Assess type, location, and intensity of pain before and 60 min following administration.
Prolonged use may lead to physical and psychological dependence and tolerance. This should not prevent patient from receiving adequate analgesia. Most patients who receive butalbital compound for pain do not develop psychological dependence.
Assess frequency of use. Frequent, chronic use may lead to daily headaches in headache-prone individuals because of physical dependence on caffeine and other components. Chronic headaches from overmedication are difficult to treat and may require hospitalization for treatment and prophylaxis.
Do not confuse Fioricet (butalbital, acetaminophen, caffeine) with Fiorinal (butalbital, aspirin, caffeine).
Explain therapeutic value of medication before administration to enhance the analgesic effect.
Regularly administered doses may be more effective than prn administration. Analgesic is more effective if given before pain becomes severe.
Medication should be discontinued gradually after long-term use to prevent withdrawal symptoms.
Instruct patient to take medication exactly as directed. Do not increase dose because of the habit-forming potential of butalbital. If medication appears less effective after a few weeks, consult health care professional. Dose of acetaminophen should not exceed maximum recommended daily dose of 4 g/day. Chronic excessive use of >4 g/day (2 g in chronic alcoholism) may lead to hepatotoxicity, renal or cardiac damage.
Advise patients with tension headaches to take medication at first sign of headache. Lying down in a quiet, dark room may also be helpful. Medications taken for prophylaxis should be continued.
May cause drowsiness or dizziness. Advise patient to avoid driving and other activities requiring alertness until response to medication is known.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
Caution patient to avoid concurrent use of alcohol or other CNS depressants.
Advise patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
Decrease in severity of pain without a significant alteration in level of consciousness.
butalbital, acetaminophen, caffeine† is a sample topic from the Davis's Drug Guide.
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