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Pronunciation |
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(byoo
TAL bi tal KOM pound & AS
pir in) |
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U.S. Brand
Names |
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Fiorgen PF®; Fiorinal®;
Isollyl® Improved; Lanorinal® |
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Generic
Available |
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Yes |
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Canadian Brand
Names |
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Tecnal |
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Synonyms |
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Aspirin and Butalbital Compound |
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Pharmacological Index |
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Barbiturate |
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Use |
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Relief of the symptomatic complex of tension or muscle contraction
headache |
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Restrictions |
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C-III |
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Pregnancy Risk
Factor |
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C/D (if used for long periods or in high doses near end of
pregnancy) |
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Contraindications |
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Porphyria; hypersensitivity to butalbital or any
component |
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Warnings/Precautions |
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Use with extreme caution in the presence of peptic ulcer or coagulation
abnormality - can produce psychological/physical drug dependence. Children and
teenagers should not use this product. |
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Adverse
Reactions |
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>10%:
Central nervous system: Dizziness, lightheadedness, drowsiness, "hangover"
effect
Gastrointestinal: Heartburn, stomach pains, dyspepsia, epigastric discomfort,
nausea
1% to 10%:
Central nervous system: Confusion, mental depression, unusual excitement,
nervousness, faint feeling, headache, insomnia, nightmares, fatigue
Dermatologic: Skin rash
Gastrointestinal: Constipation, vomiting, gastrointestinal ulceration
Hematologic: Hemolytic anemia
Neuromuscular & skeletal: Weakness
Respiratory: Troubled breathing
Miscellaneous: Anaphylactic shock |
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Drug
Interactions |
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Barbiturates are enzyme inducers. patients should be monitored when these
drugs are started or stopped for a decreased or increased therapeutic effect
respectively.
Increased toxicity when combined with other CNS depressants, benzodiazepine,
valproic acid, chloramphenicol, or antidepressants; respiratory and CNS
depression may be additive. MAOIs may prolong the effect of butalbital compound;
barbiturates inhibit the hypoprothombinemic response to warfarin.
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Usual Dosage |
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Adults: Oral: 1-2 tablets or capsules every 4 hours; not to exceed 6/day
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Mental Health: Effects
on Mental Status |
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Drowsiness is common; may cause depression, nervousness, insomnia, and
nightmares; rare reports of hallucinations |
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Mental Health:
Effects on Psychiatric
Treatment |
|
Rare reports of agranulocytosis; use caution with clozapine and
carbamazepine; CNS depressant effects of psychotropics may be enhance by
barbiturates; enzyme induction effects of barbiturates may decrease effects of
psychotropics |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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No effects or complications reported |
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Patient
Information |
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Take as directed; do not exceed prescribed amount. Avoid alcohol, aspirin or
aspirin-containing medications, or any OTC medications unless approved by
prescriber. Maintain adequate hydration (2-3 L/day of fluids unless instructed
to restrict fluid intake) to prevent constipation. You may experience
drowsiness, impaired judgment or coordination; use caution when driving or
engaging in tasks that require alertness until response to drug is known. Small
frequent meals may help reduce GI upset. Report any ringing in ears; abdominal
pain; easy bruising or bleeding; blood in urine; severe weakness; acute
unresolved dizziness or confusion, nervousness, nightmares, insomnia; or skin
rash. Pregnancy/breast-feeding precautions: Inform prescriber if you are
or intend to be pregnant. Consult prescriber if
breast-feeding. |
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Nursing
Implications |
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Raise bed rails; initiate safety measures; aid with ambulation; children and
teenagers should not use for chickenpox or flu symptoms before a physician is
consulted about Reye's syndrome (Fiorinal®)
Monitor for CNS depression |
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Dosage Forms |
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Capsule: (Fiorgen PF®, Fiorinal®,
Isollyl Improved®, Lanorinal®,
Marnal®): Butalbital 50 mg, caffeine 40 mg, and aspirin
325 mg
Tablet:
Fiorinal®, Isollyl Improved®,
Lanorinal®, Marnal®: Butalbital 50
mg, caffeine 40 mg, and aspirin 325 mg |
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