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Before Using Butalbital

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For butalbital and acetaminophen combinations, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to butalbital or other barbiturates, or to acetaminophen, aspirin, or caffeine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—

  • For butalbital: Barbiturates such as butalbital have been shown to increase the chance of birth defects in humans. Also, one study in humans has suggested that barbiturates taken during pregnancy may increase the chance of brain tumors in the baby.Butalbital may cause breathing problems in the newborn baby if taken just before or during delivery.
  • For acetaminophen: Although studies on birth defects with acetaminophen have not been done in pregnant women, it has not been reported to cause birth defects or other problems.
  • For caffeine: Studies in humans have not shown that caffeine (contained in some of these combination medicines) causes birth defects. However, use of large amounts of caffeine during pregnancy may cause problems with the heart rhythm and the growth of the fetus. Also, studies in animals have shown that caffeine causes birth defects when given in very large doses (amounts equal to those present in 12 to 24 cups of coffee a day).

 

Breast-feeding—

  • For butalbital: Barbiturates such as butalbital pass into the breast milk and may cause drowsiness, unusually slow heartbeat, shortness of breath, or troubled breathing in nursing babies.
  • For acetaminophen: Although acetaminophen has not been shown to cause problems in nursing babies, it passes into the breast milk in small amounts.
  • For caffeine: Caffeine (present in some butalbital and acetaminophen combinations) passes into the breast milk in small amounts. Taking caffeine in the amounts present in these medicines has not been shown to cause problems in nursing babies. However, studies have shown that nursing babies may appear jittery and have trouble in sleeping when their mothers drink large amounts of caffeine-containing beverages. Therefore, breast-feeding mothers who use caffeine-containing medicines should probably limit the amount of caffeine they take in from other medicines or from beverages.

 

Children—

  • For butalbital: Although barbiturates such as butalbital often cause drowsiness, some children become excited after taking them.
  • For acetaminophen: Acetaminophen has been tested in children and, in effective doses, has not been shown to cause different side effects or problems than it does in adults.
  • For caffeine: There is no specific information comparing use of caffeine in children up to 12 years of age with use in other age groups. However, caffeine is not expected to cause different side effects or problems in children than it does in adults.

 

Older adults—

  • For butalbital: Certain side effects, such as confusion, excitement, or mental depression, may be especially likely to occur in elderly patients, who are usually more sensitive than younger adults to the effects of the butalbital in this combination medicine.
  • For acetaminophen: Acetaminophen has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.
  • For caffeine: Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of caffeine in the elderly with use in other age groups.

 

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking a butalbital and acetaminophen combination, it is especially important that your health care professional know if you are taking any of the following:

  • Anticoagulants (blood thinners), or
  • Carbamazepine (e.g., Tegretol) or
  • Contraceptives, oral (birth control pills) containing estrogen, or
  • Corticosteroids (cortisone-like medicines) or
  • Corticotropin (e.g., ACTH)—Butalbital may make these medicines less effective
  • Antidepressants, tricyclic (amitriptyline [e.g., Elavil], amoxapine [e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Pertofrane], doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g., Aventyl], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil]) or
  • Central nervous system (CNS) depressants (medicines that often cause drowsiness)—These medicines may add to the effects of butalbital and increase the chance of drowsiness or other side effects
  • Divalproex (e.g., Depakote) or
  • Valproic acid (e.g., Depakene)—The chance of side effects may be increased

 

Other medical problems—The presence of other medical problems may affect the use of butalbital and acetaminophen combinations. Make sure you tell your doctor if you have any other medical problems, especially:
  • Alcohol abuse (or history of) or
  • Drug abuse or dependence (or history of)—Dependence on butalbital may develop; also, acetaminophen may cause liver damage in people who abuse alcohol
  • Asthma (or history of), emphysema, or other chronic lung disease or
  • Hepatitis or other liver disease or
  • Hyperactivity (in children) or
  • Kidney disease—The chance of serious side effects may be increased
  • Type 2 diabetes mellitus or
  • Mental depression or
  • Overactive thyroid or
  • Porphyria (or history of)—Butalbital can make these conditions worse
  • Heart disease (severe)—The caffeine in some butalbital and acetaminophen combinations can make some kinds of heart disease worse

 

Also called: Analgesics, Pain medicines

Pain relievers are medicines that reduce or relieve headaches, sore muscles, arthritis or any number of other aches and pains. There are many different pain medicines, and each one has advantages and risks. Some types of pain respond better to certain medicines than others. Each person may also have a slightly different response to a pain reliever.

Over-the-counter (OTC) medicines are good for many types of pain. There are two main types of OTC pain medications: acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs). Aspirin, naproxen (Aleve) and ibuprofen (Advil, Motrin) are examples of OTC NSAIDs. If OTC medicines don't relieve your pain, your doctor may prescribe something stronger. Many NSAIDs are available at prescription doses. The most powerful pain relievers are narcotics. These drugs can have serious side effects. You must use them only under a doctor's supervision.

 

What is Central Pain Syndrome?
Central pain syndrome is a neurological condition caused by damage to or dysfunction of the central nervous system (CNS), which includes the brain, brainstem, and spinal cord. This syndrome can be caused by stroke, multiple sclerosis, tumors, epilepsy, brain or spinal cord trauma, or Parkinson's disease. The character of the pain associated with this syndrome differs widely among individuals partly because of the variety of potential causes. Central pain syndrome may affect a large portion of the body or may be more restricted to specific areas, such as hands or feet. The extent of pain is usually related to the cause of the CNS injury or damage. Pain is typically constant, may be moderate to severe in intensity, and is often made worse by touch, movement, emotions, and temperature changes, usually cold temperatures. Individuals experience one or more types of pain sensations, the most prominent being burning. Mingled with the burning may be sensations of "pins and needles;" pressing, lacerating, or aching pain; and brief, intolerable bursts of sharp pain similar to the pain caused by a dental probe on an exposed nerve. Individuals may have numbness in the areas affected by the pain. The burning and loss of touch sensations are usually most severe on the distant parts of the body, such as the feet or hands. Central pain syndrome often begins shortly after the causative injury or damage, but may be delayed by months or even years, especially if it is related to post-stroke pain.

Is there any treatment?

Pain medications often provide some reduction of pain, but not complete relief of pain, for those affected by central pain syndrome. Tricyclic antidepressants such as nortriptyline or anticonvulsants such as neurontin (gabapentin) can be useful. Lowering stress levels appears to reduce pain.

 

What is the prognosis?

Central pain syndrome is not a fatal disorder, but the syndrome causes disabling chronic pain and suffering among the majority of individuals who have it.

 

What research is being done?

The NINDS vigorously pursues a research program seeking new treatments for chronic pain and nervous system damage. The goals of this research are to develop ways to more effectively treat and potentially reverse debilitating conditions such as central pain syndrome.

 

          


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