What type of drug is esgic

This medication can be habit-forming. Do not take a larger dose, take it more often, or for a longer period than your doctor tells you to. Acetaminophen, Butalbital, Caffeine may cause an upset stomach.

Take this medicine with food or milk. Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature, away from excess heat and moisture not in the bathroom.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program.

Procedures to limit the continuing absorption of the drug must be readily performed since the hepatic injury is dose dependent and occurs early in the course of intoxication. One or two capsules every four hours.

Total daily dosage should not exceed 6 capsules. Extended and repeated use of this product is not recommended because of the potential for physical dependence. They are supplied in bottles of capsules, NDC DailyMed will deliver notification of updates and additions to Drug Label information currently shown on this site through its RSS feed.

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We anticipate reposting the images once we are able identify and filter out images that do not match the information provided in the drug labels. View Package Photos. Drug Label Info. NDC National Drug Code - Each drug product is assigned this unique number which can be found on the drug's outer packaging.

Each capsule contains: Butalbital This combination drug product is intended as a treatment for tension headache. Pharmacokinetics The behavior of the individual components is described below. This product is contraindicated under the following conditions: Hypersensitivity or intolerance to any component of this product. Patients with porphyria. Hepatotoxicity Acetaminophen has been associated with cases of acute liver failure, at times resulting in liver transplant and death.

Do not take more than milligrams of acetaminophen per day. Call your doctor if you took more than the recommended dose. Carcinogenesis, Mutagenesis, Impairment of Fertility No adequate studies have been conducted in animals to determine whether acetaminophen or butalbital have a potential for carcinogenesis, mutagenesis or impairment of fertility.

Pregnancy Teratogenic Effects Animal reproduction studies have not been conducted with this combination product. Nonteratogenic Effects Withdrawal seizures were reported in a two-day-old male infant whose mother had taken a butalbital-containing drug during the last two months of pregnancy. Nursing Mothers Caffeine, barbiturates and acetaminophen are excreted in breast milk in small amounts, but the significance of their effects on nursing infants is not known.

Pediatric Use Safety and effectiveness in pediatric patients below the age of 12 have not been established. Geriatric Use Clinical studies of butalbital, acetaminophen and caffeine capsules did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Frequently Observed The most frequently reported adverse reactions are drowsiness, lightheadedness, dizziness, sedation, shortness of breath, nausea, vomiting, abdominal pain, and intoxicated feeling.

Infrequently Observed All adverse events tabulated below are classified as infrequent. Autonomic Nervous System: dry mouth, hyperhidrosis.

Cardiovascular: tachycardia. Musculoskeletal: leg pain, muscle fatigue. Genitourinary: diuresis. Abuse and Dependence Butalbital : Barbiturates may be habit-forming : Tolerance, psychological dependence, and physical dependence may occur especially following prolonged use of high doses of barbiturates. A treatment facility paid to have their center promoted here.

Learn more about how to be featured in a paid listing. Calls to numbers on a specific treatment center listing will be routed to that treatment center. Chats will be received and answered by one of treatment providers listed below, each of which is a paid advertiser:. Fioricet Addiction And Abuse Fioricet is a Barbiturate-based prescription medication for chronic headaches.

While it can be effective, it can also be dangerous. Fioricet carries risks of withdrawal, addiction, and overdose. Start the road to recovery. Get a Call. Questions about treatment? Call now for: Access to top treatment centers Caring, supportive guidance Financial assistance options Addiction Center is not affiliated with any insurance.

How Do I Prepare for Rehab? How Long Does Detox Take? How Much Does Treatment Cost? What Is Inpatient Drug Rehab? Should I Go Back to Rehab? Get professional rehab and addiction education from a qualified doctor today!

What Is Fioricet? Acetaminophen is a medication which alleviates pain and reduces fever. Acetaminophen works by impairing the production of the prostaglandin chemical in the brain. This chemical activates pain signals in the nervous system. This neurotransmitter calms the nervous system by blocking signals among neurons. It also relaxes muscle tension in the head, thereby alleviating headaches.

While high blood pressure is not necessarily healthy, low blood pressure worsens headaches by causing blood vessels to expand and push against the brain. By raising blood pressure, Caffeine causes blood vessels to constrict and increases blood flow. This effect helps relieve headaches. Is Fioricet Addictive? The Symptoms Of Withdrawal In most cases, Fioricet withdrawal lasts anywhere from 8 hours to three days after the last dose.

Other symptoms of withdrawal include: Anxiety Dizziness Insomnia Muscle spasms Nausea and vomiting Rapid emotional changes Seizures in rare cases Weakness Looking for a place to start? Reach out to a treatment provider for free today. Because barbiturates may impair the ability of the liver to metabolize ammonia, barbiturates are best avoided in patients with hepatic encephalopathy. Note that barbiturates are hepatic enzyme inducers and patients should be monitored for altered drug levels and therapeutic effects as indicated.

Liver function tests may need to be monitored. Because butalbital can cause dose-dependent respiratory depression, it should be used cautiously in patients with pulmonary disease states causing respiratory depression, dyspnea, severe pulmonary insufficiency or airway obstruction.

Barbiturates should be avoided in patients with bronchopneumonia. Use with close supervision in patients with sleep apnea or chronic obstructive pulmonary disease COPD.

Avoid butalbital use in patients with status asthmaticus or asthma. Acetaminophen; butalbital; caffeine may cause blurred vision, drowsiness, or dizziness, especially with initial use. Advise patients to use caution when driving or operating machinery until they are aware of the effects of the drug.

Like all barbiturates, butalbital may cause CNS depression. Because butalbital can cause drowsiness and a decreased level of consciousness, there is a higher risk of falls, particularly in the elderly, with the potential for subsequent severe injuries. CNS depressant effects are increased during coadministration with other CNS depressants, including alcohol. Avoid ethanol ingestion during the use of barbiturates due to the potential for additive CNS depressant effects; the lethal dose of a barbiturate is significantly less if alcohol is also ingested.

Ethanol intoxication must be avoided. Additionally, acetaminophen should not be used in patients who consume 3 or more alcoholic beverages per day due to a potential increased risk of drug-induced hepatotoxicity.

Use of this drug product in patients with alcoholism is not advisable. In general, use acetaminophen; butalbital; caffeine with caution in those patients with acute abdomen conditions or with severe renal impairment or renal failure. Acetaminophen; butalbital; caffeine combinations are classified as FDA pregnancy-risk category C and should be used during pregnancy only if the benefits to the mother outweigh the potential risks to the fetus.

All three components cross the placenta. There have been reports of physical abnormalities in infants correlating to exposure to barbiturates in utero. Additionally, a retrospective study revealed that in utero exposure to barbiturates was associated with intelligence deficits.

Repeated use of butalbital during the third trimester can also cause physical dependence in the neonate. A withdrawal seizure has been reported in a 2-day old infant whose mother had been taking a butalbital-containing medication during the last 2 months of her pregnancy. If the mother used butalbital late in pregnancy, newborns should also be carefully observed for signs of ventilatory depression, particularly if the infant is premature.

There is no established use for butalbital during labor or obstetrical delivery. Neonatal arrhythmias e. Caffeine withdrawal in the neonate after birth may account for these symptoms. Fatal arrhythmias in neonates with caffeine use by the mother have also been reported. Females should be warned of the potential adverse effects on the fetus should pregnancy occur while taking acetaminophen-butalbital-caffeine combinations. Acetaminophen; butalbital; caffeine components may all be excreted to some extent into breast milk.

According to the manufacturer, because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug. Caffeine can accumulate in the neonate. Chronic barbiturate use while breast-feeding may cause dependence in the neonate.

The chronic use of acetaminophen; butalbital; caffeine during breast-feeding is not recommended. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition.

If a breast-feeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA. The safety and efficacy of acetaminophen; butalbital; caffeine combinations have not been established in children. Symptoms of acute infection e. Sudden, abrupt discontinuation of butalbital in epileptic patients may precipitate acute seizures, status epilepticus, or other seizure disorder.

Patients taking warfarin Coumadin anticoagulant therapy may not be appropriate candidates for acetaminophen; butalbital see Drug Interactions. Acetaminophen; butalbital; caffeine should be used with caution in geriatric patients due to sensitivity to the CNS and respiratory depressant effects of butalbital; use care in dosage selection.

Butalbital is known to be substantially excreted by the kidney. Because elderly patients are more likely to have decreased renal function, it may be useful to monitor renal function. According to the Beers Criteria, barbiturates are considered potentially inappropriate medications PIMs in geriatric patients and should be avoided due to the high rate of physical dependence, tolerance to sedative effects, and risk of overdose at low dosages.

The federal Omnibus Budget Reconciliation Act OBRA regulates medication use in residents of long-term care facilities LTCFs ; barbiturates generally should not be used since they are highly addictive and can cause multiple adverse effects in the elderly and may increase the metabolism of other necessary chronic medications and lessen their effectiveness.

Patients with G6PD deficiency who overdose with acetaminophen may be at increased risk for drug-induced hemolysis. During acetaminophen overdose, cyanosis may not be apparent in patients with preexisting anemia, in spite of dangerously high blood concentrations of methemoglobin.

Competition for the metabolic pathway is thought to have caused a case of acetaminophen-related hepatotoxicity. This interaction may be more clinically significant in patients with depleted glutathione stores, such as patients with acquired immunodeficiency syndrome, poor nutrition, or alcoholism. Abemaciclib: Major Avoid coadministration of butalbital with abemaciclib due to decreased exposure to abemaciclib and its active metabolites, which may lead to reduced efficacy.

Consider alternative treatments. Acetaminophen; Aspirin, ASA; Caffeine: Moderate Due to high protein binding, salicylates could be displaced from binding sites, or could displace other highly protein-bound drugs such as barbiturates. An enhanced effect of the displaced drug may occur. Moderate Prolonged concurrent use of acetaminophen and salicylates is not recommended.

High-dose, chronic administration of the combined analgesics significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease.

Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. Acetaminophen; Butalbital: Minor Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. Minor The metabolism of caffeine can be increased by concurrent use with barbiturates. The hypnotic effects of barbiturates can be reduced by caffeine administration.

Acetaminophen; Butalbital; Caffeine; Codeine: Major Concomitant use of codeine with barbiturates may cause respiratory depression, hypotension, profound sedation, and death. Limit the use of opioid pain medications with barbiturates to only patients for whom alternative treatment options are inadequate.

It is recommended to avoid this combination when codeine is being used for cough. If concurrent use is necessary, reduce initial dosage and titrate to clinical response; use the lowest effective doses and minimum treatment durations. Educate patients about the risks and symptoms of respiratory depression and sedation. Additionally, concomitant use of codeine with a barbiturate can decrease codeine concentrations, resulting in less metabolism by CYP2D6 and decreased morphine concentrations; this may result in decreased efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence.

Monitor for reduced efficacy of codeine and signs of opioid withdrawal. Discontinuation of a barbiturate may increase the risk of opioid-related adverse reactions, such as fatal respiratory depression.

Barbiturates induce CYP3A4. Minor Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. Acetaminophen; Caffeine; Dihydrocodeine: Major Concomitant use of dihydrocodeine with barbiturates may cause respiratory depression, hypotension, profound sedation, and death. It is recommended to avoid this combination when dihydrocodeine is being used for cough. Additionally, concomitant use of dihydrocodeine with a barbiturate can decrease dihydrocodeine concentrations, resulting in less metabolism by CYP2D6 and decreased dihydromorphine concentrations; this may result in decreased efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence.

Monitor for reduced efficacy of dihydrocodeine and signs of opioid withdrawal. Barbiturates induce CYP3A4, an isoenzyme partially responsible for the metabolism of dihydrocodeine.

Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine: Moderate Due to high protein binding, salicylates could be displaced from binding sites, or could displace other highly protein-bound drugs such as barbiturates. Although salicylates are rarely associated with nephrotoxicity, high-dose, chronic administration of salicylates combined other analgesics, including acetaminophen, significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease.

Additive hepatic toxicity may occur, especially in combined overdose situations. Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide: Moderate Due to high protein binding, salicylates could be displaced from binding sites, or could displace other highly protein-bound drugs such as barbiturates. Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine: Moderate Additive CNS depression may occur if barbiturates are co-used with sedating antihistamines, such as chlorpheniramine.

Monitor for additive CNS and respiratory effects, and warn about the potential effects to driving and other activities. Moderate CNS-stimulating actions of caffeine can be additive with other CNS stimulants or psychostimulants like phenylephrine; caffeine should be avoided or used cautiously.

Excessive caffeine ingestion via medicines, supplements or beverages including coffee, green tea, other teas, guarana, colas may contribute to side effects like nervousness, irritability, insomnia, or tremor. Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine: Moderate Additive CNS depression may occur if barbiturates are co-used with sedating antihistamines, such as chlorpheniramine.

Moderate CNS-stimulating actions of caffeine can be additive with other CNS stimulants or psychostimulants; caffeine should be avoided or used cautiously. Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine: Moderate Additive CNS depression may occur if barbiturates are co-used with sedating antihistamines, such as chlorpheniramine.

Acetaminophen; Codeine: Major Concomitant use of codeine with barbiturates may cause respiratory depression, hypotension, profound sedation, and death. Acetaminophen; Dextromethorphan; Doxylamine: Moderate Because doxylamine can cause pronounced sedation, an enhanced CNS depressant effect may occur when it is combined with other CNS depressants including anxiolytics, sedatives, and hypnotics, such as barbiturates.

Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine: Moderate CNS-stimulating actions of caffeine can be additive with other CNS stimulants or psychostimulants like phenylephrine; caffeine should be avoided or used cautiously. Acetaminophen; Dextromethorphan; Phenylephrine: Moderate Additive CNS depression may occur if barbiturates are co-used with sedating antihistamines, such as chlorpheniramine. Acetaminophen; Dextromethorphan; Pseudoephedrine: Moderate CNS-stimulating actions of caffeine can be additive with other CNS stimulants or psychostimulants; caffeine should be avoided or used cautiously.

Acetaminophen; Dichloralphenazone; Isometheptene: Major Additive CNS depression may occur if barbiturates are used concomitantly with dichloralphenazone. Moderate Caffeine is a CNS-stimulant and such actions are expected to be additive when coadministered with other CNS stimulants or psychostimulants. Acetaminophen; Diphenhydramine: Major Because diphenhydramine can cause pronounced sedation, an enhanced CNS depressant effect may occur when it is combined with other CNS depressants including anxiolytics, sedatives, and hypnotics, such as barbiturates.

Acetaminophen; Guaifenesin; Phenylephrine: Moderate CNS-stimulating actions of caffeine can be additive with other CNS stimulants or psychostimulants like phenylephrine; caffeine should be avoided or used cautiously. Acetaminophen; Hydrocodone: Major Concomitant use of hydrocodone with barbiturates may cause respiratory depression, hypotension, profound sedation, and death.

It is recommended to avoid this combination when hydrocodone is being used for cough. Additionally, concomitant use of hydrocodone with a barbiturate can decrease hydrocodone concentrations; this may result in decreased efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence.

Monitor for reduced efficacy of hydrocodone and signs of opioid withdrawal. Acetaminophen; Oxycodone: Major Concomitant use of oxycodone with a barbiturate may cause respiratory depression, hypotension, profound sedation, and death. Limit the use of opioid pain medications with a barbiturate to only patients for whom alternative treatment options are inadequate. Additionally, concurrent use of oxycodone with a barbiturate may decrease oxycodone plasma concentrations, decrease opioid efficacy, and potentially lead to a withdrawal syndrome in those with physical dependence to opioid agonists.

Monitor for signs of opioid withdrawal. Discontinuation of a barbiturate may increase the risk of increased opioid-related adverse reactions, such as fatal respiratory depression. Pentazocine should be used cautiously in any patient receiving these agents, which may include barbiturates. Acetaminophen; Pseudoephedrine: Moderate CNS-stimulating actions of caffeine can be additive with other CNS stimulants or psychostimulants; caffeine should be avoided or used cautiously.

Acetaminophen; Tramadol: Major Concomitant use of tramadol with barbiturates may cause respiratory depression, hypotension, profound sedation, and death. Additionally, concomitant use of tramadol with a barbiturate can decrease tramadol concentrations; this may result in decreased efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence. Monitor for reduced efficacy of tramadol and signs of opioid withdrawal.

Discontinuation of a barbiturate may increase the risk of seizures, serotonin syndrome, and the risk of opioid-related adverse reactions, such as fatal respiratory depression.

Acetazolamide: Minor Acetazolamide can induce osteomalacia in patients treated chronically with barbiturates. Potential mechanisms for this interaction include a carbonic anhydrase inhibitor induced increase in the urinary excretion of calcium and an increase in barbiturate effects resulting from metabolic acidosis. Acetazolamide can also increase the rate of excretion of weakly acidic drugs, such as barbiturates.

Aclidinium; Formoterol: Moderate Sensitive patients may wish to limit or avoid excessive caffeine intake from foods, beverages, dietary supplements and medications during therapy with beta-agonists. Additive side effects may occur between caffeine and beta-agonists. Caffeine is a CNS-stimulant and beta-agonists are sympathomimetic agents. Sensitive patients might experience tremor, sleep difficulties, or mild increases in heart rate. Acrivastine; Pseudoephedrine: Moderate Additive CNS depression may occur if barbiturates are used concomitantly with acrivastine.

Adenosine: Major Methylxanthines, such as theophylline, aminophylline, or caffeine, competitively block the effects of adenosine. If possible, stop use of methylxanthines at least 5 half-lives prior to administering adenosine. Patients receiving theophylline, aminophylline and adenosine should be monitored for adenosine efficacy; larger doses of adenosine may be required to achieve antiarrhythmic goals in some patients.

In addition, larger doses of adenosine may be required for therapeutic effect if administered to patients with high daily caffeine intake including caffeine from foods and beverages such as coffee, green tea, other teas, colas, and chocolate.

Theophylline, aminophylline may increase the risk of seizures associated with adenosine; avoid methylxanthine use in patients who have experienced an adenosine-associated seizure. Methylxanthines, such as caffeine, theophylline, and theobromine, are also found in guarana.

Albuterol: Moderate Sensitive patients may wish to limit or avoid excessive caffeine intake from foods, beverages, dietary supplements and medications during therapy with beta-agonists. Albuterol; Ipratropium: Moderate Sensitive patients may wish to limit or avoid excessive caffeine intake from foods, beverages, dietary supplements and medications during therapy with beta-agonists. Therefore, psychotropic pharmacodynamic interactions could occur following concomitant administration of drugs with significant CNS activity.

Use with caution. Alfentanil: Major Concomitant use of alfentanil with a barbiturate may cause respiratory depression, hypotension, profound sedation, and death. Additionally, concurrent use of alfentanil with a barbiturate may decrease alfentanil plasma concentrations, decrease opioid efficacy, and potentially lead to a withdrawal syndrome in those with physical dependence to opioid agonists. Aliskiren; Amlodipine: Major Barbiturates may induce the CYP3A4 metabolism of calcium-channel blockers such as amlodipine, and thereby reduce their oral bioavailability.

The dosage requirements of amlodipine may be increased in patients receiving concurrent enzyme inducers; monitor blood pressure closely. Moderate Barbiturates may potentiate orthostatic hypotension when used concurrently with thiazide diuretics.

Aliskiren; Hydrochlorothiazide, HCTZ: Moderate Barbiturates may potentiate orthostatic hypotension when used concurrently with thiazide diuretics. Additionally, the oral clearance of alprazolam 0. Alprazolam is a CYP3A4 substrate. Barbiturates are CYP3A4 inducers.

Altretamine: Minor Because altretamine undergoes significant metabolism by the cytochrome P system, agents that stimulate CYP enzymes, such as barbiturates, increase the metabolism of altretamine and may result in decreased therapeutic effects.

Amantadine: Major Amantadine used concomitantly with psychostimulants, such as caffeine, can result in increased stimulant effects, such as nervousness, irritability, or insomnia, and can lead to seizures or cardiac arrhythmias. Close monitoring of the patient is recommended.

Amiloride; Hydrochlorothiazide, HCTZ: Moderate Barbiturates may potentiate orthostatic hypotension when used concurrently with thiazide diuretics. Aminosalicylate sodium, Aminosalicylic acid: Moderate Due to high protein binding, salicylates could be displaced from binding sites, or could displace other highly protein-bound drugs such as barbiturates.

The clinical significance of this potential interaction is not known. Additionally, barbiturates may increase the metabolism of chlordiazepoxide. Chlordiazepoxide is a CYP3A4 substrate. Amlodipine: Major Barbiturates may induce the CYP3A4 metabolism of calcium-channel blockers such as amlodipine, and thereby reduce their oral bioavailability.

Amlodipine; Atorvastatin: Major Barbiturates may induce the CYP3A4 metabolism of calcium-channel blockers such as amlodipine, and thereby reduce their oral bioavailability. Monitor for potential reduced cholesterol-lowering efficacy when these drugs are co-administered. Amlodipine; Benazepril: Major Barbiturates may induce the CYP3A4 metabolism of calcium-channel blockers such as amlodipine, and thereby reduce their oral bioavailability.

Amlodipine; Olmesartan: Major Barbiturates may induce the CYP3A4 metabolism of calcium-channel blockers such as amlodipine, and thereby reduce their oral bioavailability. Amlodipine; Telmisartan: Major Barbiturates may induce the CYP3A4 metabolism of calcium-channel blockers such as amlodipine, and thereby reduce their oral bioavailability. Amlodipine; Valsartan: Major Barbiturates may induce the CYP3A4 metabolism of calcium-channel blockers such as amlodipine, and thereby reduce their oral bioavailability.

Amobarbital: Minor Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. Amoxapine: Major Monitor for excessive sedation and somnolence during coadministration of amoxapine and barbiturates. Concurrent use may result in additive CNS depression. Amoxicillin; Clarithromycin; Lansoprazole: Moderate Monitor for decreased efficacy of lansoprazole if concomitant use of lansoprazole and barbiturates is necessary.

Amoxicillin; Clarithromycin; Omeprazole: Major Avoid coadministration of omeprazole with barbiturates because it can result in decreased efficacy of omeprazole. Amphetamine: Moderate Avoid excessive caffeine intake during use of the amphetamine salts.

Caffeine is a CNS-stimulant and such actions are expected to be additive when coadministered with other CNS stimulants or psychostimulants. Excessive caffeine ingestion via medicines, foods like chocolate, dietary supplements, or beverages including coffee, green tea, other teas, colas may contribute to side effects like nervousness, irritability, nausea, insomnia, or tremor. Patients should avoid medications and dietary supplements which contain high amounts of caffeine.

Amphetamine; Dextroamphetamine Salts: Moderate Avoid excessive caffeine intake during use of the amphetamine salts. Amphetamine; Dextroamphetamine: Moderate Avoid excessive caffeine intake during use of the amphetamine salts. Amprenavir: Major Coadministration with phenobarbital and, potentially, other barbiturates may increase the metabolism of amprenavir and lead to decreased amprenavir concentrations resulting in reduction of antiretroviral efficacy and development of viral resistance.

If amprenavir and barbiturates are used together, the patient must be closely monitored for antiviral efficacy. In theory, coadministration of anagrelide with substrates of CYP1A2, including caffeine, could lead to increases in the serum concentrations of caffeine and, thus, adverse effects. Coadministration of anagrelide with drugs that induce CYP1A2, such as barbiturates, could theoretically increase the elimination of anagrelide and decrease the efficacy of anagrelide. Antacids: Minor Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected.

Apomorphine: Moderate Apomorphine causes significant somnolence. Concomitant administration of apomorphine and CNS depressants could result in additive depressant effects. Apraclonidine: Minor No specific drug interactions were identified with systemic agents and apraclonidine during clinical trials.

Theoretically, apraclonidine might potentiate the effects of CNS depressant drugs such as the anxiolytics, sedatives, and hypnotics, including barbiturates or benzodiazepines. Apremilast: Major The coadministration of apremilast and barbiturates is not recommended. A similar reduction in systemic exposure may be seen with coadministration of apremilast and barbiturates which may result in a loss of efficacy of apremilast. Aprepitant, Fosaprepitant: Minor Use caution if acetaminophen and aprepitant are used concurrently and monitor for an increase in acetaminophen-related adverse effects for several days after administration of a multi-day aprepitant regimen.

As a single mg or 40 mg oral dose, the inhibitory effect of aprepitant on CYP3A4 is weak, with the AUC of midazolam increased by 1.

After administration, fosaprepitant is rapidly converted to aprepitant and shares many of the same drug interactions. However, as a single mg intravenous dose, fosaprepitant only weakly inhibits CYP3A4 for a duration of 2 days; there is no evidence of CYP3A4 induction.

Fosaprepitant mg IV as a single dose increased the AUC of midazolam given on days 1 and 4 by approximately 1.