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This medication contains acetaminophen and butalbital, and it's crucial to be aware of the associated safety risks and precautions. Here are the important safety warnings you need to consider:

• Liver Damage: Acetaminophen can cause severe liver damage if taken in excess. Adults should not exceed 4000 milligrams (4 grams) daily. Those with liver issues or children should consult a healthcare provider for appropriate dosing. Avoid using multiple medications containing acetaminophen simultaneously. Immediate medical attention is necessary if an overdose occurs, even if you feel fine. Symptoms of overdose may include nausea, vomiting, loss of appetite, stomach pain, extreme tiredness, yellowing of the skin or eyes, and dark urine. Daily alcohol consumption, especially with acetaminophen, increases liver damage risk.

• Cognitive Effects: This medication may impair concentration and alertness. Avoid activities requiring full attention, such as driving or operating heavy machinery, until you understand how the medication affects you. Risks are heightened when combined with alcohol or other sedatives and in individuals aged 65 and older.

• Dependence and Withdrawal: Butalbital can be addictive and lead to physical dependence. Avoid using the medication longer, more frequently, or at higher doses than prescribed. Stopping suddenly can result in withdrawal symptoms such as seizures or restlessness. Consult your healthcare provider for a safe discontinuation plan if necessary.

• Severe Skin Reactions: Acetaminophen can cause rare but serious skin reactions, which may include skin redness, peeling, painful rashes, or blisters. Discontinue use and seek emergency care if these symptoms occur.

• Severe Allergic Reactions: Some people may experience severe allergic reactions to acetaminophen, which can include breathing difficulties, itching, or swelling of the face, mouth, or throat. Immediate medical attention is necessary if these symptoms arise.

• Contraindications: Do not use this medication if you have porphyria, a condition affecting the skin and nerves. Always consult your healthcare provider if you have concerns or conditions that may be affected by this medication.

When taking this medication, some common side effects might occur, including nausea, vomiting, abdominal pain, lightheadedness, dizziness, and drowsiness. These effects are usually mild, but if they persist or worsen, it is advisable to consult a healthcare provider. To minimize dizziness and lightheadedness, it's helpful to rise slowly from sitting or lying positions.

In some cases, more serious side effects may develop, such as shortness of breath, mental or mood changes, fainting, seizures, and a rapid heartbeat. Signs of infection like a persistent sore throat or fever, as well as easy bruising or bleeding, should be communicated to a healthcare provider promptly. Additionally, rare instances of serious allergic reactions may occur, which include symptoms like rash, itching or swelling particularly of the face, tongue, or throat, severe dizziness, and difficulty breathing.

Moreover, other reported side effects include lack of coordination, decreased alertness, and in cases of overdose, symptoms such as extreme sleepiness, confusion, stomach pain, dark urine, yellowing skin or eyes, and sweating can arise. Withdrawal symptoms might involve seizures, delusions, restlessness, trouble sleeping, and shakiness. Serious skin reactions, characterized by skin reddening, peeling, painful rashes, and fluid-filled blisters, can also occur. If any unusual effects not listed occur, it is important to contact a healthcare provider.

When taking this medication, it can interact with several other drugs and substances. For instance, it may quicken the removal of certain medications from your system, affecting their efficacy. This includes drugs like doxycycline, estrogen, felodipine, quinidine, Tamoxifen, and Theophylline, as well as blood thinners like Warfarin, certain beta blockers such as metoprolol, and corticosteroids like Prednisone.

Be sure to inform your healthcare provider if you are using other drugs that induce drowsiness. These can include opioid painkillers or cough suppressants like codeine or hydrocodone, alcohol, cannabis, sleep aids or anti-anxiety medications such as Alprazolam or Lorazepam, muscle relaxants such as Carisoprodol, or antihistamines like Cetirizine or diphenhydramine. Always check the labels on your medications for ingredients that might cause drowsiness, and consult your pharmacist about safe usage.

This medication may also reduce the effectiveness of hormonal birth control methods, such as pills, patches, or rings, potentially leading to pregnancy. Discuss with your healthcare provider about using a reliable backup birth control method and report any new spotting or breakthrough bleeding as these could indicate that your birth control is not working effectively.

Additionally, this medication might interfere with certain laboratory tests, such as urine 5-HIAA levels, potentially causing incorrect results. Ensure that all your healthcare providers and lab personnel are aware of your medication use.

Furthermore, certain medications are not recommended to be used alongside this drug, such as Riociguat and Viloxazine. In some cases, using this medication with others like Alfentanil, Alprazolam, Carisoprodol, Darunavir, and a variety of barbiturates and benzodiazepines may require dose adjustments or monitoring by your doctor. Always consult with your healthcare provider to manage any potential interactions properly.