Butalbital, acetaminophen, and caffeine and Isoniazid interaction

Butalbital, acetaminophen, and caffeine and Isoniazid: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Butalbital, acetaminophen, and caffeine (BUTALBITAL, ACETAMINOPHEN AND CAFFEINE) label · effective 2026-05-19

Moderate

Drug Interactions The CNS effects of butalbital may be enhanced by monoamine oxidase (MAO) inhibitors.

Drug interactionsby drug classView label on DailyMed

From the Isoniazid label · effective 2026-04-27

Moderate

Acetaminophen A report of severe acetaminophen toxicity was reported in a patient receiving isoniazid.

Drug interactionsnames Butalbital, acetaminophen, and caffeineView label on DailyMed
Moderate

It is believed that the toxicity may have resulted from a previously unrecognized interaction between isoniazid and acetaminophen and a molecular basis for this interaction has been proposed.

Drug interactionsnames Butalbital, acetaminophen, and caffeineView label on DailyMed
Moderate

Studies have demonstrated that pretreatment with isoniazid potentiates acetaminophen hepatotoxicity in rats 1,2 .

Drug interactionsnames Butalbital, acetaminophen, and caffeineView label on DailyMed
Moderate

Theophylline A recent study has shown that concomitant administration of isoniazid and theophylline may cause elevated plasma levels of theophylline, and in some instances a slight decrease in the elimination of isoniazid.

Drug interactionsby drug classView label on DailyMed
Moderate

Since the therapeutic range of theophylline is narrow, theophylline serum levels should be monitored closely, and appropriate dosage adjustments of theophylline should be made 7 .

Drug interactionsby drug classView label on DailyMed

Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.