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Pain Information


This section about chronic pain is not intended as a comprehensive source of medical information, but as a hub for links to other more detailed sources.


Acute pain is the body's alarm system. It signals that something is wrong. It signals that you are in danger of injury or that the injured part needs to be protected and rested.

Chronic pain serves no useful purpose and may cause disability and distress to sufferers and their families. Estimates of the number of people with chronic pain vary from 8% to 45% depending on severity and whether medical help is sought. Chronic pain is more common in women and in the elderly. Many types of chronic pain have been identified. However some people with chronic pain do not have a diagnosis from their doctor. The Pain Relief Foundation funds research into the causes and treatment of chronic pain.


If you have a pain problem, which needs treatment you should contact your own doctor who can refer you to a pain clinic in your area. This site is for information only and cannot be treated as a substitute for the medical advice of your own doctor. The Pain Relief Foundation is not able to offer individual medical advice.


 

 

What other drugs will affect aspirin/butalbital/caffeine?

Do not take aspirin/butalbital/caffeine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. Dangerous sedation could result.

Aspirin/butalbital/caffeine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves.

Dangerous side effects may occur if aspirin is taken with any of the following medicines:

  • oral anticoagulants such as warfarin (Coumadin);

  • probenecid (Benemid) or sulfinpyrazone (Anturane);

  • nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil, Nuprin, others), ketoprofen (Orudis, Orudis KT, Oruvail), and naproxen (Naprosyn, Anaprox, Aleve);
  • other salicylates (forms of aspirin) such as choline salicylate and magnesium salicylate;

  • steroids such as prednisone (Deltasone), prednisolone (Prelone, Pediapred, others), methylprednisolone (Medrol, others), dexamethasone (Decadron), and others; or

  • insulin and oral antidiabetic drugs such as glipizide (Glucotrol) and glyburide (Micronase, Diabeta, Glynase).

Do not take this medication without first talking to your doctor if you are taking any of the medications listed above.

Many other medicines contain aspirin, especially over-the-counter pain, fever, cold, and allergy medications. Too much aspirin can be very dangerous.

Drugs other than those listed here may also interact with aspirin/butalbital/caffeine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

 

Where can I get more information?

  • Your pharmacist has additional information about aspirin/butalbital/caffeine written for health professionals that you may read.

What does my medication look like?

Aspirin/butalbital/caffeine is available with a prescription generically and under the brand name Fiorinal. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Aspirin/butalbital/caffeine strengths are as follows:

  • Fiorinal 325 mg/50 mg/40 mg--white, round tablets

  • Fiorinal 325 mg/50 mg/40 mg-dark green and lime green capsules

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Headaches that disturb sleep, occur whenever the person is active, or that are recurrent or chronic may also require examination and treatment by a health care provider.

Treatment    

The goal is to relieve symptoms and prevent future headaches. Prevention is the best treatment. If possible, remove or control your headache "triggers."

Learn and practice stress management strategies. Some people find relaxation exercises or meditation helpful. Biofeedback may improve relaxation exercises and may be helpful for chronic tension headache.

Other preventive measures may include keeping warm if the headache is associated with cold, using a different pillow, or changing sleeping positions. Use good posture when reading, working, or doing other activities that may cause headache. Exercise the neck and shoulders frequently when typing, working on computers, or doing close work.

Enough sleep and rest, or massage of sore muscles can help reduce the chance that a headache will occur. Hot or cold showers or baths may relieve a headache for some people.

Over-the-counter analgesics such as aspirin, ibuprofen, or acetaminophen may relieve pain if the above measures are ineffective. An antidepressant or other medication may be advised for chronic headache. A nonsedating muscle relaxant like metaxalone (Skelaxin) helps some patients. In severe cases, the combination of butalbital and acetaminophen (Fioricet) or butalbital and aspirin (Fiorinal) may be helpful.

A headache diary may help you identify the source of chronic headaches. When a headache occurs, write down the date and time the headache began. Note what you ate for the preceding 24 hours, sleep pattern and amount of sleep, what was being experienced immediately before the headache, unusual stress or other circumstances, how long the headache lasted, and what made it stop.

Lifestyle changes may be required for chronic tension headaches. This may include adequate rest and exercise, change in job or recreational habits, or other changes.

Expectations (prognosis)    

Tension headaches usually respond well to treatment without residual effects. They are annoying, but not dangerous.

Complications    

  • The headache may not be a tension headache, but it may be a symptom of another, more serious, disorder.
  • Rebound headaches may occur from overuse of analgesic medications.

Calling your health care provider    

See your health care provider if headaches are severe, persistent, recurrent, or are accompanied by other symptoms (drowsiness, vision changes, changes in movement or sensation, seizures, changes in alertness, nausea and vomiting).

Also call if headaches disturb sleep, occur whenever you are active, are recurrent or chronic, or if a headache does not respond to treatment.

Prevention    

Avoid situations that may cause a tension headache. This can include keeping warm if the headache is associated with cold, using a different pillow or sleeping position, or similar changes.

Use good posture when reading, working, or involved in activities that may cause a headache. Exercise the neck and shoulders frequently.

For More Information

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892?3675
Phone: 301?495?4484 or
877?22朜IAMS (226?4267) (free of charge)
TTY: 301?565?2966
Fax: 301?718?6366
E-mail: NIAMSInfo@mail.nih.gov
www.niams.nih.gov

National Institute of Neurological Disorders and Stroke
NIH Neurological Institute

P.O. Box 5801
Bethesda, MD 20824
Phone: 301?496?5751 or
800?352?9424 (free of charge)
TTY: 301?468?5981
www.ninds.nih.gov

National Center for Complementary and Alternative Medicine
P.O. Box 7923
Gaithersburg, MD 20898
Phone: 301?519?3153 (international)
or 888?644?6226 (free of charge)
TTY: 866?464?3615
Fax: 866?464?3616
E-mail: info@nccam.nih.gov
www.nccam.nih.gov

Agency for Health Care Research and Quality Clearinghouse
540 Gaither Road
Rockville, MD 20850
Phone: 301?427?1364
www.ahcpr.gov

Clearinghouse for Occupational Safety and Health Information
Information Services Branch MSC-13
4676 Columbia Parkway
Cincinnati, OH 45226
Phone: 513?533?8326 or
800?356?4674 (free of charge)
www.cdc.gov/niosh/homepage.html

American Academy of Orthopaedic Surgeons
P.O. Box 2058
Des Plaines, IL 60017
Phone: 800?824朆ONE (2663) (free of charge)
www.aaos.org

North American Spine Society (part of AAOS)
22 Calendar Court
2nd Floor
LaGrange, IL 60525
Phone: 877朣PINE-DR (free of charge)
E-mail: info@spine.org
www.spine.org

American College of Rheumatology
1800 Century Place, Suite 250
Atlanta, GA 30345
Phone: 404?633?3777
www.rheumatology.org

Arthritis Foundation
1330 West Peachtree Street, Suite 100
Atlanta, GA 30309
Phone: 404?872?7100 or
800?568?4045 (free of charge)
www.arthritis.org

American Chiropractic Association
1701 Clarendon Boulevard
Arlington, VA 22209
Phone: 800?986?4636 (free of charge)
www.amerchiro.org

American Osteopathic Association
142 East Ontario Street
Chicago, IL 60611
Toll-free phone: (800) 621-1773
Phone: (312) 202-8000
http://www.osteopathic.org/

 



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