Butalbital/acetaminophen, sold under the brand name Butapap among others, is a combination medication used to treat tension headaches and migraine headaches.
It contains butalbital, a barbiturate and paracetamol (acetaminophen), an analgesic. Versions also containing caffeine are sold under the brand name Fioricet among others.
It is taken by mouth. The combination is also sold with codeine.
The most common side effects include sleepiness, dizziness, trouble breathing, and abdominal pain. Other severe side effects may include liver problems, confusion, addiction, and allergic reactions. Frequent use may result in medication overuse headache.
Barbiturate withdrawal may occur if rapidly stopped following long term use. Use is not generally recommended during pregnancy or breastfeeding.
The combination was approved for medical use in the United States in 1984. It is available as a generic medication.
In 2019, the combination butalbital/acetaminophen/caffeine was the 228th most commonly prescribed medication in the United States, with more than 2 million prescriptions.
In the United States it is a schedule III controlled substance in some states but not federally. It is banned in a number of European countries.
Butalbital 300 mg per day PO, acetaminophen 4 grams per day PO, and caffeine 240 mg per day PO.
Butalbital 300 mg per day PO, acetaminophen 4 grams per day PO, and caffeine 240 mg per day PO.
Butalbital 300 mg per day PO, acetaminophen 4 grams per day PO, and caffeine 240 mg per day PO.
12 years: Butalbital 300 mg per day PO, acetaminophen 4 grams per day PO, and caffeine 240 mg per day PO.
Less than 12 years: Safety and efficacy have not been established.
Safety and efficacy have not been established.