A new product is out, with less acetaminophen than Fioricet or Esgic: Orbivan, which has 50mg of butalbital, 300mg of acetaminophen, and 40mg of caffeine….very similar to Fioricet/Esgic(brand names), or the generic for those.
Also out is a version without butalbital, similar to Phrenilin, is Orbivan CF, which has 50mg of butalbital and 300mg of acetaminophen, without caffeine.
I feel that butalbital meds are a 2-edged sword: they are useful as painkillers for headache patients, but on the downside they may add to medication overuse headache(MOH) and may cause addiction. Despite these downsides, i do feel they play animportant role in a # of situations, and should remain on the market.
There was a negative anti-butalbital article out in the journal Headache several weeks ago; I wrote a Letter to the Editor titled “IN DEFENSE OF BUTALBITAL”, stating all the pluses and minuses of these meds. I will post that letter, which was accepted into the journal for publication, at some point.

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