Butalbital, Aspirin and Caffeine

BUTALBITAL, ASPIRIN AND CAFFEINE- butalbital, aspirin and caffeine tablet
Rebel Distributors Corp

DESCRIPTION:

Each Butalbital, Aspirin, and Caffeine Tablet for oral administration contains:

Butalbital, USP…………………50 mg

Aspirin, USP…………………..325 mg

Caffeine, USP…………………..40 mg

Butalbital, 5-allyl-5-isobutylbarbituric acid, a white, odorless, crystalline powder having a slightly bitter taste, is a short to intermediate-acting barbiturate. It has the following structural formula:

Structural formula for Butalbital
(click image for full-size original)

C11 H16 N2 O3 M.W. 224.26

Aspirin, salicylic acid acetate, is a non-opiate analgesic, anti-inflammatory and antipyretic agent. It occurs as a white, crystalline tabular or needle-like powder and is odorless or has a faint odor. It has the following structural formula:

Structural formula for Aspirin
(click image for full-size original)

C9 H8 O4 M.W. 180.16

Caffeine, 1,3,7,-trimethylxanthine, is a central nervous system stimulant which occurs as a white powder or white glistening needles. It also has a bitter taste. Its structure is as follows:

Structural formula for Caffeine
(click image for full-size original)

C8 H10 N4 O2 M.W. 194.19

Inactive Ingredients: Corn Starch, Hydrogenated Vegetable Oil, Microcrystalline Cellulose, Pregelatinized Starch, Sodium Starch Glycolate and Talc.

CLINICAL PHARMACOLOGY:

Pharmacologically, Butalbital, Aspirin, and Caffeine Tablets combine the analgesic properties of aspirin with the anxiolytic and muscle relaxant properties of butalbital.

The clinical effectiveness of a product containing butalbital, aspirin, and caffeine in tension headache has been established in double-blind, placebo-controlled, multiclinic trials. A factorial design study compared the combination product with each of its major components. This study demonstrated that each component contributes to the efficacy of the combination product in the treatment of the target symptoms of tension headache (headache pain, psychic tension, and muscle contraction in the head, neck, and shoulder region). For each symptom and the symptom complex as a whole, the product containing butalbital, aspirin, and caffeine was shown to have significantly superior clinical effects to either of the major components alone.

INDICATIONS AND USAGE:

Butalbital, Aspirin and Caffeine Tablets are indicated for the relief of the symptom complex of tension (or muscle contraction) headache.

CONTRAINDICATIONS:

Hypersensitivity to aspirin, caffeine or barbiturates. Patients with porphyria.

PRECAUTIONS:

1. General:

Butalbital, Aspirin, and Caffeine Tablets should be used with caution in patients with certain medical problems, including those with a history of asthma, allergies and nasal polyps. Also, the drug must be prescribed carefully for patients with hemophilia or other bleeding problems, peptic ulcer, renal impairment, or a history of drug abuse or dependence.

2. Information for Patients:

Butalbital, Aspirin, and Caffeine Tablets may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks, such as driving a car or operating machinery. The patient should be cautioned accordingly.

3. Drug Interactions:

Patients receiving narcotic analgesics, antipsychotics, antianxiety agents, or other CNS depressants (including alcohol) concomitantly with Butalbital, Aspirin, and Caffeine Tablets may exhibit additive CNS depressant effects. When combined therapy is contemplated, the dose of one or both agents should be reduced.

DRUGS EFFECT
Aspirin w/anti-inflammatory agents

Increased
ulcerogenic effects.

Butalbital w/coumarin anticoagulants

Decreased effect of
anticoagulant
because of
increased
metabolism
resulting from
enzyme induction.

Butalbital w/tricyclic antidepressants

Decreased blood
levels of the
antidepressant.

4. Usage in Pregnancy:

Adequate studies have not been performed in animals to determine whether this drug affects fertility in males or females, has teratogenic potential or has other adverse effects on the fetus. While there are no well-controlled studies in pregnant women, over twenty years of marketing and clinical experience does not include any positive evidence of adverse effects on the fetus. Although there is no clearly defined risk, such experience cannot exclude the possibility of infrequent or subtle damage to the human fetus. Butalbital, Aspirin, and Caffeine Tablets should be used in pregnant women only when clearly needed.

5. Nursing Mothers:

The effects of Butalbital, Aspirin, and Caffeine Tablets on infants of nursing mothers are not known. Salicylates and barbiturates are excreted in the breast milk of nursing mothers. The serum levels in infants are believed to be insignificant with therapeutic doses.

6. Pediatric Use:

Safety and effectiveness in children below the age of 12 have not been established.

ADVERSE REACTIONS:

The most frequent adverse reactions are drowsiness and dizziness. Less frequent adverse reactions are lightheadedness and gastrointestinal disturbances including nausea, vomiting, and flatulence. Mental confusion or depression can occur due to intolerance or overdosage of butalbital.

Several cases of dermatological reactions including toxic epidermal necrolysis and erythema multiforme have been reported.

DRUG ABUSE AND DEPENDENCE:

Butalbital, Aspirin, and Caffeine Tablets are classified as a Schedule III controlled substance.

Prolonged use of barbiturates can produce drug dependence, characterized by psychic dependence, and less frequently, physical dependence and tolerance. The abuse liability of Butalbital, Aspirin, and Caffeine Tablets are similar to that of other barbiturate-containing drug combinations. Caution should be exercised when prescribing medication for patients with a known propensity for taking excessive quantities of drugs, which is not uncommon in patients with chronic tension headache.

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