Talk:Butalbital/acetaminophen

picture says it's the generic but looks like Fioricet
Hmm -- the caption for the Fioricet picture says it's the generic; those pills look suspiciously like name-brand Fioricet. The generics, as far as I know, are white and tab-shaped.

There are are actually generic blue tablets. for complete information and images see http://www.drugdigest.org/DD/PillImages/PillImagesSearch/1,20327,,00.html


 * the TEVA (west-ward) version of the generic is blue eLeigh33 23:07, 29 March 2007 (UTC)

Contraindication with other drugs
Is one able to take in conjunction with imetrex?

Should butalbital-containing analgesics be banned? Yes.
Should butalbital-containing analgesics be banned? Yes.

Young WB, Siow HC.

Jefferson Headache Center, Department of Neurology, Thomas Jefferson University, 111 South 11th Street, Philadelphia, PA 19107, USA. William.B.Young@mail.tju.edu

Curr Pain Headache Rep. 2002 Apr;6(2):151-5.

Abstract

In the United States analgesic-overuse headache is often caused by butalbital-containing analgesics. These agents can cause physical and psychological dependency, and dangerous withdrawal syndromes. Butalbital-containing analgesics have already been banned in several European countries. They are proven effective in tension-type headache, but not in migraine; there are many alternative treatments for migraine and tension-type headache. In the 20 years since analgesic overuse headache was widely recognized, butalbital overuse has remained distressingly common. It is time to ban these agents.

— Preceding unsigned comment added by 99.190.133.143 (talk) 17:58, 23 October 2011 (UTC)

Do butalbital-containing products have a role in the management of migraine? [No]
Do butalbital-containing products have a role in the management of migraine?

Pharmacotherapy. 2002 Aug;22(8):1029-35.

Wenzel RG, Sarvis CA. Diamond Headache Clinic Inpatient Unit, St. Joseph Hospital, Resurrection Health Care, Chicago, IL 60657, USA. rwenz@hotmail.com

http://www.ncbi.nlm.nih.gov/pubmed/12173787 — Preceding unsigned comment added by 99.190.133.143 (talk) 18:00, 23 October 2011 (UTC)

Butalbital in the treatment of headache: history, pharmacology, and efficacy.
Butalbital in the treatment of headache: history, pharmacology, and efficacy.

Headache. 2001 Nov-Dec;41(10):953-67.

Silberstein SD, McCrory DC.

Jefferson Headache Center, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.

Abstract

Analgesics containing butalbital compounded with aspirin, acetaminophen, and/or caffeine are widely used for the treatment of migraine and tension-type headache. The butalbital-containing compounds are efficacious in placebo-controlled trials among patients with episodic tension-type headaches. Despite their frequent clinical use for migraine, they have not been studied in placebo-controlled trials among patients with migraine. Barbiturates can produce intoxication, hangover, tolerance, dependence, and toxicity. Butalbital can result in intoxication that is clinically indistinguishable from that produced by alcohol. Butalbital-containing analgesics can produce drug-induced headache in addition to tolerance and dependence. Higher doses can produce withdrawal syndromes after discontinuation. Butalbital-containing analgesics may be effective as backup medications or when other medications are ineffective or cannot be used. Because of concerns about overuse, medication-overuse headache, and withdrawal, their use should be limited and carefully monitored.

— Preceding unsigned comment added by 99.190.133.143 (talk) 18:01, 23 October 2011 (UTC)

Analgesics with barbiturates such as Butalbital are banned in Germany
… The use of analgesics containing Butalbital is controversial to say the least. Analgesics with barbiturates such as Butalbital are banned in Germany, and expert advisory panels elsewhere have warned of their potential for abuse.2,3 Some experts warn that butalbital is particularly likely to lead to rebound (analgesic overuse) headache and/or dependence and question whether their benefit outweighs these problems.3 The authors comment:

http://headaches.about.com/cs/druginfo/a/fiorinal_care.htm

[Part of a larger article] — Preceding unsigned comment added by 99.190.133.143 (talk) 18:04, 23 October 2011 (UTC)

Citation of a number of scientific authorities emphasizing risk of drug dependence and abuse posed by barbiturate-containing analgesics
Resources:

Silberstein, Stephen D. & McCrory, Douglas C. (2001) "Butalbital in the Treatment of Headache: History, Pharmacology, and Efficacy." Headache: The Journal of Head and Face Pain 41 (10), 953-967. Available from: http://dx.doi.org/10.1046/j.1526-4610.2001.01189.x [$] [Free synopsis http://www.ncbi.nlm.nih.gov/pubmed/11903523]

2 Sellers EM, Hoornweg K, Busto UE, Romach MK. Risk of drug dependence and abuse posed by barbiturate-containing analgesics. Can J Clin Pharmacol. 1999;6:18-25.

3 McLean W, Boucher EA, Brennan M, et al. Is there an indication for the use of barbiturate-containing analgesic agents in the treatment of pain? Guidelines for their safe use and withdrawal management. Can J Clin Pharmacol. 2000;7:191-197.

4 Ciraulo DA & Greenblatt DJ. Sedative-, hypnotic-, or anxiolytic-related disorders. In: Kaplan HI, Sadock BJ, eds. Comprehensive Textbook of Psychiatry. 6th ed. Baltimore: Williams & Wilkins; 1995:872-887.

5 Sullivan JT & Sellers EM. Treatment of the barbiturate abstinence syndrome. Med J Aust. 1986;145:456-458.

6 Fraser HF, Wikier A, Essig CF, Isbell H. Degree of physical dependence induced by secobarbital or pentobarbital. JAMA. 1958;166:126-129.

7 Sullivan JT & Sellers EM. Treatment of the barbiturate abstinence syndrome. Med J Aust. 1986;145:456-458. — Preceding unsigned comment added by 99.190.133.143 (talk) 18:06, 23 October 2011 (UTC)

PMC article examining failure to follow evidence-based guidelines relegating butalbitol to 2d tier or below for migraine
Am J Pharm Educ. 2010 February 10; 74(1): 4.

Didactic Migraine Education in US Doctor of Pharmacy Programs

...


 * CONCLUSIONS

"Although the majority of PharmD programs teach information consistent with the US Consortium's recommendations, opportunities exist to improve didactic migraine education. Particular attention should be directed towards expanded dissemination of evidence-based care, the rational selection of nonprescription versus prescription products, risks of butalbital-containing products and narcotics, and tools to assess migraine-related debilitation.

Full article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829152/?tool=pubmed

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829152/?tool=pubmed — Preceding unsigned comment added by Ocdnctx (talk • contribs) 13:20, 15 August 2012 (UTC)

Silberstein, ... evidence-based guidelines for migraine ... (evidence butalbital does more harm than good)
Silberstein SD.

Neurology. 2000 Sep 26;55(6):754-62.

'''Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology.

Source

American Academy of Neurology, St. Paul, MN 55116, USA.

Erratum in

Neurology 2000 Jan 9;56(1):142.

— Preceding unsigned comment added by Ocdnctx (talk

Fioricet article should be merged into a combined discussion of butalbital combinations in single discussion in the butalbitol article
Fioricet is simply the brand name for a butalbital combination. It is available as a generic, and does not merit a separate article. This separate article amounts to advertising for the proprietary name.

The separate Fioricet article should be merged into a combined discussion of butalbital combinations in single section of the butalbitol article

comment added by Ocdnctx (talk • contribs) 15:01, 15 August 2012 (UTC)

Fioricet poses a "high risk for the development of medication-overuse headache" -- Mayo Clinic Staff
Rebound headaches

Causes

By Mayo Clinic staff © 1998-2011 Mayo Foundation for Medical Education and Research

http://www.mayoclinic.com/health/rebound-headaches/DS00613/DSECTION=causes

•	Combination pain relievers. Over-the-counter pain relievers that contain a combination of caffeine, aspirin and acetaminophen (Excedrin, others) are common culprits. This group also includes prescription medications such as Fioricet, Fiorinal and Esgic-Plus, which also contain the sedative butalbital. All of these medications are high risk for the development of medication-overuse headache. Some combination medications have even been withdrawn from the market in certain European countries.

[emphasis supplied]

new Fioricet schedulling
Fioricet's website states that they are exempt from schedule 3 status. http://www.fioricet.com/ source, and here's a quote from the website:

"Contains 50 mg butalbital, 300 mg acetaminophen, and 40 mg caffeine.2

The FDA has designated Fioricet® with 300 mg of acetaminophen as having the same therapeutic effect as the discontinued product, which contained 325 mg of acetaminophen3 Fioricet® has received exempted prescription drug status from the DEA and is no longer regulated as a CIII product3"

I suppose they could be wrong about it, but I just wanted to share that bit of info. — Preceding unsigned comment added by 65.118.16.36 (talk) 17:34, 28 December 2013 (UTC)

One very important and potentially dangerous typo/misquote of the "Confusion over Control status" subsection under "New Fioricet Formulation". In the labeller/schedule/strength table, the "strength" column title correctly states the standard drug order printed on Fioricet prescriptions in the United States (butalbital/acetaminophen/caffeine), however the dosage order of the three rows below it incorrectly state "300/325 mg, 50 mg, 40 mg". This indicates that there are either 300 mg or 325 mg of butalbital in each capsule or tablet (which can be a fatal overdose for many individuals, i.e. children, elderly, alcoholics/addicts and other non-prescribed users). This also implies only 50 mg of aspirin are in each dose (15-17% of the correct amount), a potentially dangerous understatement for those with stomach conditions. The formula order of butalbital and aspirin should be reversed to avoid confusion (50 mg butalbital, 300-325 mg aspirin), while the caffeine strength (40 mg) is correct and should remain unchanged. 2602:304:CF5C:5720:80A9:3121:8E54:54AE (talk) 21:04, 5 June 2014 (UTC)

Cost of fiorect
Two months ago this was $33. Last month $39. I just priced all local pharmacies and got prices from $49-$440. What is going on Dfrees (talk) 18:17, 25 October 2016 (UTC)