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Esgic Plus is a barbiturate sedative (butalbital) mixed with
a non-aspirin pain medication (acetaminophen) and caffeine. This non-narcotic
pain medication and relaxant is often prescribed for tension headaches
caused by contractions of the muscles in the neck and shoulder area, and
migraines. Acetaminophen is a pain reliever and fever reducer. Butalbital
is in a class of drugs called barbiturates that slow down your central nervous
system (brain and nerve impulses) causing relaxation. Caffeine
is believed to constrict dilated blood vessels that may contribute to
tension headaches.
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The following information is a summary. This information is not intended to replace a doctor's instructions.
To prevent upset stomach, take Esgic with food or milk. Pain medications work best in preventing pain before it occurs. Once the pain becomes intense, Esgic is not as effective in relieving it. Take Esgic as prescribed. Do not increase your dose or take Esgic more frequently without your doctor's approval.
If you experience any of the following serious side effects, stop taking acetaminophen / butalbital / caffeine and seek emergency medical attention: an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); slow, weak breathing; liver damage (yellowing of the skin or eyes, nausea, abdominal pain or discomfort, unusual bleeding or bruising, severe fatigue); blood problems (easy or unusual bleeding or bruising); or low blood sugar (fatigue, increased hunger or thirst, dizziness, or fainting). These side effects are very rare and are not likely to occur during proper treatment with acetaminophen and caffeine. If you experience any unusual reactions, stop taking this medicine and seek the advice of your doctor. Other, less serious side effects may be more likely to occur. Continue to take acetaminophen / butalbital / caffeine and talk to your doctor if you experience drowsiness; dizziness, confusion or lightheadedness; shortness of breath; dry mouth; nausea, vomiting, abdominal pain, or decreased appetite; tiredness, leg pain, or muscle weakness; agitation, irritability, nervousness, anxiety or excitability; rash or itching; feeling of intoxication; headache; or constipation. Butalbital may be habit forming. Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
Use caution when driving, operating machinery, or performing other hazardous activities. Butalbital will cause drowsiness or dizziness. If you experience drowsiness or dizziness, avoid these activities. Avoid sleeping pills, antihistamines, sedatives, and tranquilizers except under the supervision of your doctor. These may also make you drowsy. Avoid alcohol. Alcohol taken during therapy with acetaminophen and butalbital can be very damaging to your liver and can increase drowsiness and dizziness. Check the acetaminophen content of other over-the-counter and prescription products while taking this medication. You should not exceed 4 grams (4000 mg) of acetaminophen per day. Avoid taking too much caffeine. Check the caffeine content of other over-the-counter and prescription products as well as beverages (coffee, tea, and colas) while taking Esgic Plus.
Do not take acetaminophen / butalbital / caffeine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. Dangerous side effects could result. Acetaminophen and butalbital may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), other pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves. Many other medicines contain acetaminophen, especially over-the-counter pain, fever, cold, and allergy medications. Too much acetaminophen can be very dangerous. Drugs other than those listed here may also interact with acetaminophen / butalbital / caffeine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.
Seek emergency medical attention. Symptoms of an acetaminophen / butalbital / caffeine overdose include insomnia, restlessness, tremor, nausea, vomiting, diarrhea, abdominal pain, sweating, seizures, drowsiness, decreased breathing, dizziness or fainting, confusion, an irregular heartbeat, and coma.