![]() Advise patient to use an additional nonhormonal method of contraception while taking butalbital compound. Rep: Advise females of reproductive potential notify health care professional if pregnancy is planned or suspected and to avoid breastfeeding during therapy. Taking caffeine by mouth together with pain relievers such aspirin and acetaminophen is effective for treating migraines.Caution patient to avoid concurrent use of alcohol or other CNS depressants, may cause overdose.Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.Advise patient to avoid driving and other activities requiring alertness until response to medication is known. Medications taken for prophylaxis should be continued. Lying down in a quiet, dark room may also be helpful. Advise patients with tension headaches to take medication at first sign of headache.Discontinue gradually to prevent withdrawal symptoms (anxiety, diaphoresis, disturbed sleep, nausea/vomiting, restlessness, seizures, worsened headache). It is concluded that the paracetamolcaffeine and aspirincaffeine systems are similar and exhibit two invariants, one eutectic and one metatectic. Chronic excessive use of >4 g/day (2 g in chronic alcoholism) may lead to hepatotoxicity, renal or cardiac damage. Dose of acetaminophen should not exceed maximum recommended daily dose of 4 g/day. If medication appears less effective after a few weeks, consult health care professional. Do not increase dose because of the habit-forming potential of butalbital. Instruct patient to take medication exactly as directed.Concurrent use of kava kava, valerian, skullcap, chamomile, or hops can increase CNS depression. ![]() MAO inhibitors, felbamate, primidone, and valproic acid may prevent metabolism and ↑ the effectiveness of butalbital.May increase the liver metabolism and ↓ the effectiveness of other drugs including amiodarone, benzodiazepines, bupropion, calcium channel blockers, carbamazepine, citalopram, clarithromycin, cyclosporine, erythromycin, fluoxetine, fluvoxamine, glipizide, hormonal contraceptives, losartan, methadone, mirtazapine, nateglinide, nefazodone, nevirapine, phenytoin, pioglitazone, promethazine, propranolol, protease inhibitors, proton pump inhibitors, rifampin, ropinirole, selegiline, sertraline, tacrolimus, theophylline, venlafaxine, voriconazole, warfarin, and zafirlukast.Additive CNS depression with other CNS depressants, including alcohol, antihistamines, antidepressants, opioid analgesics, and sedative/hypnotics. ![]()
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