Esgic drugs: Uses, indications and notes when using

Esgic contains acetaminophen, barbiturates, and a caffeine pain reliever combination. Esgic is effective for the treatment of tension headaches in adult and pediatric patients 12 years of age and older. However, long-term use of Esgic is not recommended, easily leading to the risk of drug abuse as well as the risk of liver toxicity due to acetaminophen overdose.

Esgic has three ingredients in one dose: butalbital / acetaminophen / caffeine . This is a combination product used to treat headaches with the effects of each ingredient detailed as follows:
Butalbital is a narcotic that depresses the central nervous system. Acetaminophen is a pain reliever and fever reducer. The mechanism by which acetaminophen relieves pain is by raising the pain threshold, i.e. by requiring a larger amount of pain before the body feels pain. At the same time, acetaminophen also reduces fever by acting on the thermoregulatory center of the brain, which tells the center to lower the body's temperature when the body temperature is high. Caffeine has analgesic properties and may promote the action of other pain medications by a poorly understood mechanism. In addition, caffeine can also reduce the activity of pain-sensing nerves in the brain.

Esgic is available in tablet or capsule form and is taken orally to treat the complex symptoms of tension headaches or occasional migraines.
In one Esgic tablet, which is equivalent to a standard dose, contains 50 mg of butalbital, 300 mg or 325 mg of acetaminophen and 40 mg of caffeine.
For adults, the usual dose is 1 to 2 tablets taken every 4 hours. Do not exceed 6 tablets in a 24-hour period. The maximum dose is acetaminophen 4 grams/day, caffeine 240 mg/day, and butalbital 300 mg/day.
For children and adolescents from 12 years of age and older, the dose should be consulted with a doctor to determine the appropriate indication for each situation. However, the dose should not exceed the maximum dose of acetaminophen 4 grams/day, caffeine 240mg/day and butalbital 300 mg/day.
For children under 12 years of age, the safety and effectiveness of Esgic has not been established.
For patients with liver failure or liver damage, acetaminophen should be used with extreme caution. Also, acetaminophen should not be given to patients with a history of alcoholism. Patients with stable liver disease can be treated with acetaminophen but need to stop early or reduce the dose for a short time, usually less than 5 days.
For patients with renal impairment, no dose adjustment when using Esgic is necessary.

Hepatotoxicity Acetaminophen has been associated with acute liver failure, sometimes leading to the need for a liver transplant and death. Most cases of acetaminophen use in excess of 4000 milligrams per day are usually associated with more than one acetaminophen-containing product. Acetaminophen overdose often occurs because patients try to find more pain relief with other products that also contain acetaminophen.
The risk of acute liver failure is higher in people with underlying liver disease and in people who drink alcohol when using acetaminophen.
Hypersensitivity or anaphylaxis There have been post-marketing reports of hypersensitivity or anaphylaxis adverse events associated with acetaminophen use. Clinical signs include swelling of the face and neck, respiratory distress, rash, and erythema.
At this point, it is necessary to stop taking the drug and notify the doctor or go to the nearest emergency center for timely medical intervention.

Do not use Esgic if the patient has a history of allergy to any of its ingredients.
Do not use more than 4000 milligrams of acetaminophen per day due to the risk of acute liver damage. In patients with prior liver disease, liver function should be monitored periodically while taking Esgic.
Because Esgic drugs can impair the ability to concentrate to do tasks such as driving or operating machinery, caution should be exercised when using the drug.
Alcohol and other substances with central nervous system effects should be avoided in combination with Esgic drugs because they will have a dangerously sedating effect on the nervous system. At the same time, Butalbital, acetaminophen, and caffeine can also increase the effects of other narcotic pain relievers, sedatives such as chlordiazepoxide.
The ingredient butalbital may lead to a risk of drug abuse. Therefore, patients should only use the drug for the period of time prescribed with the correct amount of medicine as prescribed by the doctor.
The CNS effects of butalbital may be enhanced by monoamine oxidase (MAO) inhibitors.
Do not use Esgic during pregnancy because it can cause teratogenic effects.
In a nutshell, Esgic is a combination of butalbital, acetaminophen, and caffeine. This is a capsule that combines salicylate-free analgesic and antipyretic ingredients as well as a central nervous system depressant indicated for the improvement of tension headaches. Because of the adverse effects when overdose, it is necessary to adhere to the use of Esgic drug exactly as prescribed by the doctor, to avoid the risk of drug abuse and to ensure the safety of the patient.

References: headaches.org , pdr.net