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Butalbital/acetaminophen, sold under the brand name Butapap among others, is a combination medication used to treat tension headaches and migraine headaches. [1] [4] [5] It contains butalbital, a barbiturate and paracetamol (acetaminophen), an analgesic. [4] Versions also containing caffeine are sold under the brand name Fioricet among others. [6]
Butalbital is often combined with other medications, such as paracetamol (acetaminophen) (as Butalbital/acetaminophen) or aspirin, for the treatment of pain and headache. The various formulations combined with codeine are FDA -approved for the treatment of tension headaches .
Opioids and butalbital are sometimes inappropriately used as treatment for migraine and headache and should be avoided in favor of more effective, migraine-specific treatments. [21] [22] Opioid and butalbital use can worsen headaches and cause MOH. [21]
Aspirin/paracetamol/caffeine is a combination drug for the treatment of pain, especially tension headache and migraine. [1] It contains aspirin , a non-steroidal anti-inflammatory drug ; paracetamol (acetaminophen), an analgesic ; and caffeine , a stimulant .
One example is APC (aspirin, phenacetin, and caffeine) compound tablets common from the 1940s to 1983; because of harmful side effects of phenacetin, Anacin in the U.S. was reformulated to eliminate it; while Vincent's APC is no longer sold. Some others have been judged to contribute too often to substance abuse. [citation needed]
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.
High caffeine consumption in energy drinks (at least one liter or 320 mg of caffeine) was associated with short-term cardiovascular side effects including hypertension, prolonged QT interval, and heart palpitations. These cardiovascular side effects were not seen with smaller amounts of caffeine consumption in energy drinks (less than 200 mg). [79]
COX-2 selective inhibitors have fewer gastrointestinal side effects, but promote thrombosis, and some of these agents substantially increase the risk of heart attack. As a result, certain COX-2 selective inhibitors—such as rofecoxib —are no longer used due to the high risk of undiagnosed vascular disease . [ 11 ]