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| Clinical data | |
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| Other names | 5-allyl-5-isobutylbarbituric acid |
| AHFS/Drugs.com | Micromedex Detailed Consumer Information |
| MedlinePlus | a601009 |
| Routes of administration | By mouth |
| Drug class | Barbiturate |
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| Pharmacokinetic data | |
| Bioavailability | 20-45% |
| Metabolism | Liver mainlyCYP3A4 |
| Eliminationhalf-life | 35 hours[2] |
| Excretion | Kidney |
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| CompTox Dashboard(EPA) | |
| ECHA InfoCard | 100.000.926 |
| Chemical and physical data | |
| Formula | C11H16N2O3 |
| Molar mass | 224.260 g·mol−1 |
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Butalbital is abarbiturate with an intermediate duration of action. Butalbital is often combined with other medications, such asparacetamol (acetaminophen) (asbutalbital/acetaminophen) oraspirin, for the treatment ofpain andheadache. The various formulations combined withcodeine areFDA-approved for the treatment oftension headaches. Butalbital has the same chemical formula astalbutal but a different structure—namely,5-allyl-5-isobutylbarbituric acid.[3]
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Combinations include:[citation needed]
There are specific treatments which are appropriate for targetingmigraines and headaches.[4] Butalbital is not recommended as a first-line treatment because it impairs alertness, brings risk of dependence and addiction, and increases the risk that episodic headaches will become chronic.[5] When other treatments are unavailable or ineffective, butalbital may be appropriate if the patient can be monitored to prevent the development of chronic headache.[5]
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Side effects for butalbital is usually well tolerated. Commonly reported side effects for butalbital, some of which tend to subside with continued use, include:[citation needed]
Rare side effects includeStevens–Johnson syndrome, an adverse reaction to barbiturates, andanaphylaxis.
The risk and severity of all side effects is greatly increased when butalbital are combined with other sedatives (e.g.,alcohol,opioids,benzodiazepines,antihistamines). Butalbital when taken with sedatives can cause life-threatening respiratory depression and death. Inhibitors of the hepatic enzymeCYP3A4 may also increase the risk, severity, and duration of side effects, many drugs inhibit this enzyme as do some foods such asgrapefruit and theblood orange.[citation needed]
Butalbital can causedependence oraddiction.[citation needed]
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Mixing withalcohol, benzodiazepines, and otherdepressants increases the risk of intoxication, increases respiratory depression, and increases liver toxicity when in combination with paracetamol (acetaminophen). Use of butalbital and alcohol, benzodiazepines, and other depressants can contribute to coma, and in extreme cases, fatality.[citation needed]
