Last update: July 20, 2020

Butalbital

High Risk for breastfeeding


Poorly safe. Evaluate carefully.
Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives).
Read the Comment.

Butalbital is a barbiturate with general properties similar to those of amobarbital. It is a sedative-hypnotic drug.
It is used to treat pain in combination preparations with paracetamol or caffeine.
Disused medicine due to risk of overdose and abuse (Suddock 2020).

Since the last update we have not found any published data on its excretion in breast milk.
Its pharmacokinetic data (low molecular weight, low protein binding and very long half-life) makes transfer to milk possible in amounts that could be significant.

A 7-day-old newborn, whose mother was taking a butalbital compound (50 mg) -paracetamol-caffeine four times a day, developed sedation, lethargy, hypotonia, insufficient nutrition, and vomiting. The infant had urine butalbital levels (Vohra 2019).

Safer known alternatives are preferable, especially during the neonatal period and in cases of prematurity (Burch 2020 y 2019, Worthington 2013).

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Butalbital is also known as


Butalbital in other languages or writings:

Group

Butalbital belongs to this group or family:

Tradenames

Main tradenames from several countries containing Butalbital in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 224 daltons
Protein Binding 45 %
VD 0,8 l/Kg
pKa 8,48 -
Tmax 1 - 2 hours
T1/2 35 - 61 hours

References

  1. Suddock JT, Cain MD. Barbiturate Toxicity. 2020 Jul 2. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Abstract
  2. Burch R. Epidemiology and Treatment of Menstrual Migraine and Migraine During Pregnancy and Lactation: A Narrative Review. Headache. 2020 Jan;60(1):200-216. Abstract
  3. Burch R. Headache in Pregnancy and the Puerperium. Neurol Clin. 2019 Feb;37(1):31-51. Abstract
  4. Vohra V, Marraffa JM. Maternal use of acetaminophen-butalbital-caffeine product resulting in neonate butalbital exposure through breast milk. Abstract 273 in 39th International Congress of the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) 21-24 May 2019, Naples, Italy, Clin Toxicol. 2019;57:127.
  5. Worthington I, Pringsheim T, Gawel MJ, Gladstone J, Cooper P, Dilli E, Aube M, Leroux E, Becker WJ; Canadian Headache Society Acute Migraine Treatment Guideline Development Group. Canadian Headache Society Guideline: acute drug therapy for migraine headache. Can J Neurol Sci. 2013 Sep;40(5 Suppl 3):S1-S80. Review. Abstract Full text (in our servers)

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