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Acetaminophen / butalbital / caffeine Pregnancy and Breastfeeding Warnings

Acetaminophen / butalbital / caffeine is also known as: Alagesic LQ, Anolor 300, Anoquan, Arcet, Dolmar, Endolor, Esgic, Esgic-Plus, Ezol, Femcet, Fioricet, Fiorpap, Geone, Isocet, Margesic, Orbivan, Pharmagesic, Phrenilin Forte, Repan, Tenake, Tencet, Triad, Two-Dyne, Vanatol LQ, Zebutal

Medically reviewed on January 25, 2018

Acetaminophen / butalbital / caffeine Pregnancy Warnings

Use is not recommended unless clearly needed

US FDA pregnancy category: C

Comment: Monitor for barbiturate withdrawal in neonates

Animal reproduction studies have not been conducted on this combination product. Epidemiologic data for acetaminophen, including a population based case-control study from the National Birth Defects Prevention Study (n= 11,610) and data from 26,424 live singleton births have shown no increased risk of major birth defects in children with first trimester prenatal exposure. In 2015, the US Food and Drug Administration released results of their evaluation on published research studies looking at mothers who took acetaminophen (either over the counter or as a prescription product) at any time during their pregnancy and the risk of attention deficit hyperactivity (ADHD) in their babies. They found all studies reviewed had potential limitations in their designs that prevented drawing reliable conclusions. Barbiturates have been reported to readily cross the placental barrier. A 2-day old infant whose mother had taken a butalbital-containing product during the last two months of pregnancy experienced withdrawal seizures; butalbital was found in the infant's serum. There are no controlled data in human pregnancy.

US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

See references

Acetaminophen / butalbital / caffeine Breastfeeding Warnings

Acetaminophen, butalbital, and caffeine are excreted into human milk in small concentrations. The significance of the effects on nursing infants has not been reported, but due to the potential for serious adverse reactions in nursing infants, other agents may be preferred.

A decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother.

Excreted into human milk: Yes (acetaminophen); Yes (barbiturates); Yes (caffeine)

See references

References for pregnancy information

  1. "Product Information. Esgic (acetaminophen/butalbital/caffeine)." Forest Pharmaceuticals, St. Louis, MO.
  2. "Product Information. Fioricet (APAP/butalbital/caffeine)." Novartis Pharmaceuticals, East Hanover, NJ.
  3. "Product Information. Vanatol LQ (acetaminophen/butalbital/caffeine)." GM Pharmaceuticals, Arlington, TX.
  4. U.S. Food and Drug Administration U.S. Food and Drug Administration U.S. Food and Drug Administration U.S. Food and Drug Administration "FDA Drug Safety Communication: FDA has reviewed possible risks of pain medicine use during pregnancy Available from: URL: http://www.fda.gov/Drugs/DrugSafety/ucm429117.htm." (01/09/2015):
  5. "Product Information. Acetaminophen/Butalbital/Caffeine (acetaminophen/butalbital/caffeine)." Par Pharmaceutical Inc (formerly Qualitest Pharmaceuticals Inc), Huntsville, AL.

References for breastfeeding information

  1. "Product Information. Fioricet (APAP/butalbital/caffeine)." Novartis Pharmaceuticals, East Hanover, NJ.
  2. "Product Information. Vanatol LQ (acetaminophen/butalbital/caffeine)." GM Pharmaceuticals, Arlington, TX.
  3. "Product Information. Esgic (acetaminophen/butalbital/caffeine)." Forest Pharmaceuticals, St. Louis, MO.
  4. "Product Information. Acetaminophen/Butalbital/Caffeine (acetaminophen/butalbital/caffeine)." Par Pharmaceutical Inc (formerly Qualitest Pharmaceuticals Inc), Huntsville, AL.
  5. United States National Library of Medicine "Toxnet. Toxicology Data Network. Available from: URL: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT." ([cited 2013 -]):

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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