QuickView for Butalbital (compound)

Summary
General Info

PubChem

PubChem Compound 2481

Name:	butalbital
PubChem Compound ID:	2481
Molecular formula:	C₁₁H₁₆N₂O₃
Molecular weight:	224.256 g/mol
Synonyms:	Allylisobutylbarbital; D03182; DEA No. 2100; Tetrallobarbital; NINDS_000970; Sandoptal (TN); 23554-70-3; Butalbarbital; Allylbarbital; Profundal. show more » Allylisobutylbarbital; D03182; DEA No. 2100; Tetrallobarbital; NINDS_000970; Sandoptal (TN); 23554-70-3; Butalbarbital; Allylbarbital; Profundal; Butalbitale [DCIT]; KBio1_000970; EINECS 201-017-8; Allylbarbitone; Alisobumal; 5-Allyl-5-(2'-methyl-n-propyl) barbituric acid; Axotal; Sandoptal; 77-26-9; BARBITURIC ACID, 5-ALLYL-5-ISOBUTYL-; 5-Allyl-5-isobutylbarbituric acid; Optalidon; Allylisobutylbarbiturate; Alisobumalum; DivK1c_000970; Butalbital; Allylbarbituric acid; Itobarbital; Iso-butylallylbarbituric acid; Fiorinal; Butalbital [USAN:INN]; Butalbital (USP); Butalbitalum [INN-Latin]; 2,4,6(1H,3H,5H)-Pyrimidinetrione, 5-(2-methylpropyl)-5-(2-propenyl)- show less «

DrugBank

Identification

Name:	butalbital
Name (isomeric):	DB00241
Drug Type:	small molecule
Synonyms:	Butalbital M (OH); Allylbarbital
Brand name mixture:	Trianal Tablet(Acetylsalicylic Acid + Butalbital + Caffeine), Trianal-C 1/2 Capsule(Acetylsalicylic Acid + Butalbital + Caffeine + Codeine Phosphate), Ratio-Tecnal(Acetylsalicylic Acid + Butalbital + Caffeine), Fiorinal C1/2 Cap(Acetylsalicylic Acid + Butalbital + Caffeine + Codeine Phosphate), Ratio-Tecnal C1/4(Acetylsalicylic Acid + Butalbital... show more » Trianal Tablet(Acetylsalicylic Acid + Butalbital + Caffeine), Trianal-C 1/2 Capsule(Acetylsalicylic Acid + Butalbital + Caffeine + Codeine Phosphate), Ratio-Tecnal(Acetylsalicylic Acid + Butalbital + Caffeine), Fiorinal C1/2 Cap(Acetylsalicylic Acid + Butalbital + Caffeine + Codeine Phosphate), Ratio-Tecnal C1/4(Acetylsalicylic Acid + Butalbital + Caffeine + Codeine Phosphate), Ratio-Tecnal C 1/2(Acetylsalicylic Acid + Butalbital + Caffeine + Codeine Phosphate), Trianal Capsules(Acetylsalicylic Acid + Butalbital + Caffeine), Fiorinal Tab(Acetylsalicylic Acid + Butalbital + Caffeine), Fiorinal C1/4 Cap(Acetylsalicylic Acid + Butalbital + Caffeine + Codeine Phosphate) show less «
Category:	Analgesics
CAS number:	77-26-9

Pharmacology

Indication:	Used in combination with acetaminophen or aspirin and caffeine for its sedative and relaxant effects in the treatment of tension headaches, migraines, and pain.
Pharmacology:	Butalbital is a short to intermediate-acting barbiturate. Barbiturates act as nonselective depressants of the central nervous system (CNS), capable of producing all levels of CNS mood alteration from excitation to mild sedation, hypnosis, and deep coma. In sufficiently high therapeutic doses, barbiturates induce anesthesia.
Mechanism of Action:	Butalbital binds at a distinct binding site associated with a Cl^- ionopore at the GABA_A receptor, increasing the duration of time for which the Cl^- ionopore is open. The post-synaptic inhibitory effect of GABA in the thalamus is, therefore, prolonged.
Absorption:	Well absorbed from the gastrointestinal tract and is expected to distribute to most tissues in the body.
Protein binding:	45%
Biotransformation:	Hepatic, although most of the dose is eliminated via the kidney (59 to 88%). Urinary excretion products included parent drug (about 3.6% of the dose), 5-isobutyl-5-(2,3-dihydroxypropyl) barbituric acid (about 24% of the dose), 5-allyl-5(3-hydroxy-2-methyl-1-propyl) barbituric acid (about 4.8%).
Half Life:	35 hours
Toxicity:	Symptoms of acute barbiturate poisoning include drowsiness, confusion, coma, respiratory depression, hypotension, and shock.
Affected organisms:	Humans and other mammals

Interactions

Drug interaction:

Estradiol	The enzyme inducer, butalbital, decreases the effect of the hormone agent, estradiol.
Voriconazole	Butalbital may reduce serum concentrations and efficacy of voriconazole. Concomitant voriconazole and long-acting barbiturates therapy is contraindicated.
Ethinyl Estradiol	This product may cause a slight decrease of contraceptive effect
Teniposide	Barbiturates such as butalbital may decrease the serum concentration of teniposide. Consider alternatives to combined treatment with barbiturates and teniposide due to the potential for decreased teniposide concentrations. If the combination cannot be avoided, monitor teniposide response closely.
Felodipine	The barbiturate, butalbital, decreases the effect of felodipine.

Estradiol	The enzyme inducer, butalbital, decreases the effect of the hormone agent, estradiol.
Voriconazole	Butalbital may reduce serum concentrations and efficacy of voriconazole. Concomitant voriconazole and long-acting barbiturates therapy is contraindicated.
Ethinyl Estradiol	This product may cause a slight decrease of contraceptive effect
Teniposide	Barbiturates such as butalbital may decrease the serum concentration of teniposide. Consider alternatives to combined treatment with barbiturates and teniposide due to the potential for decreased teniposide concentrations. If the combination cannot be avoided, monitor teniposide response closely.
Felodipine	The barbiturate, butalbital, decreases the effect of felodipine.
Hydrocortisone	The barbiturate, butalbital, may decrease the effect of the corticosteroid, hydrocortisone.
Dexamethasone	The barbiturate, butalbital, may decrease the effect of the corticosteroid, dexamethasone.
Trimipramine	The barbiturate, Butalbital, may increase the metabolism and clearance of Trimipramine. Monitor for changes in the therapeutics and adverse effects of Trimipramine if Butalbital is initiated, discontinued or dose changed. Dose adjustments of Trimipramine may be required.
Warfarin	Butalbital may decrease the serum concentration of warfarin by increasing its metabolism. Monitor for changes in the therapeutic and adverse effects of warfarin if butalbital is initiated, discontinued or dose changed.
Methadone	The barbiturate, butalbital, decreases the effect of methadone.
Metronidazole	The barbiturate, butalbital, decreases the effect of metronidazole.
Theophylline	The barbiturate, butalbital, decreases the effect of theophylline.
Doxycycline	The anticonvulsant, butalbital, decreases the effect of doxycycline.
Clomipramine	Barbiturates such as butalbital may increase the metabolism of tricyclic antidepressants such as clomipramine. Monitor for decreased therapeutic effects of tricyclic antidepressants if a barbiturate is initiated/dose increased, or increased effects if a barbiturate is discontinued/dose decreased. The tricyclic antidepressant dosage will likely need to be increased during concomitant barbiturate therapy, and reduced upon barbiturate discontinuation.
Hydroxyzine	Hydroxyzine may enhance the CNS depressant effect of barbiturates such as butalbital. Consider a decrease in the barbiturate dose, as appropriate, when used together with hydroxyzine. With concurrent use, monitor patients closely for excessive response to the combination.
Desipramine	Barbiturates such as butalbital may increase the metabolism of tricyclic antidepressants such as desipramine. Monitor for decreased therapeutic effects of tricyclic antidepressants if a barbiturate is initiated/dose increased, or increased effects if a barbiturate is discontinued/dose decreased. The tricyclic antidepressant dosage will likely need to be increased during concomitant barbiturate therapy, and reduced upon barbiturate discontinuation.
Droperidol	Droperidol may enhance the CNS depressant effect of CNS depressants such as butalbital. Consider dose reductions of droperidol or of other CNS agents (e.g., opioids, barbiturates) with concomitant use.
Triprolidine	The CNS depressants, Triprolidine and Butalbital, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy.
Protriptyline	Barbiturates such as butalbital may increase the metabolism of tricyclic antidepressants such as protriptyline. Monitor for decreased therapeutic effects of tricyclic antidepressants if a barbiturate is initiated/dose increased, or increased effects if a barbiturate is discontinued/dose decreased. The tricyclic antidepressant dosage will likely need to be increased during concomitant barbiturate therapy, and reduced upon barbiturate discontinuation.
Nortriptyline	Barbiturates such as butalbital may increase the metabolism of tricyclic antidepressants such as nortriptyline. Monitor for decreased therapeutic effects of tricyclic antidepressants if a barbiturate is initiated/dose increased, or increased effects if a barbiturate is discontinued/dose decreased. The tricyclic antidepressant dosage will likely need to be increased during concomitant barbiturate therapy, and reduced upon barbiturate discontinuation.
Imipramine	Barbiturates such as butalbital may increase the metabolism of tricyclic antidepressants such as imipramine. Monitor for decreased therapeutic effects of tricyclic antidepressants if a barbiturate is initiated/dose increased, or increased effects if a barbiturate is discontinued/dose decreased. The tricyclic antidepressant dosage will likely need to be increased during concomitant barbiturate therapy, and reduced upon barbiturate discontinuation.
Triamcinolone	The barbiturate, butalbital, may decrease the effect of the corticosteroid, triamcinolone.
Prednisone	The barbiturate, butalbital, may decrease the effect of the corticosteroid, prednisone.
Betamethasone	The barbiturate, butalbital, may decrease the effect of the corticosteroid, betamethasone.
Clomifene	The enzyme inducer, butalbital, decreases the effect of the hormone agent, clomifene.
Verapamil	Butalbital, a CYP3A4 inducer, may increase the serum concentration of Verapamil, a CYP3A4 substrate. Monitor for changes in the therapeutic/adverse effects of Verapamil if Butalbital is initiated, discontinued or dose changed.
Amitriptyline	Barbiturates such as butalbital may increase the metabolism of tricyclic antidepressants such as amitriptyline. Monitor for decreased therapeutic effects of tricyclic antidepressants if a barbiturate is initiated/dose increased, or increased effects if a barbiturate is discontinued/dose decreased. The tricyclic antidepressant dosage will likely need to be increased during concomitant barbiturate therapy, and reduced upon barbiturate discontinuation.
Doxepin	Barbiturates such as butalbital may increase the metabolism of tricyclic antidepressants such as doxepin. Monitor for decreased therapeutic effects of tricyclic antidepressants if a barbiturate is initiated/dose increased, or increased effects if a barbiturate is discontinued/dose decreased. The tricyclic antidepressant dosage will likely need to be increased during concomitant barbiturate therapy, and reduced upon barbiturate discontinuation.
Chloramphenicol	Barbiturates such as butalbital may increase the metabolism of Chloramphenicol. Chloramphenicol may decrease the metabolism of Barbiturates. Monitor for decreased serum concentrations/therapeutic effects of chloramphenicol if a barbiturate is initiated/dose increased, or increased effects if a barbiturate is discontinued/dose decreased. In addition, monitor for increased effects of barbiturates if chloramphenicol is initiated/dose increased, or decreased effects if chloramphenicol is discontinued/dose decreased.
Medroxyprogesterone	The enzyme inducer, butalbital, decreases the effect of the hormone agent, medroxyprogesterone.
Folic Acid	Folic acid decreases the effect of anticonvulsant, butalbital.
Levonorgestrel	Phenobarbital decreases the effect of levonorgestrel
Aminophylline	The barbiturate, butalbital, decreases the effect of aminophylline.
Megestrol	The enzyme inducer, butalbital, decreases the effect of the hormone agent, megestrol.
Conjugated Estrogens	The enzyme inducer, butalbital, decreases the effect of the hormone agent, conjugated estrogens.
Lamotrigine	Barbiturates such as butalbital may decrease the serum concentration of lamotrigine. There are separate management guidelines for patients age 12 and under and for patients older than 12 years of age. Please refer to the current approved prescribing information for additional information. Monitor for decreased serum concentrations/therapeutic effects of lamotrigine if a barbiturate is initiated/dose increased, or increased effects if a barbiturate is discontinued/dose decreased.
Gefitinib	The CYP3A4 inducer, butalbital, may decrease the serum concentration and therapeutic effects of gefitinib.
Fludrocortisone	The barbiturate, butalbital, may decrease the effect of the corticosteroid, fludrocortisone.
Diethylstilbestrol	The enzyme inducer, butalbital, decreases the effect of the hormone agent, diethylstilbestrol.
Quinidine	The anticonvulsant, butalbital, decreases the effect of quinidine.
Acenocoumarol	Barbiturates such as butalbital may increase the metabolism of Vitamin K Antagonists such as acenocoumarol. Monitor for decreased therapeutic effects of oral anticoagulants if a barbiturate is initiated/dose increased (anticoagulant dosage increases of 30% to 60% may be needed based on monitored PT), or increased effects if a barbiturate is discontinued/dose decreased. An increased frequency of PT monitoring should be considered for the period immediately following barbiturate initiation/dosage changes.
Amoxapine	Barbiturates such as butalbital may increase the metabolism of tricyclic antidepressants amoxapine. Monitor for decreased therapeutic effects of tricyclic antidepressants if a barbiturate is initiated/dose increased, or increased effects if a barbiturate is discontinued/dose decreased. The tricyclic antidepressant dosage will likely need to be increased during concomitant barbiturate therapy, and reduced upon barbiturate discontinuation.
Cyclosporine	The barbiturate, butalbital, increases the effect of cyclosporine.
Divalproex sodium	Divalproex sodium increases the effect of the barbiturate, butalbital.
Norethindrone	This product may cause a slight decrease of contraceptive effect
Nifedipine	The barbiturate, butalbital, decreases the effect of the calcium channel blocker, nifedipine.
Griseofulvin	The barbiturate, butalbital, decreases the effect of griseofulvin.
Oxtriphylline	The barbiturate, butalbital, decreases the effect of oxtriphylline.
Prednisolone	The barbiturate, butalbital, may decrease the effect of the corticosteroid, prednisolone.

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Targets

Gamma-aminobutyric-acid receptor subunit alpha-1

Gamma-aminobutyric-acid receptor subunit alpha-2

Gamma-aminobutyric-acid receptor subunit alpha-3

Gamma-aminobutyric-acid receptor subunit alpha-4

Gamma-aminobutyric-acid receptor subunit alpha-5

Gamma-aminobutyric-acid receptor subunit alpha-6

Neuronal acetylcholine receptor subunit alpha-4

Neuronal acetylcholine receptor subunit alpha-7

Glutamate receptor 2

Glutamate receptor, ionotropic kainate 2