BARBITURATES & ASPIRIN (Also contains caffeine)

Brand & Generic Names

Axotal	Fortabs
B-A-C	Idenal
Butalbital A-C	Isobutal
BUTALBITAL, ASPIRIN	Isobutyl
& CAFFEINE	Isolin
Butalbital Compound	Isollyl (Improved)
Butalgen	Laniroif
Farbital	Lanorinal
Fiorex	Marnal
Fiorgen PF	Salipral
Fiorinal	Tecnal
Fiormor	Vibutal
Florital

Basic Information

• Habit forming? Yes
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Analgesic, anti-inflammatory (non-steroidal), sedative

Uses

• Reduces anxiety or nervous tension (low dose).
• Reduces pain, fever, inflammation.

Dosage & Usage Information

How to take:
Tablet or capsule--Swallow with liquid or food to lessen stomach irritation. If you can't swallow whole, crumble tablet or open capsule and take with liquid or food.

When to take:
At the same times each day. No more often than every 4 hours.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
May partially block nerve impulses at nerve cell connections.
Affects hypothalamus, the part of the brain that regulates temperature by dilating small blood vessels in the skin.
Prevents clumping of platelets (small blood cells) so blood vessels remain open.
Decreases prostaglandin effect.
Suppresses body's pain messages.

Time lapse before drug works:
30 minutes.

Don't take with:
Non-prescription drugs without consulting doctor.
See Interaction section and consult doctor.

Overdose

SYMPTOMS:
Deep sleep, weak pulse, ringing in ears, nausea, vomiting, dizziness, fever, deep and rapid breathing, hallucinations, convulsions, coma.

WHAT TO DO:

• Dial 911 (emergency) or 0 (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY information.

Possible Adverse Reactions or Side Effects

Life-threatening:

Hives, rash, intense Seek emergency treatment immediately. itching, faintness soon after a dose (anaphylaxis); wheezing; tightness in chest; black or bloody vomit; black stools; shortness of breath.

Common:

Dizziness, drowsiness, heartburn.

Infrequent:

Jaundice, vomiting blood; easy bruising; skin rash, hives; confusion; depression; sore throat, fever, mouth sores; hearing loss; slurred speech; decreased vision.

Rare:

• Diminished vision, blood in urine, unexplained fever.
• Insomnia, nightmares, constipation, headache, jaundice, nervousness.

Warnings & Precautions

Don't take if:

• You are allergic to any barbiturate or aspirin.
• You have a peptic ulcer of stomach or duodenum, bleeding disorder, porphyria.

Before you start, consult your doctor:

• If you have had stomach or duodenal ulcers.
• If you have asthma, nasal polyps, epilepsy, kidney or liver damage, anemia, chronic pain.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.

Over age 60:

• Adverse reactions and side effects may be more frequent and severe than in younger persons.
• More likely to cause hidden bleeding in stomach or intestines. Watch for dark stools.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing until you finish medicine. Consult doctor for advice on maintaining milk supply.

Infants & children:

• Overdose frequent and severe. Keep bottles out of children's reach.
• Use only under doctor's supervision.
• Consult doctor before giving to persons under age 18 who have fever and discomfort of viral illness, especially chicken pox and influenza. Probably increases risk of Reye's syndrome.

Prolonged use:

• Kidney damage. Periodic kidney function test recommended.
• May cause addiction, anemia, chronic intoxication.
• May lower body temperature, making exposure to cold temperatures hazardous.

Skin & sunlight:
May cause rash or intensify sunburn in areas exposed to sun or sunlamp.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes, such as antihistamines, tranquilizers, sedatives, pain medicine, narcotics and mind-altering drugs.

Discontinuing:
May be unnecessary to finish medicine. Follow doctor's instructions. If you develop withdrawal symptoms of hallucinations, agitation or sleeplessness after discontinuing, call doctor right away.

Others:

• Aspirin can complicate surgery; illness; pregnancy, labor and delivery.
• For arthritis--Don't change dose without consulting doctor.
• Urine tests for blood sugar may be inaccurate.
• Great potential for abuse.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
-------------------------	-----------------------
Allopurinol	Decreased allopurinol effect.
Antacids*	Decreased aspirin effect.
Anticoagulants,	Increased anticoagulant effect.
oral*	Abnormal bleeding.
Anticonvulsants*	Changed seizure patterns.
Antidepressants*	Decreased antidepressant effect.
	Possible dangerous oversedation.
Antidiabetics,	Increased butalbital effect. Low
oral*	blood sugar.
Antihistamines*	Dangerous sedation. Avoid.
Aspirin, other	Likely aspirin toxicity.
Beta-adrenergic	Decreased effect of beta-adrenergic
blockers*	blocker.
Contraceptives,	Decreased contraceptive effect.
Cortisone drugs*	Increased cortisone effect. Risk of
	ulcer and stomach bleeding.
Digitoxin	Decreased digitoxin effect.
Doxycycline	Decreased doxycycline effect.
Dronabinol	Increased effect of both drugs.
Furosemide	Possible aspirin toxicity.
Gold compounds*	Increased likelihood of kidney damage.
Griseofulvin	Decreased griseofulvin effect.
Indapamide	Increased indapamide effect.
Indomethacin	Risk of stomach bleeding and ulcers.
MAO inhibitors*	Increased butalbital effect.
Methotrexate	Increased methotrexate effect.
Mind-altering	Dangerous sedation. Avoid.
Minoxidil	Decreased minoxidil effect.
Naltrexone	Decreased analgesic effect.
Narcotics*	Dangerous sedation. Avoid.
Non-steroidal	Risk of stomach bleeding and ulcers.
Pain relievers*	Dangerous sedation. Avoid.
Rifampin	May decrease butalbital effect.
Salicylates*, others	Likely aspirin toxicity.
Sedatives*	Dangerous sedation. Avoid.
Sleep inducers*	Dangerous sedation. Avoid.
Spironolactone	Decreased spironolactone effect.
Sulfinpyrazone	Decreased sulfinpyrazone effect.
Terfenadine	May conceal symptoms of aspirin
	overdose, such as ringing in ears.
Tranquilizers*	Dangerous sedation. Avoid.
Valproic acid	Increased butalbital effect.
Vitamin C	Possible aspirin toxicity.
Zidovudine	Increased toxicity of both.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Possible stomach irritation and
	bleeding, possible fatal oversedation.
	Avoid.
Beverages:	None expected.
Cocaine:	Decreased butalbital effect.
Foods:	None expected.
Marijuana:	Possible increased pain relief, but
	marijuana may slow body's recovery.
	Avoid.
Tobacco:	None expected.