caffeine + aspirin + butalbital + codeine

**Caffeine + aspirin + butalbital + codeine** is a fixed-dose oral prescription analgesic combination, typically supplied as capsules containing aspirin, butalbital, caffeine, and codeine phosphate. It is indicated for management of tension or muscle-contraction headache when non-opioid analgesics and alternative treatments are inadequate. Aspirin irreversibly inhibits cyclooxygenase enzymes and reduces prostaglandin-mediated pain signaling; butalbital is a barbiturate central nervous system depressant that positively modulates GABA-A receptor signaling; caffeine antagonizes adenosine receptors and can augment analgesia; and codeine is an opioid analgesic whose activity is mediated principally through mu-opioid receptor agonism, including after metabolism to morphine. The product is a Schedule III controlled substance in the United States and carries boxed warnings for addiction, abuse, misuse, life-threatening respiratory depression, accidental ingestion, and dangerous additive central nervous system depression with alcohol, benzodiazepines, or other depressants. ([dailymed.nlm.nih.gov](https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=243a6aea-0f48-42a9-a85e-ff247ab94336))

Brand names

Ascomp with CodeineFiorinal with Codeine

Other names

butalbital + aspirin + caffeine + codeine phosphatebutalbital aspirin caffeine codeine phosphate