Medical Editor: John P. Cunha, DO, FACOEP
Trianal (butalbital, acetylsalicylic acid, and caffeine tablets or capsules) is a combination of a barbiturate, an analgesic (pain reliever), and a mild stimulant indicated for the relief of tension-type headache. Trianal is a Canadian brand name for butalbital, acetylsalicylic acid (aspirin), and caffeine. A brand name for butalbital, aspirin, and caffeine in the U.S. is Fiorinal. Common side effects of Trianal include:
- pupil constriction,
- lightheadedness, and
- gastrointestinal disturbances including:
- vomiting, and
The adult dose of Trianal is 1 or 2 tablets/capsules followed by 1 tablet/capsule every 3 to 4 hours, if needed. Trianal may interact with alcohol or other CNS depressants (other narcotic analgesics, general anesthetics, tranquilizers, sedative-hypnotics), monoamine oxidase inhibitors (MAOIs), oral antidiabetic agents and insulin, anticoagulants, 6-mercaptopurine, methotrexate, nonsteroidal anti-inflammatory drugs (NSAIDs), and uricosuric agents. Tell your doctor all medications and supplements you use. Trianal is not recommended for use during pregnancy; it may harm a fetus. The medications in Trianal pass into breast milk and their effects on nursing infants are unknown. Because of the potential for serious adverse reactions in nursing infants, breastfeeding is not recommended while using Trianal. Withdrawal symptoms may occur if you suddenly stop taking Trianal.
Our Trianal (butalbital, acetylsalicylic acid, and caffeine tablets or capsules) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
The most frequent adverse reactions are drowsiness and dizziness. Less frequent adverse reactions are constipation, rash, miosis, lightheadedness and gastrointestinal disturbances including nausea, vomiting and flatulence. A single incidence of bone marrow suppression has been reported with the use of ASA-caffeine-butalbital. Several cases of dermatological reactions including toxic epidermal necrolysis, Stevens-Johnson syndrome, lichenoid eruption and erythema multiforme have been reported.
The following adverse drug events may be borne in mind as potential effects of the components of TRIANAL TABLETS/TRIANAL CAPSULES. Potential effects of high dosage are listed in the SYMPTOMS and TREATMENT of OVERDOSAGE section below.
ASA: occult blood, hemolytic anemia, iron deficiency anemia, dyspepsia, nausea, peptic ulcer, prolonged bleeding time, nephropathy toxic when taken in high doses for prolonged periods, urine uric acid decreased, hepatitis.
Caffeine: tachycardia, irritability, tremor, dependence, hyperglycemia.
Butalbital: incoordination, difficulty thinking, poor memory, faulty judgment, decreased attention, emotional lability, exaggeration of personality traits.
Read the entire FDA prescribing information for Trianal ()