Butalbital, acetaminophen, and caffeine and Valproic acid interaction
Butalbital, acetaminophen, and caffeine and Valproic acid: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.
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
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.
From the Valproic acid label · effective 2024-05-02
All patients receiving concomitant barbiturate therapy should be closely monitored for neurological toxicity.
Serum barbiturate concentrations should be obtained, if possible, and the barbiturate dosage decreased, if appropriate.
There is evidence for severe CNS depression, with or without significant elevations of barbiturate or valproate serum concentrations.
Primidone, which is metabolized to a barbiturate, may be involved in a similar interaction with valproate.
Drugs for which either no interaction or a likely clinically unimportant interaction has been observed Acetaminophen Valproate had no effect on any of the pharmacokinetic parameters of acetaminophen when it was concurrently administered to three epileptic patients.
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot 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.