Zebutal

Zebutal is a pain reliever, antipyretic (anti- fever) and muscle relaxant/ sedative drug, used to treat a tension headache and migraine. It is a drug combination of acetaminophen, butalbital, and caffeine.

Acetaminophen relieves pain and decreases high body temperature (fever). Butalbital slows down brain and nerve activities that result to muscle relaxation, sleepiness and anxiety relief. Caffeine enhances the effects of acetaminophen.

Read your medication guide and follow your doctor’s prescription at all times.

• Take Zebutal by mouth/ orally before or after meals whenever you need it or per doctor’s prescription. Make sure to have 4 hours interval between doses.
• If you experience stomach upset while on Zebutal, take it with food or milk.
• Use a standard medicine cup/ spoon (not household spoon) to obtain the accurate amount for each dose if you are using the liquid preparation.
• The dosage depends on your medical condition or treatment response. Do not adjust your dose without your doctor’s recommendation.
• Take this medication immediately upon the very onset/ beginning of pain because pain relievers are more effective when they are taken before the pain becomes severe and intolerable.
• Do not stop taking Zebutal abruptly without doctor’s recommendation to avoid withdrawal symptoms. Your dose will be gradually reduced until your doctor tells you to completely stop the medication.
• Avoid alcohol intake to prevent liver damage and do no engage in activities that require mental alertness (i.e. driving, operating machinery) because Zebutal causes dizziness or drowsiness.
• Limit intake of coffee, energy drink, colas, tea and other caffeinated products to prevent adverse effects of Zebutal.

Inform your doctor immediately if your condition aggravates or does not improve.

Take your missed dose as soon as possible only if you are taking this medication on a regular schedule (not as needed only). However, make sure that the time interval between the missed and the next dose is not too close.

Otherwise, stick with the regular schedule and leave out the missed dose. Do not double dose to cover up a missed dose. Record your missed dose and inform your doctor immediately if you missed several doses.

Zebutal may interact with:

• Erythromycin
• Cimetidine
• Disulfiram
• Fluvoxamine
• Probenecid
• Valproic acid
• Isoniazid
• Lithium
• MAO inhibitor drugs (i.e. isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, selegiline, tranylcypromine)
• Cyclosporine, doxycycline, estrogen, felodipine, metronidazole, quinidine, theophylline,metroprolol, prednisone and warfarin (drugs that are removed faster from the body when used with Zebutal)
• Amitriptyline, alprazolam, carbamazepine, codeine, diazepam, diphenhydramine, muscle relaxants, risperidone, trazodone and zolpidem (drugs that increase drowsiness) and
• Hormonal birth control products (Zebutal makes these drugs less efficient).

Some drugs may either lessen the beneficial effects or worsen the side effects of Zebutal. Likewise, Zebutal may make some drugs less efficient or intensify their side effects.

Make sure to inform your doctor about all other drugs you are currently taking or using (prescribed and non-prescribed medications including vitamins, minerals, and herbal products) to check for possible drug interaction with Zebutal.

Never alter the doses of other medications while on Zebutal neither stop nor start any medicine without the doctor’s recommendation.

There are no side effects known aside from a possible allergic reaction in people who have previous or unknown hypersensitivity to the drug.

Watch out for signs of allergic reactions such as:

• Rash
• Itching
• Swelling

Before taking Zebutal, tell your health care provider if you have/are:

• Any allergies to any substance, food or medication, particularly to Zebutal, acetaminophen, butalbital or caffeine
• Medical history or a present condition such as:
  • Porphyria
  • Diabetes
  • Phenylketonuria
  • Alcohol-induced liver disease
  • Alcohol or Drug dependence/abuse
  • Kidney disease

• If you have taken MAO inhibitor drugs for the past 14 days
• Mental or mood disorder with suicidal ideation or attempts and
• Pregnant, planning to get pregnant or currently breastfeeding a baby (It is not known if Zebutal can harm the unborn child but it passes through the breast milk that may harm the nursing child. The risk and benefits of using this medication during pregnancy should be discussed thoroughly with your doctor.)