BUTALBITAL-ASPIRIN-CAFFEINE (BUTALBITAL/ASPIRIN/CAFFEINE)

Moderate

• A-hydrocort

• A-methapred

• Abilify

• Abilify Discmelt

• Abilify Maintena

• Accupril

• Accuretic

• acebutolol

• Aceon

• acetazolamide

• acetazolamide sodium

• Activella

• Adasuve

• Adoxa

• Alora

• Altace

• Amaryl

• aminophylline

• amlodipine-benazepril

• Angeliq

• Anucort-hc

• Anusol-hc

• aripiprazole

• Aristospan Intra-articular

• Aristospan Intralesional

• Arixtra

• Avidoxy

• benazepril

• benazepril-hydrochlorothiazide

• betamethasone acet & sod phos

• betaxolol

• Brintellix

• Brisdelle

• budesonide

• captopril

• captopril-hydrochlorothiazide

• Celestone Soluspan

• Celexa

• Cenestin

• chlorpromazine

• citalopram

• Climara

• Climara Pro

• colchicine-probenecid

• Colocort

• Combipatch

• Compazine

• Compro

• conj estrogens-bazedoxifene

• conjugated estrogens

• Cortef

• Cortenema

• Cortifoam

• cortisone

• Covaryx

• Covaryx H.s.

• Cymbalta

• dalteparin (porcine)

• Delestrogen

• Depacon

• Depakene

• Depakote

• Depakote Er

• Depakote Sprinkles

• Depo-estradiol

• Depo-medrol

• desvenlafaxine

• desvenlafaxine fumarate

• desvenlafaxine succinate

• dexamethasone

• Dexamethasone Intensol

• dexamethasone sodium phos (PF)

• dexamethasone sodium phosphate

• Dexpak 10 Day

• Dexpak 13 Day

• Dexpak 6 Day

• dextromethorphan-quinidine

• Diabeta

• Diamox Sequels

• divalproex

• Divigel

• Doryx

• Doxy-100

• doxycycline calcium

• doxycycline hyclate

• doxycycline monohydrate

• drospirenone-estradiol

• Duavee

• Duetact

• duloxetine

• Dutoprol

• Eemt

• Eemt Hs

• Effexor Xr

• Elestrin

• Elixophyllin

• Elmiron

• enalapril maleate

• enalapril-hydrochlorothiazide

• enalaprilat

• Enjuvia

• enoxaparin

• Entocort Ec

• Epaned

• escitalopram oxalate

• 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

• Fetzima

• First-duke's

• First-mary's Mouthwash

• Flagyl

• Flagyl Er

• Flo-pred

• fludrocortisone

• fluoxetine

• fluphenazine decanoate

• fluphenazine HCl

• fluvoxamine

• fondaparinux

• fosinopril

• fosinopril-hydrochlorothiazide

• Fragmin

• glimepiride

• glipizide

• glipizide-metformin

• Glucotrol

• Glucotrol Xl

• Glucovance

• glyburide

• glyburide micronized

• glyburide-metformin

• Glynase

• Grx Hicort 25

• Haldol

• Haldol Decanoate

• haloperidol

• haloperidol decanoate

• haloperidol lactate

• Hemril-30

• heparin (porcine)

• heparin (porcine) in D5W

• heparin(porcine) in 0.45% NaCl

• heparin, porcine (PF)

• hydrocortisone

• hydrocortisone acetate

• hydrocortisone sod succ (PF)

• hydrocortisone sod succinate

• Inderal La

• Inderal Xl

• Innopran Xl

• Jinteli

• Kenalog

• Khedezla

• lepirudin

• levomilnacipran

• Lexapro

• lisinopril

• lisinopril-hydrochlorothiazide

• lithium carbonate

• lithium citrate

• Lithobid

• Lopressor

• Lopressor Hct

• Lotensin

• Lotrel

• Lovenox

• loxapine

• loxapine succinate

• Loxitane

• Luvox Cr

• Mavik

• Medrol

• Medrol (pak)

• Menest

• Menostar

• methazolamide

• 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

• milnacipran

• Mimvey

• Minivelle

• moexipril

• moexipril-hydrochlorothiazide

• Monodox

• Morgidox

• nateglinide

• Neptazane

• Nuedexta

• nystatin-hydrocortisone-diphen

• nystatin-TCN-HC-diphenhydramin

• Ogen 2.5

• olanzapine-fluoxetine

• Oracea

• Orapred

• Orapred Odt

• paroxetine HCl

• paroxetine mesylate

• Paxil

• Paxil Cr

• Pediapred

• pentosan polysulfate sodium

• perindopril erbumine

• perphenazine

• perphenazine-amitriptyline

• Pexeva

• Phenadoz

• Phenergan

• Physicians Ez Use M-pred

• pioglitazone-glimepiride

• prednisolone

• prednisolone acetate

• prednisolone sodium phosphate

• prednisone

• Prednisone Intensol

• Prefest

• Premarin

• Prinivil

• Pristiq

• probenecid

• 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

• Prozac

• Prozac Weekly

• quinapril

• quinapril-hydrochlorothiazide

• quinidine gluconate

• quinidine sulfate

• ramipril

• Rayos

• Rectacort-hc

• Refludan

• Risperdal

• Risperdal Consta

• Risperdal M-tab

• risperidone

• risperidone microspheres

• Sarafem

• Savella

• Sectral

• Seroquel

• sertraline

• Solu-cortef

• Solu-cortef (pf)

• Solu-medrol

• Solu-medrol (pf)

• Starlix

• Stavzor

• Symbyax

• synthetic conj estrogens A

• synthetic conj estrogens B

• Tarka

• Theo-24

• Theochron

• theophylline

• theophylline in dextrose 5 %

• thioridazine

• ticlopidine

• tolazamide

• tolbutamide

• Toprol Xl

• trandolapril

• trandolapril-verapamil

• triamcinolone acetonide

• triamcinolone hexacetonide

• triamcinolone-lidocaine

• trifluoperazine

• Uceris

• Uniretic

• Univasc

• Vagifem

• valproate sodium

• valproic acid

• valproic acid (as sodium salt)

• Vandazole

• Vaseretic

• Vasotec

• venlafaxine

• Veripred 20

• Vibramycin

• Viibryd

• vilazodone

• Vivelle-dot

• vortioxetine

• Zestoretic

• Zestril

• Zoloft

Moderate

• Anemia

• Cardiac arrhythmia

• Complex sleep behavior

• Disease of liver

• Hyperkinesis

• Hypertension

• Insomnia

• Kidney disease with reduction in GFR

• Nasal polyp

• Neutropenic disorder

• Renal disease with moderate to severe impairment

• Seizure disorder

• Severe hepatic disease

• Thrombocytopenic disorder

• Vitamin K deficiency

Aspirin (>150Mg)

• Severity Level:

  1

• Additional Notes: No fda category; not recommended especially in 3rd trimester or near term

Butalbital

• Severity Level:

  C

• Additional Notes: Case report of neonatal withdrawal seizures with butalbital combo product

Caffeine

• Severity Level:

  C

• Additional Notes: Reports of miscarriage,poor fetal growth possibly assoc w/high doses of caffeine

Contraindicated

Aspirin (>150Mg)

One report of metabolic acidosis; risk of reye's synd in viral illness.

General	Excretion Potential	Effect on Infant	Notes
Drug should not be given to breast feeding mothers	Excreted	Drug shown to have adverse effect	One report of metabolic acidosis; risk of reye's synd in viral illness.

Precaution Exists

Butalbital

Possibility of central nervous system depression in nursing infant.

High doses may cause hyperactivity and wakefulness in 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.

Caffeine

Possibility of central nervous system depression in nursing infant.

High doses may cause hyperactivity and wakefulness in infant.

General	Excretion Potential	Effect on Infant	Notes
Evaluate use carefully	Excreted	Drug shown to have adverse effect	High doses may cause hyperactivity and wakefulness in infant.

No Known Risk

None

General	Excretion Potential	Effect on Infant	Notes
			None

Contraindicated

None

Precaution Exists

Butalbital

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

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