This combination medication is used to treat tension headaches. Codeine is an opioid (narcotic) pain reliever that acts on certain centers in the brain to give you pain relief. Aspirin helps to decrease the pain from the headache. Caffeine helps increase the effects of aspirin. Butalbital is a sedative that helps to decrease anxiety and cause sleepiness and relaxation.
How to use
Read the Medication Guide provided by your pharmacist before you start taking this product and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth, usually every 4 hours as needed or as directed by your doctor. Do not take more than 6 capsules in a 24-hour period. Use the smallest effective dose. Take with a full glass of water (8 ounces or 240 milliliters) unless your doctor directs you otherwise. Do not lie down for at least 10 minutes after taking this medication. If you have nausea, you may take this medication with food. Ask your doctor or pharmacist about other ways to decrease nausea (such as lying down for 1-2 hours with as little head movement as possible).
The dosage is based on your medical condition, age, and response to therapy. This medication works best if it is used as the first signs of a headache occur. If you wait until the headache has worsened, the medication may not work as well.
Do not increase your dose or use this drug more often or for longer than prescribed, because your risk of side effects may increase. Properly stop the medication when so directed.
Nausea, vomiting, stomach upset, gas, shaking (tremor), constipation, dry mouth, lightheadedness, dizziness, drowsiness, or trouble sleeping may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.
To lower your risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.
To prevent constipation, eat dietary fiber, drink enough water, and exercise. You may also need to take a laxative. Ask your pharmacist which type of laxative is right for you.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Warnings & Precautions
Before taking this medication, tell your doctor or pharmacist if you are allergic to aspirin, caffeine, codeine, or butalbital; or to other barbiturates (e.g., phenobarbital), salicylates (e.g., salsalate), nonsteroidal anti-inflammatory drugs (e.g., ibuprofen), opioid pain medications (e.g., morphine) or xanthine derivatives (e.g., theophylline); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma (including a history of worsening breathing with runny/stuffy nose after taking aspirin or other NSAIDs), brain disorders (e.g., seizures, head injury, tumor, increased intracranial pressure), breathing problems (e.g., chronic obstructive pulmonary disease-COPD, sleep apnea), bleeding/blood clotting disorders (e.g., hemophilia, von Willebrand’s disease, thrombocytopenia), a certain enzyme disorder (porphyria), disease of the pancreas (e.g., pancreatitis), heart disease (e.g., irregular heartbeat, recent heart attack), certain enzyme deficiencies (pyruvate kinase or G6-PD deficiency), gout, liver disease, kidney disease, heartburn, growths in the nose (nasal polyps), a certain spinal problem (kyphoscoliosis), gallbladder disease, personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol), mental/mood disorders, stomach/intestinal problems (e.g., stomach/intestinal ulcers, infectious diarrhea, colitis), adrenal gland problem (e.g., Addison’s disease), difficulty urinating (e.g., due to enlarged prostate or urethral stricture), underactive thyroid (hypothyroidism), recent bowel/abdominal surgery, obesity.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Some products that may interact with this drug include: acetazolamide, antacids, anticholinergic medications (e.g., scopolamine), certain drugs used to treat gout (including uricosuric drugs such as probenecid, sulfinpyrazone), certain antibiotics (including penicillin, sulfonamides such as sulfamethoxazole), darunavir, dichlorphenamide, drugs affecting liver enzymes that remove this medication from your body (such as cimetidine, disulfiram, valproic acid), lithium, MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine), 6-mercaptopurine, methotrexate, methoxyflurane, mifepristone, naltrexone, other medications for pain (e.g., pentazocine, nalbuphine, morphine), sodium oxybate.
This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, “blood thinners” such as dabigatran/enoxaparin/warfarin, among others.