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BUPAP (BUTALBITAL/ACETAMINOPHEN)
- Tension-type headache
50 mg-300 mg tablet
- 1 - 2 tablets by oral route every 4 hours as needed not to exceed 6 tablets per 24Hrs
Tension-type headache
- 1 tablet by oral route every 4 hours as needed
- 2 tablets by oral route every 4 hours as needed not to exceed 6 tablets per 24Hrs
- 1 - 2 tablets by oral route every 4 hours as needed not to exceed 6 tablets per 24Hrs
- sodium oxybate
- Xyrem
Contraindicated
- Afinitor
- Afinitor Disperz
- Altavera (28)
- Alyacen 1/35 (28)
- Alyacen 7/7/7 (28)
- Amethia
- Amethia Lo
- Amethyst
- Apri
- Aranelle (28)
- Astagraf Xl
- Aubra
- Aviane
- Azurette (28)
- Balziva (28)
- Beyaz
- Brevicon (28)
- Briellyn
- Camila
- Camrese
- Camrese Lo
- Caziant (28)
- Chateal
- Coumadin
- Cryselle (28)
- Cyclafem 1/35 (28)
- Cyclafem 7/7/7 (28)
- Cyclessa (28)
- cyclosporine
- cyclosporine modified
- Dasetta 1/35 (28)
- Dasetta 7/7/7 (28)
- Daysee
- desog-e.estradiol/e.estradiol
- Desogen
- desogestrel-ethinyl estradiol
- drospirenone-e.estradiol-lm.FA
- drospirenone-ethinyl estradiol
- Elinest
- Emoquette
- Enpresse
- Enskyce
- Errin
- Estarylla
- estradiol valerate-dienogest
- Estrostep Fe-28
- ethynodiol diac-eth estradiol
- etonogestrel
- etonogestrel-ethinyl estradiol
- everolimus
- Falmina (28)
- Femcon Fe
- Generess Fe
- Gengraf
- Gianvi (28)
- Gildagia
- Gildess
- Gildess Fe
- Heather
- Hecoria
- Introvale
- Jantoven
- Jencycla
- Jolessa
- Jolivette
- Junel 1.5/30 (21)
- Junel 1/20 (21)
- Junel Fe 1.5/30 (28)
- Junel Fe 1/20 (28)
- Kariva (28)
- Kelnor 1/35 (28)
- Kurvelo
- L norgest&E estradiol-E estrad
- Larin 1/20 (21)
- Larin Fe
- Leena 28
- Lessina
- Levonest (28)
- levonorg-eth estrad triphasic
- levonorgestrel
- levonorgestrel-ethinyl estrad
- Levora 0.15/30 (28)
- Levora-28
- Lo Loestrin Fe
- Loestrin 1.5/30 (21)
- Loestrin 1/20 (21)
- Loestrin Fe 1.5/30 (28)
- Loestrin Fe 1/20 (28)
- Lomedia 24 Fe
- Loryna (28)
- Loseasonique
- Low-ogestrel (28)
- Lutera (28)
- Lyza
- Marlissa
- Microgestin 1.5/30 (21)
- Microgestin 1/20 (21)
- Microgestin Fe 1.5/30 (28)
- Microgestin Fe 1/20 (28)
- Minastrin 24 Fe
- Mircette (28)
- Mirena
- Modicon (28)
- Mono-linyah
- Mononessa (28)
- My Way
- Myzilra
- Natazia
- Necon 0.5/35 (28)
- Necon 1/35 (28)
- Necon 1/50 (28)
- Necon 10/11 (28)
- Necon 7/7/7 (28)
- Neoral
- Nexplanon
- Next Choice One Dose
- Nor-qd
- Nora-be
- norelgestrom-ethinyl estradiol
- noreth-ethinyl estradiol-iron
- norethin-e.estradiol triphasic
- norethin-eth estrad biphasic
- norethindrone (contraceptive)
- norethindrone ac-eth estradiol
- norethindrone-e.estradiol-iron
- norethindrone-ethin estradiol
- norethindrone-mestranol
- norgestimate-ethinyl estradiol
- norgestrel-ethinyl estradiol
- Norinyl 1+35 (28)
- Norinyl 1+50 (28)
- Nortrel 0.5/35 (28)
- Nortrel 1/35 (21)
- Nortrel 1/35 (28)
- Nortrel 7/7/7 (28)
- Nuvaring
- Ocella
- Ogestrel (28)
- Orsythia
- Ortho Evra
- Ortho Micronor
- Ortho Tri-cyclen (28)
- Ortho Tri-cyclen Lo (28)
- Ortho-cept (28)
- Ortho-cyclen (28)
- Ortho-novum 1/35 (28)
- Ortho-novum 7/7/7 (28)
- Ovcon-35 (28)
- Philith
- Pimtrea (28)
- Pirmella
- Plan B One-step
- Portia
- Previfem
- Prograf
- Quartette
- Quasense
- quetiapine
- Rapamune
- Reclipsen (28)
- Safyral
- Samsca
- Sandimmune
- Seasonique
- Seroquel Xr
- sirolimus
- Skyla
- Sprintec (28)
- Sronyx
- Syeda
- tacrolimus
- temsirolimus
- Tilia Fe
- tolvaptan
- Torisel
- Tri-estarylla
- Tri-legest Fe
- Tri-linyah
- Tri-norinyl (28)
- Tri-previfem (28)
- Tri-sprintec (28)
- Trinessa (28)
- Trivora (28)
- Velivet Triphasic Regimen (28)
- Vestura (28)
- Viorele (28)
- Vyfemla (28)
- warfarin
- Wera (28)
- Wymzya Fe
- Yasmin (28)
- Yaz 28
- Zarah
- Zenchent (28)
- Zenchent Fe
- Zeosa
- Zortress
- Zovia 1/35E (28)
- Zovia 1/50E (28)
Severe
Moderate
- A-hydrocort
- A-methapred
- Abilify
- Abilify Discmelt
- Abilify Maintena
- acebutolol
- Activella
- Adasuve
- Adoxa
- Alora
- aminophylline
- Angeliq
- Anucort-hc
- Anusol-hc
- aripiprazole
- Aristospan Intra-articular
- Aristospan Intralesional
- Avidoxy
- betamethasone acet & sod phos
- betaxolol
- budesonide
- Celestone Soluspan
- Cenestin
- chlorpromazine
- Climara
- Climara Pro
- Colocort
- Combipatch
- Compazine
- Compro
- conj estrogens-bazedoxifene
- conjugated estrogens
- Cortef
- Cortenema
- Cortifoam
- cortisone
- Covaryx
- Covaryx H.s.
- Delestrogen
- Depo-estradiol
- Depo-medrol
- dexamethasone
- Dexamethasone Intensol
- dexamethasone sodium phos (PF)
- dexamethasone sodium phosphate
- Dexpak 10 Day
- Dexpak 13 Day
- Dexpak 6 Day
- dextromethorphan-quinidine
- Divigel
- Doryx
- Doxy-100
- doxycycline calcium
- doxycycline hyclate
- doxycycline monohydrate
- drospirenone-estradiol
- Duavee
- Dutoprol
- Eemt
- Eemt Hs
- Elestrin
- Elixophyllin
- Enjuvia
- Entocort Ec
- esterified estrogens
- Estrace
- estradiol
- estradiol acetate
- estradiol cypionate
- Estradiol Transdermal Patch
- estradiol valerate
- estradiol-levonorgestrel
- estradiol-norethindrone acet
- estradiol-norgestimate
- Estrasorb
- Estring
- Estrogel
- estrogens-methyltestosterone
- estropipate
- Evamist
- Ez Use Joint-tunnel-trigger
- felodipine
- Femhrt Low Dose
- Femring
- First-duke's
- First-mary's Mouthwash
- Flagyl
- Flagyl Er
- Flo-pred
- fludrocortisone
- fluphenazine decanoate
- fluphenazine HCl
- Grx Hicort 25
- Haldol
- Haldol Decanoate
- haloperidol
- haloperidol decanoate
- haloperidol lactate
- Hemril-30
- hydrocortisone
- hydrocortisone acetate
- hydrocortisone sod succ (PF)
- hydrocortisone sod succinate
- Inderal La
- Inderal Xl
- Innopran Xl
- isoniazid
- isoniazid-rifamp-pyrazinamide
- Jinteli
- Kenalog
- Lopressor
- Lopressor Hct
- loxapine
- loxapine succinate
- Loxitane
- Medrol
- Medrol (pak)
- Menest
- Menostar
- methylprednisolone
- methylprednisolone acetate
- methylprednisolone sod suc(PF)
- methylprednisolone sodium succ
- methylprednisolone-bupivacaine
- metoprolol su-hydrochlorothiaz
- metoprolol succinate
- metoprolol ta-hydrochlorothiaz
- metoprolol tartrate
- Metro I.v.
- Metrogel Vaginal
- metronidazole
- metronidazole in NaCl (iso-os)
- Millipred
- Millipred Dp
- Mimvey
- Minivelle
- Monodox
- Morgidox
- Nuedexta
- nystatin-hydrocortisone-diphen
- nystatin-TCN-HC-diphenhydramin
- Ogen 2.5
- Oracea
- Orapred
- Orapred Odt
- Pediapred
- perphenazine
- perphenazine-amitriptyline
- Phenadoz
- Phenergan
- Physicians Ez Use M-pred
- prednisolone
- prednisolone acetate
- prednisolone sodium phosphate
- prednisone
- Prednisone Intensol
- Prefest
- Premarin
- prochlorperazine
- prochlorperazine Edisylate
- prochlorperazine maleate
- Proctocort
- promethazine
- Promethazine Vc
- Promethazine Vc-codeine
- promethazine-codeine
- promethazine-DM
- promethazine-phenyleph-codeine
- promethazine-phenylephrine
- Promethegan
- propranolol
- propranolol-hydrochlorothiazid
- quinidine gluconate
- quinidine sulfate
- Rayos
- Rectacort-hc
- Rifamate
- rifampin-isoniazid
- Rifater
- Risperdal
- Risperdal Consta
- Risperdal M-tab
- risperidone
- risperidone microspheres
- Sectral
- Seroquel
- Solu-cortef
- Solu-cortef (pf)
- Solu-medrol
- Solu-medrol (pf)
- synthetic conj estrogens A
- synthetic conj estrogens B
- Theo-24
- Theochron
- theophylline
- theophylline in dextrose 5 %
- thioridazine
- Toprol Xl
- triamcinolone acetonide
- triamcinolone hexacetonide
- triamcinolone-lidocaine
- trifluoperazine
- Uceris
- Vagifem
- Vandazole
- Veripred 20
- Vibramycin
- Vivelle-dot
- Acetaminophen overdose
- Acute asthma attack
- Acute hepatic failure
- Acute hepatitis C
- Alcoholism
- Porphyria
- Sleep apnea
Contraindicated
- Acute respiratory insufficiency
- Chronic obstructive pulmonary disease
- Depression
- Disease of liver
- Drug abuse
- Hepatic coma
- Hepatic encephalopathy
- Hyperammonemia
- Protein-calorie malnutrition
- Severe renal impairment
- Shock
- Suicidal ideation
Severe
Moderate
- Anemia
- Complex sleep behavior
- Disease of liver
- Hyperkinesis
- Kidney disease with reduction in GFR
- Neutropenic disorder
- Severe hepatic disease
- Thrombocytopenic disorder
BUPAP (BUTALBITAL/ACETAMINOPHEN)
- Tension-type headache
- None
- Dizziness
- Drowsy
More Frequent
Severe
Less Severe
- Abnormal hepatic function tests
- Acute confusion
- Excitement
- Lethargy
- Constipation
- Depression
- Headache disorder
- Insomnia
- Irritability
- Nausea
- Nervousness
- Nightmares
- Symptoms of anxiety
- Syncope
- Vertigo
- Vomiting
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Accidental fall
- Acute generalized exanthematous pustulosis
- Acute hepatic failure
- Agranulocytosis
- Allergic dermatitis
- Altered consciousness
- Anaphylaxis
- Angioedema
- Apnea
- Bradycardia
- Drug-induced hepatitis
- Dyspnea
- Exfoliative dermatitis
- Hallucinations
- Hypersensitivity drug reaction
- Hypotension
- Hypoventilation
- Laryngeal edema
- Leukopenia
- Maculopapular rash
- Megaloblastic anemia
- Memory impairment
- Neutropenic disorder
- Osteopenia
- Psychiatric disorder
- Rickets
- Skin rash
- Stevens-johnson syndrome
- Throat constriction
- Thrombocytopenic disorder
- Toxic epidermal necrolysis
- Urticaria
- Wheezing
Less Severe
- Agitation
- Ataxia
- CNS depression
- Complex sleep behavior
- Disturbance in thinking
- Drug dependence
- Erythema
- Hyperkinesis
- Medication overuse headache
- Skin rash
- Urticaria
Contraindicated
None
Severe Precaution
Butalbital
Safety and effectiveness not established age < 12 years.
- 1 Day – 12 Years
- Safety and effectiveness not established age < 12 years.
Management or Monitoring Precaution
Acetaminophen (oral,rectal)
Use weight based dosing in children less than 12 years.
- 1 Day – 12 Years
- Use weight based dosing in children less than 12 years.
Acetaminophen
- Severity Level:
2
- Additional Notes: Available data suggest no known risk; otc product, no fda pregnancy warnings
Butalbital
- Severity Level:
C
- Additional Notes: Case report of neonatal withdrawal seizures with butalbital combo product
Contraindicated
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Precaution Exists
Butalbital
Possibility of central nervous system depression in nursing infant.
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Excreted | Drug shown to have adverse effect | Possibility of central nervous system depression in nursing infant. |
No Known Risk
Acetaminophen
Low levels excreted with low risk for adverse effects in infant
| General | Excretion Potential | Effect on Infant | Notes |
| No known risks; does not adversely affect lactation | Excreted | No adverse effect | Low levels excreted with low risk for adverse effects in infant |
Contraindicated
None
Precaution Exists
Acetaminophen (oral,rectal)
Hepatic-Elderly may be more susceptible to hepatotoxicity. Strict adherence to a maximum daily dose is recommended, and the maximum dose recommendation varies between 3000-3800 mg depending on strength used and source of the recommendation.
General-Not recommended in the elderly due to sedation which may predispose to falls. May exacerbate depression. Renal-Renal excretion may increase adverse events with renal impairment. Monitor renal function.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | N | Y | N | N | N | N |
BEERS: N HEDIS: N STOPP: N
Butalbital
Hepatic-Elderly may be more susceptible to hepatotoxicity. Strict adherence to a maximum daily dose is recommended, and the maximum dose recommendation varies between 3000-3800 mg depending on strength used and source of the recommendation.
General-Not recommended in the elderly due to sedation which may predispose to falls. May exacerbate depression. Renal-Renal excretion may increase adverse events with renal impairment. Monitor renal function.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | Y | Y | N | Y | N | N |
BEERS: Y HEDIS: Y STOPP: Y
No Known Risk
None
- One ingredient in this product is acetaminophen. Taking too much acetaminophen may cause serious (possibly fatal) liver disease. Adults should not take more than 4000 milligrams (4 grams) of acetaminophen a day.<br /><br />People with liver problems and children should take less acetaminophen. Ask your doctor or pharmacist how much acetaminophen is safe to take. Do not use with any other drug containing acetaminophen without asking your doctor or pharmacist first.<br /><br />Acetaminophen is in many nonprescription and prescription medications (such as pain/fever drugs or cough-and-cold products). Check the labels on all your medicines to see if they contain acetaminophen, and ask your pharmacist if you are unsure. Get medical help right away if you take too much acetaminophen (overdose), even if you feel well.<br /><br />Overdose symptoms may include nausea, vomiting, loss of appetite, sweating, stomach/abdominal pain, extreme tiredness, yellowing eyes/skin, and dark urine. Daily alcohol use, especially when combined with acetaminophen, may damage your liver. Avoid alcohol.
| Tension-type headache | |
| G44.2 | Tension-type headache |
| G44.20 | Tension-type headache, unspecified |
| G44.201 | Tension-type headache, unspecified, intractable |
| G44.209 | Tension-type headache, unspecified, not intractable |
| G44.21 | Episodic tension-type headache |
| G44.211 | Episodic tension-type headache, intractable |
| G44.219 | Episodic tension-type headache, not intractable |
| G44.22 | Chronic tension-type headache |
| G44.221 | Chronic tension-type headache, intractable |
| G44.229 | Chronic tension-type headache, not intractable |
| 0-9 | A-Z |
|---|---|
| G44.2 | Tension-type headache |
| G44.20 | Tension-type headache, unspecified |
| G44.201 | Tension-type headache, unspecified, intractable |
| G44.209 | Tension-type headache, unspecified, not intractable |
| G44.21 | Episodic tension-type headache |
| G44.211 | Episodic tension-type headache, intractable |
| G44.219 | Episodic tension-type headache, not intractable |
| G44.22 | Chronic tension-type headache |
| G44.221 | Chronic tension-type headache, intractable |
| G44.229 | Chronic tension-type headache, not intractable |
Formulary Reference Tool