Aspirin, ASA; Butalbital; Caffeine tablets and capsules

What are aspirin-butalbital-caffeine tablets or capsules?
ASPIRN-BUTALBITAL-CAFFEINE (Fiorinalreg; and others) is a combination product used to treat certain types of headaches and migraines as well as mild to moderate pain. Federal law prohibits the transfer of this medicine to any person other than the patient for whom it was prescribed. Do not share this medicine with any one else. Generic aspirin-butalbital-caffeine tablets and capsules are available.

What should my health care professional know before I take aspirin-butalbital-caffeine?
They need to know if you have any of these conditions:

  • anemia
  • asthma
  • depression
  • diabetes mellitus
  • drink more than 3-alcohol containing drinks per day
  • G6PD deficiency
  • heart or circulation problems
  • high or low blood pressure
  • infection
  • kidney disease
  • liver disease
  • lung disease or breathing difficulties
  • Nasal polyps
  • peptic ulcer disease
  • porphyria
  • problems urinating
  • thyroid disease
  • an unusual or allergic reaction to aspirin or related drugs, butalbital or other barbiturates, caffeine, tartrazine dye, other medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I take this medicine?
Take aspirin-butalbital-caffeine tablets or capsules by mouth with a full glass of water. Follow the directions on the prescription label. If aspirin-butalbital-caffeine upsets your stomach, take it with food or milk. Do not take your medicine more often than directed.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

Do not share this medicine with anyone.

What if I miss a dose?
If it is almost time for your next dose (within 2 hours), take only that dose. Do not take double or extra doses.

What drug(s) may interact with aspirin-butalbital-caffeine?

  • alcohol
  • carbamazepine
  • corticosteroids
  • cyclosporine
  • divalproex
  • female hormones, including contraceptive or birth control pills
  • grapefruit juice
  • medicines for depression or other mental health problems
  • medicines for high blood pressure or other heart problems
  • medicines for pain
  • medicines to control heart rhythm
  • phenobarbital
  • phenytoin
  • quinine
  • theophylline
  • valproic acid
  • warfarin

Because aspirin-butalbital-caffeine can cause drowsiness, other medicines that also cause drowsiness may increase this effect of aspirin-butalbital-caffeine. Some other medicines that cause drowsiness are:

  • alcohol-containing medicines
  • certain antidepressants or tranquilizers
  • certain antihistamines used in cold medicines
  • muscle relaxants

Tell your prescriber or health care professional about all other medicines that you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also, tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What side effects may I notice from taking aspirin-butalbital-caffeine?
Side effects that you should report to your prescriber or health care professional as soon as possible:

  • bone tenderness
  • changes in behavior, mood, or mental ability
  • difficulty breathing or shortness of breath
  • eye problems, very small or enlarged centers to the eyes
  • fever, sore throat
  • hallucinations
  • lightheadedness or fainting spells
  • redness, blistering, peeling or loosening of the skin, including inside the mouth
  • seizures
  • skin rash, itching, hives
  • slow or fast heartbeat
  • swelling of the face or lips
  • unusual bleeding or bruising, pinpoint red spots on the skin
  • unusual tiredness or weakness

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

  • clumsiness, unsteadiness, or a “hang-over” effect
  • confusion, agitation
  • constipation
  • difficulty sleeping or nightmares
  • drowsiness, dizziness
  • increased frequency passing urine
  • irritability, nervousness
  • nausea or vomiting
  • trembling

What should I watch for while taking aspirin-butalbital-caffeine?
Visit your prescriber or health care professional for regular checks on your progress.

After taking aspirin-butalbital-caffeine you may get a residual hangover effect that leaves you drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. To reduce dizzy or fainting spells, do not sit or stand up quickly, especially if you are an older patient. Avoid alcoholic drinks while you are taking this medicine. Alcohol can increase possible damage to your liver and can increase possible unpleasant effects.

Aspirin-butalbital-caffeine can stop birth control pills (oral contraceptives) from working properly. You may need to use an additional method of birth control while you are taking this medicine.

If you have been taking caffeine or butalbital (ingredients in this medicine) on a regular basis, you can get withdrawal symptoms if you stop taking them. Symptoms include tiredness, dizziness, headache, anxiety, or nervousness. Taking too much caffeine can also make you irritable or nervous. Try to avoid excessive caffeine from foods or beverages while taking this medicine. Grapefruit juice may increase the effects of the caffeine in this medicine.

Do not take aspirin-butalbital-caffeine with other non-prescription medicines, especially cold and allergy medicines, without asking your prescriber or health care professional for advice.

Many non-prescription medicines contain aspirin as an ingredient. Always read the labels carefully to avoid taking an accidental overdose, which can be dangerous.

If you are receiving cancer chemotherapy or other immunosuppression medicine, do not take this medicine without checking with your prescriber or health care professional. Aspirin-butalbital-caffeine may hide the signs of an infection such as fever or pain.

If you are going to have surgery, tell your prescriber or health care professional that you are taking aspirin-butalbital-caffeine.

Where can I keep my medicine?
Keep out of the reach of children in a container that small children cannot open.

Store at room temperature between 15-30 degrees C (59-86 degrees F). Keep container tightly closed. Throw away any unused medicine after the expiration date.

Johns Hopkins patient information

Copyright 1996-2014 Cerner Multum, Inc. Version: 16.02.
Revision date: June 22, 2011
Last revised: by Tatiana Kuznetsova, D.M.D.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

The drug reference included in this section is provided by Cerner Multum, Inc., of Denver, Colorado. Armenian Medical Network receives monthly updates from Multum.