes you dizzy or drowsy, do not take part in any
activity that requires alertness, such as driving a car or operating
potentially dangerous equipment.
     * Before having surgery or any other medical or dental treatment, be sure
to tell your doctor or dentist that you are taking this medication.
Aspirin-containing medication is usually discontinued five to seven days
before surgery to prevent bleeding complications.
     * The use of aspirin in children (about 16 years of age or less) with the
flu or chicken pox has been associated with a rare, life-threatening condition
called Reye's syndrome.  Aspirin-containing products should, therefore, not be
given to children with signs of infection.
     * Because this drug contains butalbital, it has the potential for abuse
and must be used with caution.  Tolerance develops quickly; do not increase
the dosage or stop taking the drug abruptly, unless you first consult your
doctor.  If you have been taking large amounts of this medication for long
periods, you may experience a withdrawal reaction (muscle aches, diarrhea,
convulsions, sleep disorders, nervousness, irritability, or weakness).  Your
doctor may, therefore, want to reduce the dosage gradually.
     * Because this product contains aspirin, additional medications that
contain aspirin should not be taken without your physician's approval.  Check
the labels on over-the-counter (nonprescription) pain, sinus, allergy, asthma,
cough, and cold products to see if they contain aspirin.
     * You should not take more than six tablets or capsules of this drug in
one day, unless your doctor specifically directs you to do so.
     * Diabetic patients should be aware that large doses of aspirin (more
than eight 325-mg tablets or capsules per day) may interfere with urine sugar
testing.  Diabetics should, therefore, check with their doctor before changing
their insulin dose.
     * Be sure to tell your doctor if you are pregnant.  The effects of this
medication during pregnancy have not been thoroughly studied in humans.
Butalbital, used regularly in large doses during pregnancy, may result in
addiction of the fetus, leading to withdrawal symptoms (irritability,
excessive crying, tremors, fever, vomiting, diarrhea, sneezing, or excessive
yawning) at birth.  Large amounts of aspirin taken close to the end of
pregnancy may prolong labor and cause bleeding problems in the mother and
heart problems in the newborn infant.  Also, tell your doctor if you are
breast-feeding an infant.  Small amounts of this medication may pass into
breast milk and cause excessive drowsiness in the nursing infant.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
