Precautions While Using This Medicine 

Check with your doctor: 

• If the medicine stops working as well as it did when  you first started using it. This may mean that you  are in danger of becoming dependent on the medicine. Do not try  to get better  pain relief by increasing the dose. 
• If  you are having headaches more often than you did before you started using this medicine. This is especially important if a new headache occurs within 1 day after you took your last dose of headache medicine, headaches begin to occur every day,  or a headache continues for several days in a row. This may mean that you are dependent on the headache medicine. Continuing  to take this medicine will cause even more headaches later on . Your doctor can give you advice on how  to relieve  the headaches. 

Check the labels of all nonprescription (over-the-counter OTC)  and prescription medicines you now take. If any contain a narcotic, a barbiturate, aspirin,  or other salicylates, including diflunisal, check with your  doctor or pharmacist. Taking them together with this medicine  may cause an overdose. 

The barbiturate and the codeine in this medicine will add  to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines  or medicine  for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; other prescription pain medicine or narcotics; other barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Also, stomach problems may be more likely to occur  if you drink alcoholic beverages while  you are taking aspirin. Therefore,  do not drink alcoholic beverages, and check with  your doctor before  taking any  of the medicines listed above, while  you are using this medicine . 

This medicine may cause some people to become drowsy, dizzy,  or lightheaded,  or to feel a false sense  of well-being. Make sure you know how  you react  to this medicine before  you drive, use machines, or do anything else  that could be dangerous  if you are dizzy  or are not alert  and clearheaded . 

Dizziness, lightheadedness, or fainting may occur, especially when  you get up suddenly from a lying  or sitting position. Getting up slowly may help lessen this problem. Lying down for a while may relieve these effects.
Nausea  or vomiting may occur,  especially after  the first couple  of doses. This effect may go away if  you lie down for a while. However, if nausea  or vomiting continues, check with  your doctor.

Before  having any kind of surgery (including  dental surgery) or emergency treatment,  tell the medical doctor or dentist in charge  that you are taking this medicine. Serious side effects can occur  if your medical doctor or dentist gives  you certain medicines without knowing that you have taken a barbiturate  or codeine. 

Do not take this medicine for 5 days before any planned surgery, including dental surgery, unless otherwise directed by  your medical doctor or dentist. Taking aspirin during this time may cause bleeding problems. 

Before  you have any medical tests, tell the person in charge that you are taking this medicine. The caffeine in the butalbital, aspirin, and codeine combination interferes with the results of certain tests that use dipyridamole (e.g., Persantine) to help show how well blood is flowing to  your heart. Caffeine  should not be taken for 8 to 12 hours before the test. The results of some other tests may also be affected by this medicine. 

If you have been taking large amounts of this medicine, or if you have been taking it regularly for several weeks or more, do not suddenly stop using it without first checking with  your doctor. Your  doctor may want you to reduce gradually the amount  you are taking before stopping completely, to lessen  the chance of withdrawal side effects. 

If  you think you or anyone else may have taken an overdose of this medicine, get emergency help at once. Taking an overdose of this medicine or taking alcohol or CNS depressants with this medicine may lead to unconsciousness or death. Signs of overdose of this medicine include convulsions (seizures); hearing loss; confusion; ringing or buzzing in  the ears; severe excitement, nervousness, or restlessness; severe dizziness; severe drowsiness; unusually slow or troubled breathing;  and severe weakness.