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Significant Interactions:
It is especially important that your health care professional know if you are taking any of the following:

- Antidepressants, tricyclic (amitriptyline [e.g., Elavil], amoxapine [e.g., Asendi n], clomipramine [e.g., Anafranil], desipramine [e.g., Pertofrane], doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g., Aventyl], protriptyline [e.g., Vivactil], trimipramine [ e.g., Surmontil]) or
- Central nervous system (CNS) depressants (medicines that often cause drowsiness)ˇXThese medicines may add to the effects of butalbital and increase the chance of drowsiness or other side effects
- Divalproex (e.g., Depakote) or
- Valproic acid (e.g., Depakene)ˇXThe chance of side effects may be increased

Symptoms of overdose
Seek emergency medical attention. Symptoms of an acetamino phenbutalbita lcaffeine - Esgic overdose include insomnia, restlessness, tremor, nausea, vomiting, diarrhea, abdominal pain, sweating, seizur es, drowsiness, decreased breathing,

How to Use
The combination of acetaminophen, butalbital, and caffeine comes as a capsule and tablet to take by mouth. It usually is taken every 4 hours as needed. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take acetaminophen, butalbital, and caffeine exactly as directed. Do not take more than six tablets or capsules in 1 day. If you think that you need more to relieve your symptoms, call your doctor.

This medication can be habit-forming. Do not take a larger dose, take it more often, or for a longer per iod than your doctor tells you to.

What Is It
Acetaminophen ispain reliever and fever reducer. Butalbital is inclass of drugs called barbiturates that slow down your central nervous system (brain and nerve impulses) causing relaxation. Caffeine i s believed to constrict dilated blood vessels that may contribute to tension headaches. Together, acetaminophen, butalbital, and caffeine - Esgic is used to relieve complex tension (muscle contraction ) headaches although precisely how it works is unknown. Acetamino phenbutalbital caffeine - Esgic may also be used for purposes other than those listed in this medication guide.

Before Using This Medicine
Before taking acetaminophen, butalbital, and caffeine,

tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially anticoagulants ('blood thin ners') such as warfarin (Coumadin), antidepressants, antihistamines, pain medications, sedatives, sleeping pills, tranquilizers, and vitamins. Many nonprescription pain relievers contain acetaminophen . Too much of this drug can be harmful.

Missed Dose
Take the missed dose as soon as you remember. Do not takedouble dose of Esgic . Wait the prescribed amount of time before taking your next dose.


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