Butalbital, acetaminophen, and caffeine and Phenobarbital interaction

Butalbital, acetaminophen, and caffeine and Phenobarbital: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Phenobarbital (SEZABY) label · effective 2025-12-23

Major

SEZABY is contraindicated in patients with: acute porphyrias [see Warnings and Precautions (5.8)], or a history of hypersensitivity reaction to phenobarbital or other barbiturates [see Warnings and Precautions (5.7)] Acute porphyrias (4)

Contraindicationsby drug classView label on DailyMed
Major

Hypersensitivity to phenobarbital or other barbiturates (4)

Contraindicationsby drug classView label on DailyMed
Major

SEZABY is contraindicated in patients who have experienced hypersensitivity to phenobarbital or other barbiturates.

Warnings and precautionsby drug classView label on DailyMed

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

Moderate

Butalbital, acetaminophen and caffeine may enhance the effects of: other narcotic analgesics, alcohol, general anesthetics, tranquilizers such as chlordiazepoxide, sedative-hypnotics, or other CNS depressants, causing increased CNS depression.

Drug interactionsby drug classView label on DailyMed

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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.