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Special warnings about this medication
Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are taking this medicine. Serious side effects can occur if y our medical doctor or dentist gives you certain medicines without knowing that you have taken butalbital.

Symptoms of overdose
Seek emergency medical attention. Symptoms of an acetaminophen / butalbital / caffeine - Fioricet overdose include insomnia, restlessness, tremor, nausea, vomiting, diarrhea, abdominal pain, sweating, seizures, drowsiness, decreased breathing,

Why is this medication prescribed?
Butalbital and acetaminophen (byoo-TAL-bi-tal and a-seat-a-MIN-oh-fen) combination is a pain reliever and relaxant. It is used to treat tension headaches. Butalbital belongs to the group of medicines called barbiturates (bar-BI-tyoo-rates) . Barbiturates act in the central nervous system (CNS) to produce their effects.

When you take butalbital for a long time, your body may get used to i t so that larger amounts are needed to produce the same effects. This is called tolerance to the medicine. Also, butalbital may become habit-forming (causing mental or physical dependence) when it is used for a long time or in large doses. Physical dependence may lead to withdrawal side effects when you stop taking the medicine.

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

Significant Interactions:
It is especially important that your health care professional know if you are taking any of the following:

- Antidepressants, tricyclic (amitriptyline [e.g., Elavil], amoxapine [e.g., Asendi n], 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

What side effects may occur?
More common side effects may include:
- Abdominal pain, dizziness, drowsiness, intoxicated feeling, light-headedness, nausea, sedation, shortness of breath, vomiting

Less common or rare side effects may include:
- Agitation, allergic reactions, constipation, depression, difficulty swallowing, dry mouth, earache, exaggerated feeling of well-being, excessive sweating, excessive u rination, excitement, fainting, fatigue, fever, flatulence, headache, heartburn, heavy eyelids, high energy, hot spells, itching, leg pain, mental confusion, muscle fatigue, numbness, rapid heartbeat, ringing in the ears, seizure, shaky feeling, skin redness and/or peeling, sluggishness, stuffy nose, tingling