Butalbital, acetaminophen, and caffeine and Ramelteon interaction

Butalbital, acetaminophen, and caffeine and Ramelteon: 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

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

From the Ramelteon (Rozerem) label · effective 2026-04-15

Moderate

The use of alcohol and other CNS depressants may increase the risk of such behaviors.

Warnings and precautionsby drug classView label on DailyMed
Minor

In addition, in vitro data indicate that ramelteon does not cause false-positive results for benzodiazepines, opiates, barbiturates, cocaine, cannabinoids, or amphetamines in two standard urine drug screening methods in vitro .

Warnings and precautionsby drug classView label on DailyMed

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

Open in the checker

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.