Skip to Content

Butalbital / Acetaminophen / Caffeine


Pronunciation: BYOO-TAL-bih-tuhl/uh-seet-uh-MIN-oh-fen/kaff-EEN
Class: Nonnarcotic analgesic

Trade Names

Alagesic LQ
- Oral solution acetaminophen 325 mg/caffeine 40 mg/butalbital 50 mg

- Capsules acetaminophen 325 mg/caffeine 40 mg/butalbital 50 mg

Dolgic Plus
- Tablets acetaminophen 750 mg/caffeine 40 mg/butalbital 50 mg

- Capsules acetaminophen 325 mg/caffeine 40 mg/butalbital 50 mg
- Tablets acetaminophen 325 mg/caffeine 40 mg/butalbital 50 mg

- Tablets acetaminophen 500 mg/caffeine 40 mg/butalbital 50 mg
- Capsules acetaminophen 500 mg/caffeine 40 mg/butalbital 50 mg

- Tablets acetaminophen 325 mg/caffeine 40 mg/butalbital 50 mg

- Capsules acetaminophen 325 mg/caffeine 40 mg/butalbital 50 mg

- Capsules acetaminophen 300 mg/caffeine 40 mg/butalbital 50 mg

- Tablets acetaminophen 325 mg/caffeine 40 mg/butalbital 50 mg

- Capsules acetaminophen 500 mg/caffeine 40 mg/butalbital 50 mg


Butalbital has generalized depressant effect on CNS and, in very high doses, has peripheral effects. Acetaminophen has analgesic and antipyretic effects; its analgesic effects may be mediated through inhibition of prostaglandin synthetase enzyme complex. Caffeine is thought to produce constriction of cerebral blood vessels.

Slideshow: Living with Your Migraines: Tips for Treatment and Prevention

Indications and Usage

Relief of symptom complex of tension (or muscle contraction) headache.


Hypersensitivity to acetaminophen, caffeine, or barbiturates; porphyria.

Dosage and Administration


PO 1 to 2 tablets or capsules or 15 to 30 mL every 4 h (max, 5 to 6 tablets or capsules or 90 mL/day).


Store at 68° to 77°F. Protect from light.

Drug Interactions

Beta-blockers (eg, propranolol), corticosteroids, doxycycline, estrogens (including oral contraceptives), felodipine, griseofulvin, nifedipine, phenylbutazone, quinidine, theophylline, warfarin

Effects of these drugs may be decreased.

Carbamazepine, sulfinpyrazone

May increase risk of hepatotoxicity.


May increase CNS effects.

Other CNS depressants (eg, ethanol, narcotics, general anesthetics, tranquilizers, sedative-hypnotics)

Increased drowsiness, dizziness, and other CNS depressive effects may occur.

Tricyclic antidepressants

Antidepressant effect may decrease.

Laboratory Test Interactions

With Chemstrip bG and Dextrostix home blood glucose systems, may cause false decrease in mean glucose values; may give false-positive urinary 5-hydroxyindoleacetic acid test result.

Adverse Reactions


Drowsiness; dizziness; light-headedness; confusion; sedation.


Erythema multiforme; rash; toxic epidermal necrolysis.


Abdominal pain; nausea; vomiting; flatulence.


Intoxicated feeling; shortness of breath.



These products contain acetaminophen. Acetaminophen has been associated with cases of acute liver failure, at times resulting in liver transplant and death. Most of the cases of liver injury are associated with the use of acetaminophen at doses that exceed 4,000 mg/day, and often involve more than 1 acetaminophen-containing product.


Monitor liver and/or renal function tests in patients with severe hepatic or renal disease.


Category C .


Excreted in breast milk.


Safety and efficacy in children have not been established ( Dolgic Plus , Alagesic LQ ). Safety and efficacy in children younger than 12 yr of age not established.


Take care in dose selection.

Renal Function

Use with caution.

Hepatic Function

Use with caution.

Special Risk Patients

Use with caution in debilitated patients or patients with acute abdominal conditions.

Drug dependency

Prolonged use may produce drug tolerance and dependency (psychologic and physical).



Blood dyscrasias, coma, confusion, delirium, drowsiness, extrasystoles, hepatic damage, hypoglycemic coma, hypotension, hypovolemic shock, insomnia, nausea, renal tubular necroses, respiratory depression, restlessness, tachycardia, thrombocytopenia, tremor, vomiting.

Patient Information

  • Caution patient that dependency/tolerance may result from regular long-term use.
  • Tell patient to take drug with full glass of water.
  • Instruct patient not to discontinue drug abruptly after long-term regular use.
  • Caution patient to avoid intake of alcoholic beverages and other CNS depressants without health care provider approval.
  • Advise patient to avoid any hazardous activity (driving or smoking) if dizziness, drowsiness, or a decrease in mental acuity occurs.
  • Warn patient that orthostatic hypotension may occur. Instruct patient to change positions slowly and to sit or lie down if symptoms occur.
  • Inform patient to report the following symptoms to health care provider: persistent or recurrent pain before next scheduled dose, difficulty breathing, increased drowsiness, vomiting or yellowing of skin or gums.

Copyright © 2009 Wolters Kluwer Health.