Acetaminophen; Butalbital; Caffeine (0021)
[ a-seat-a-min'-oh-fen; byoo-tal'-bih-tall; kaf'-een ]
| Ingredients: |
Acetaminophen; Butalbital; Caffeine |
| Indications: |
Headache, tension |
| Pregnancy Category: |
(none)
|
| FDA Approved: |
1984- 11- 01 |
| Classes: |
Analgesics, non- narcotic; Barbiturates; Xanthine derivatives |
| Brand Names: |
Americet
-
US
;
Anolor 300
-
US
;
Endolor
-
US
;
Esgic
-
US
;
Esgic-Plus
-
US
;
Ezol
-
US
;
Fioricet
-
US
;
Geone
-
US
;
Medigesic
-
US
;
Nonbac
-
US
;
Repan
-
US
;
Tenake
-
US
;
Triad
-
US
;
Two-Dyne
-
US
;
Zebutal
-
US
;
|
| DEA schedules: |
Schedule III |
DESCRIPTION
|
| |
Fioricet (butalbital, acetaminophen, and caffeine tablets) is supplied in tablet form fororal administration.
Each Tablet Contains the Following Ingredients: Butalbital, 50 mg; acetaminophen, 325 mg; caffeine, 40 mg.
Inactive Ingredients: Crospovidone, FD&C blue no. 1, magnesium stearate, microcrystalline cellulose, povidone, pregelatinized starch, and stearic
acid.
Butalbital, (5- allyl- 5- isobutylbarbituric acid), is a short- to intermediate- acting barbiturate.
Its molecular formula is C11 H16 N2 O3 , and its molecular weight is 224.26
Acetaminophen, (4′- hydroxyacetanilide), is a non- opiate, non- salicylate analgesic, and antipyretic.
Its molecular formula is C8 H9 NO2 , and its molecular weight 151.17.
Caffeine, (1, 3, 7- trimethylxanthine), is a central nervous system stimulant.
Its molecular formula is C8 H10 N4 O2 , and its molecular weights is 194.19.
|
CLINICAL PHARMACOLOGY
|
| |
This combination drug product is intended as a treatment for tension headache.
It consists of a fixed combination of acetaminophen, butalbital and caffeine. The role each component plays in the relief
of the complex of symptoms known as tension headache is incompletely understood.
Pharmacokinetics
|
| |
The behavior of the individual components is described below.
Butalbital
|
| |
Butalbital is well absorbed from the gastrointestinal tract and is expected to distribute to most tissues in the body. Barbiturates
in general may appear in breast milk and readily cross the placental barrier. They are bound to plasma and tissue proteins
to a varying degree and binding increases directly as a function of lipid solubility.
Elimination of butalbital is primarily via the kidney (59- 88% of the dose) as unchanged drug or metabolites. The plasma half-
life is about 35 hours. Urinary excretion products include parent drug (about 3.6% of the dose), 5- isobutyl- 5- (2, 3- dihydroxypropyl)
barbituric acid (about 24% of the dose), 5- allyl- 5 (3- hydroxy- 2- methyl- 1- propyl) barbituric acid (about 4.8% of the
dose), products with the barbituric acid ring hydrolyzed with excretion of urea (about 14% of the dose), as well as unidentified
materials. Of the material excreted in urine, 32% is conjugated.
The in vitro plasma protein binding of butalbital is 45% over the concentration range of 0.5 to 20 μg/ ml. This falls within the range
of plasma protein binding (20- 45%) reported with other barbiturates such as phenobarbital, pentobarbital, and secobarbital
sodium. The plasma- to- blood concentration ratio was almost unity indicating that there is no preferential distribution of
butalbital into either plasma or blood cells. (See OVERDOSAGE for toxicity information.)
|
Acetaminophen
|
| |
Acetaminophen is rapidly absorbed from the gastrointestinal tract and is distributed throughout most body tissues. The plasma
half- life is 1.25 to 3 hours, but may be increased by liver damage and following overdosage. Elimination of acetaminophen
is principally by liver metabolism (conjugation) and subsequent renal excretion of metabolites. Approximately 85% of an oral
dose appears in the urine within 24 hours of administration, most as the glucuronide conjugate, with small amounts of other
conjugates and unchanged drug. (See OVERDOSAGE for toxicity information.)
|
Caffeine
|
| |
Like most xanthines, caffeine is rapidly absorbed and distributed through most body tissues and fluids, including the CNS,
fetal tissues, and breast milk.
Caffeine is cleared through metabolism and excretion in the urine. The plasma half- life is about 3 hours. Hepatic biotrasformation
prior to excretion, results in about equal amounts of 1- methylxanthine and 1- methyluric acid. Of the 70% of the dose that
is recovered in the urine, only 3% is unchanged drug. (See OVERDOSAGE for toxicity information.)
|
|
|
INDICATIONS AND USAGE
|
| |
Butalbital, acetaminophen and caffeine tablets are indicated for the relief of the symptom complex of tension (or muscle contraction)
headache.
Evidence supporting the efficacy and safety of this combination product in the treatment of multiple recurrent headaches is
unavailable. Caution in this regard is required because butalbital is habit- forming and potentially abusable.
|
CONTRAINDICATIONS
|
| |
This product is contraindicated under the following conditions:
| • |
Hypersensitivity or intolerance to any component of this product.
|
| • |
Patients with porphyria.
|
|
WARNINGS
|
| |
Butalbital is habit- forming and potentially abusable. Consequently, the extended use of this product is not recommended.
|
PRECAUTIONS
|
| |
General
|
| |
Acetaminophen, butalbital and caffeine tablets should be prescribed with caution in certain special- risk patients, such as
the elderly or debilitated, and those with severe impairment of renal or hepatic function, or acute abdominal conditions.
|
Information for the Patient
|
| |
This product may impair mental and/ or physical abilities required for the performance of potentially hazardous tasks such
as driving a car or operating machinery. Such tasks should be avoided while taking this product.
Alcohol and other CNS depressants may produce an additive CNS depression, when taken with this combination product, and should
be avoided.
Butalbital may be habit- forming. Patients should take the drug only for as long as it is prescribed, in the amounts prescribed,
and no more frequently than prescribed.
For information on use in geriatric patients, see PRECAUTIONS, Geriatric Use .
|
Laboratory Tests
|
| |
In patients with severe hepatic or renal disease, effects of therapy should be monitored with serial liver and/ or renal function
tests.
|
Drug/Laboratory Test Interactions
|
| |
Acetaminophen may produce false- positive test results for urinary 5- hydroxyindoleacetic acid.
|
Carcinogenesis, Mutagenesis, and Impairment of Fertility
|
| |
No adequate studies have been conducted in animals to determine whether acetaminophen or butalbital have a potential for carcinogenesis,
mutagenesis or impairment of fertility.
|
Pregnancy, Teratogenic Effects, Pregnancy Category C
|
| |
Animal reproduction studies have not been conducted with this combination product. It is also not known whether acetaminophen,
butalbital and caffeine can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. This
product should be given to a pregnant woman only when clearly needed.
Nonteratogenic Effects
|
| |
Withdrawal seizures were reported in a 2- day- old male infant whose mother had take a butalbital- containing drug during
the last 2 months of pregnancy. Butalbital was found in the infant's serum. The infant was given phenobarbital 5 mg/ kg, which
was tapered without further seizure or other withdrawal symptoms.
|
|
Nursing Mothers
|
| |
Caffeine, barbiurates and acetaminophen are excreted in breast milk in small amounts, but the significance of their effects
on nursing infants is not known. Because of potential for serious adverse reactions in nursing infants from acetaminophen,
butalbital and caffeine, a decision should be made whether to discontinue nursing or to discontinue drug, taking into account
the importance of the drug to the mother.
|
Pediatric Use
|
| |
Safety and effectiveness in children below the age of 12 have not been established.
|
Geriatric Use
|
| |
Clinical studies of butalbital, acetaminophen, and caffeine tablets) did notinclude sufficient numbers of subjects aged 65
and over to determine whether they responddifferently from younger subjects. Other reported clinical experience has not identifieddifferences
in responses between the elderly and younger patients. In general, dose selection foran elderly patient should be cautious,
usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac
function, and ofconcomitant disease or other drug therapy.
Butalbital is known to be substantially excreted by the kidney, and the risk of toxic reactions tothis drug may be greater
in patients with impaired renal function. Because elderly patients aremore likely to have decreased renal function, care should
be taken in dose selection, and it maybe useful to monitor renal function.
|
|
DRUG INTERACTIONS
|
| |
The CNS effects of butalbital may be enhanced by monoamine oxidase (MAO) inhibitors.
Acetaminophen, butalbital and caffeine tablets may enhance the effects of: Other narcotic analgesics, alcohol, general anesthetics, tranquilizers such as chlordiazepoxide, sedative- hypnotics, or other
CNS depressants, causing increased CNS depression.
|
ADVERSE REACTIONS
|
| |
Frequently Observed
|
| |
The most frequently reported adverse reactions are drowsiness, lightheadedness, dizziness, sedation, shortness of breath,
nausea, vomiting, abdominal pain, and intoxicated feeling.
|
Infrequently Observed
|
| |
All adverse events tabulated below are classified as infrequent.
- Central Nervous System: Headache, shaky feeling, tingling, agitation, fainting, fatigue, heavy eyelids, high energy, hot spells, numbness, sluggishness,
seizure. Mental confusion, excitement or depression can also occur due to intolerance, particularly in elderly or debilitated
patients, or due to overdosage of butalbital.
- Autonomic Nervous System: Dry mouth, hyperhidrosis.
- Gastrointestinal: Difficulty swallowing, heartburn, flatulence, constipation.
- Cardiovascular: Tachycardia.
- Musculoskeletal: Leg pain, muscle fatigue.
- Genitourinary: Diuresis.
- Miscellaneous: Pruritus, fever, earache, nasal congestion, tinnitus, euphoria, allergic reactions.
Several cases of dermatological reactions, including toxic epidermal necrolysis and erythema multiforme, have been reported.
The following adverse drug events may be borne in mind as potential effects of the components of this product. Potential effects
of high dosage are listed in OVERDOSAGE .
- Acetaminophen: Allergic reactions, rash, thrombocytopenia, agranulocytosis.
- Caffeine: Cardiac stimulation, irritability, tremor, dependence, nephrotoxicity, hyperglycemia.
|
|
DRUG ABUSE AND DEPENDENCE
|
| |
Butalbital
|
| |
Barbiturates may be habit- forming: Tolerance, psychological dependence, and physical dependence may occur especially following prolonged use of high doses of
barbiturates. The average daily dose for the barbiturate addict is usually about 1500 mg. As tolerance to barbiturates develops,
the amount needed to maintain the same level of intoxication increase; tolerance to a fatal dosage, however, does not increase
more than 2- fold. As this occurs, the margin between an intoxication dosage and fatal dosage becomes smaller. The lethal
dose of a barbiturate is far less if alcohol is also ingested. Major withdrawal symptoms (convulsions and delirium) may occur
within 16 hours and last up to 5 days after abrupt cessation of these drugs. Intensity of withdrawal symptoms gradually declines
over a period of approximately 15 days. Treatment of barbiturate dependence consists of cautious and gradual withdrawal of
the drug. Barbiturate- dependent patients can be withdrawn by using a number of different withdrawal regimens. One method
involves initiating treatment at the patient's regular dosage level and gradually decreasing the daily dosage as tolerated
by the patient.
|
|
OVERDOSAGE
|
| |
Following an acute overdosage of acetaminophen, butalbital and caffeine, toxicity may result from the barbiturate or the acetaminophen.
Toxicity due to caffeine is less likely, due to the relatively small amounts in this formulation.
Signs and Symptoms
|
| |
Toxicity from barbiturate poisoning include drowsiness, confusion, and coma; respiratory depression; hypotension; and hypovolemic shock.
In acetaminophen overdosage: dose- dependent, potentially fatal hepatic necrosis is the most serious adverse effect. Renal tubular necroses,
hypoglycemic coma and thrombocytopenia may also occur. Early symptoms following a potentially hepatotoxic overdose may include:
nausea, vomiting, diaphoresis and general malaise. Clinical and laboratory evidence of hepatic toxicity may not be apparent
until 48- 72 hours post- ingestion. In adults, hepatic toxicity has rarely been reported with acute overdoses of less than
10 g, or fatalities with less than 15 g.
Acute caffeine poisoning may cause insomnia, restlessness, tremor, delirium, tachycardia and extrasystoles.
|
Treatment
|
| |
A single or multiple overdose with this combination product is a potentially lethal polydrug overdose, and consultation with
a regional poison control center is recommended.
Immediate treatment includes support of cardiorespiratory function and measures to reduce drug absorption. Vomiting should
be induced mechanically, or with syrup of ipecac, if the patient is alert (adequate pharyngeal and laryngeal reflexes). Oral
activated charcoal (1 g/ kg) should follow gastric emptying. The first dose should be accompanied by an appropriate cathartic.
If repeated doses are used, the cathartic might be included with alternate doses as required. Hypotension is usually hypovolemic
and should respond to fluids. Pressors should be avoided. A cuffed endotracheal tube should be inserted before gastric lavage
of the unconscious patient and, when necessary, to provide assisted respiration. If renal function is normal, forced diuresis
may aid in the elimination of the barbiturate. Alkalinization of the urine increases renal excretion of some barbiturates,
especially phenobarbital.
Meticulous attention should be given to maintaining adequate pulmonary ventilation. In severe cases of intoxication, peritoneal
dialysis, or preferably hemodialysis may be considered. If hypoprothrombinemia occurs due to acetaminophen overdose, vitamin
K should be administered intravenously.
If the dose of acetaminophen may have exceeded 140 mg/ kg, acetylcysteine should be administered as early as possible. Serum
acetaminophen levels should be obtained, since levels 4 or more hours following ingestion help predict acetaminophen toxicity.
Do not await acetaminophen assay results before initiating treatment. Hepatic enzymes should be obtained initially, and repeated
at 24 hour intervals.
Methemoglobinemia over 30% should be treated with methylene blue by slow IV administration.
|
Toxic Doses (for adults)
|
| |
- Butalbital: Toxic dose 1 g (20 tablets).
- Acetaminophen: Toxic dose 10 g (30 tablets).
- Caffeine: Toxic dose 1 g (25 tablets).
In all cases of suspected overdosage, call your Regional Poison Control Center to obtain themost up- to- date information
about the treatment of overdosage. Telephone numbers of certifiedRegional Poison Control Centers are listed in the Physicians’
Desk Reference.
|
|
DOSAGE AND ADMINISTRATION
|
| |
One or two tablets every 2- 4 hours as needed. Total daily dosage should not exceed 6 tablets.
Extended and repeated use of this product is not recommended because of the potential for physical dependence.
|
HOW SUPPLIED
|
| |
Fioricet (butalbital, acetaminophen, and caffeine tablets) are light- blue, speckled, round uncoated tablets, debossed with "FIORICET" on one side and a three- head profile on the other
side.
Storage
|
| |
Store below 30°C (86°F).
Dispense in a tight container.
|
|
PRODUCT IDENTIFICATION
|
| |
Acetaminophen; Butalbital; Caffeine ,
capsule ,
325 mg-50 mg-40 mg
[ Forest Pharmaceuticals
]
Acetaminophen; Butalbital; Caffeine ,
tablet ,
325 mg-50 mg-40 mg
[ Sandoz Inc
]
Acetaminophen; Butalbital; Caffeine ,
tablet ,
325 mg-50 mg-40 mg
[ Creighton Products Corporation
]
Acetaminophen; Butalbital; Caffeine ,
tablet ,
325 mg-50 mg-40 mg
[ Novartis Pharmaceuticals
]
Acetaminophen; Butalbital; Caffeine ,
tablet ,
500 mg-50 mg-40 mg
[ Forest Pharmaceuticals
]
Acetaminophen; Butalbital; Caffeine ,
tablet ,
325 mg-50 mg-40 mg
[ IVAX Corporation
]
Acetaminophen; Butalbital; Caffeine ,
tablet ,
325 mg-50 mg-40 mg
[ Inwood Laboratories Inc
]
Acetaminophen; Butalbital; Caffeine ,
tablet ,
325 mg-50 mg-40 mg
[ Qualitest Pharmaceuticals Inc
]
Acetaminophen; Butalbital; Caffeine ,
tablet ,
325 mg-50 mg-40 mg
[ Sandoz Inc
]
Acetaminophen; Butalbital; Caffeine ,
tablet ,
325 mg-50 mg-40 mg
[ Mikart Inc
]
Acetaminophen; Butalbital; Caffeine ,
tablet ,
325 mg-50 mg-40 mg
[ Martec Pharmaceuticals Inc
]
Acetaminophen; Butalbital; Caffeine ,
tablet ,
325 mg-50 mg-40 mg
[ Physicians Total Care
]
Acetaminophen; Butalbital; Caffeine ,
tablet ,
325 mg-50 mg-40 mg
[ Quality Care Products/Lake Erie Medical
]
Acetaminophen; Butalbital; Caffeine ,
tablet ,
325 mg-50 mg-40 mg
[ Watson Pharmaceuticals
]
|
PRODUCT LISTING - RATED THERAPEUTICALLY EQUIVALENT
|
| |
| capsule - oral - 500 mg- 50 mg- 40 mg -
|
| 100.0 |
$142.92 |
Zebutal
First Horizon Pharmaceutical Corporation
|
59630017010 |
| 100.0 |
$143.03 |
Esgic- Plus
Forest Pharmaceuticals
|
00456067901 |
| capsule - oral - 325 mg- 50 mg- 40 mg -
|
| 100.0 |
$18.04 |
Two- Dyne
Hyrex Pharmaceuticals
|
00314222901 |
| 100.0 |
$25.13 |
Anolor 300
Blansett Pharmacal Company Inc
|
51674000901 |
| 100.0 |
$29.00 |
Endolor
Keene Pharmaceuticals Inc
|
00588777701 |
| 100.0 |
$41.50 |
Geone
Alphagen Laboratories Inc
|
59743000401 |
| 100.0 |
$41.99 |
GENERIC
Qualitest Pharmaceuticals Inc
|
00603254621 |
| 100.0 |
$53.18 |
Medigesic
U.S. Pharmaceutical Corporation
|
52747060060 |
| 100.0 |
$161.09 |
Esgic
Forest Pharmaceuticals
|
00535001201 |
| tablet - oral - 500 mg- 50 mg- 40 mg -
|
| 8.0's |
$10.60 |
Esgic- Plus
Allscripts Healthcare Solutions
|
54569344100 |
| 12.0's |
$21.39 |
Esgic- Plus
PD- RX Pharmaceuticals
|
55289026412 |
| 12.0's |
$21.79 |
GENERIC
PD- RX Pharmaceuticals
|
55289043912 |
| 30.0's |
$39.74 |
Esgic- Plus
Allscripts Healthcare Solutions
|
54569344101 |
| 100.0's |
$57.36 |
GENERIC
West- Ward Pharmaceutical Corporation
|
00143111501 |
| 100.0's |
$96.18 |
GENERIC
Qualitest Pharmaceuticals Inc
|
00603255121 |
| 100.0's |
$110.00 |
GENERIC
United Research Laboratories/ Mutual Pharmaceutical Company
|
00677173801 |
| 100.0's |
$110.00 |
GENERIC
Able Laboratories Inc
|
53265023510 |
| 100.0's |
$115.75 |
GENERIC
Inwood Laboratories Inc
|
00258365701 |
| 100.0's |
$143.53 |
Esgic- Plus
Forest Pharmaceuticals
|
00456067801 |
| 500.0's |
$506.00 |
GENERIC
Able Laboratories Inc
|
53265023550 |
| 500.0's |
$565.31 |
GENERIC
West- Ward Pharmaceutical Corporation
|
00143111505 |
| 500.0's |
$580.60 |
Esgic- Plus
Forest Pharmaceuticals
|
00456067802 |
| tablet - oral - 325 mg- 50 mg- 40 mg -
|
| 10.0's |
$17.78 |
GENERIC
PD- RX Pharmaceuticals
|
55289087910 |
| 12.0's |
$9.82 |
Fioricet
Allscripts Healthcare Solutions
|
54569001302 |
| 15.0's |
$22.50 |
GENERIC
PD- RX Pharmaceuticals
|
55289087915 |
| 20.0's |
$7.76 |
GENERIC
Alpharma USPD
|
63874044820 |
| 20.0's |
$27.21 |
GENERIC
PD- RX Pharmaceuticals
|
55289087920 |
| 30.0's |
$9.75 |
GENERIC
Alpharma USPD
|
63874044830 |
| 30.0's |
$24.57 |
Fioricet
Allscripts Healthcare Solutions
|
54569001300 |
| 30.0's |
$36.66 |
GENERIC
PD- RX Pharmaceuticals
|
55289087930 |
| 100.0's |
$15.25 |
GENERIC
Inwood Laboratories Inc
|
00258366501 |
| 100.0's |
$19.05 |
GENERIC
Major Pharmaceuticals Inc
|
00904328061 |
| 100.0's |
$19.50 |
GENERIC
Major Pharmaceuticals Inc
|
00904328060 |
| 100.0's |
$35.00 |
GENERIC
West- Ward Pharmaceutical Corporation
|
00143178701 |
| 100.0's |
$43.95 |
GENERIC
Teva Pharmaceuticals USA
|
00093085401 |
| 100.0's |
$44.10 |
GENERIC
Axiom Pharmaceutical Corporation
|
67870011101 |
| 100.0's |
$48.05 |
GENERIC
Par Pharmaceutical Inc
|
49884081101 |
| 100.0's |
$50.15 |
GENERIC
Alpharma USPD
|
63874044801 |
| 100.0's |
$59.25 |
GENERIC
Mikart Inc
|
46672005310 |
| 100.0's |
$59.68 |
GENERIC
Able Laboratories Inc
|
53265023610 |
| 100.0's |
$60.12 |
GENERIC
Watson Pharmaceuticals
|
00591048501 |
| 100.0's |
$62.00 |
GENERIC
Watson Pharmaceuticals
|
52544048501 |
| 100.0's |
$63.99 |
GENERIC
United Research Laboratories/ Mutual Pharmaceutical Company
|
00677174801 |
| 100.0's |
$64.07 |
GENERIC
Mallinckrodt Medical Inc
|
00406097001 |
| 100.0's |
$64.15 |
GENERIC
Qualitest Pharmaceuticals Inc
|
00603254721 |
| 100.0's |
$81.94 |
Fioricet
Novartis Pharmaceuticals
|
00078008406 |
| 100.0's |
$105.39 |
Fioricet
Novartis Pharmaceuticals
|
00078008405 |
| 100.0's |
$176.73 |
Esgic
Forest Pharmaceuticals
|
00535001101 |
| 500.0's |
$74.95 |
GENERIC
Inwood Laboratories Inc
|
00258366505 |
| 500.0's |
$79.10 |
GENERIC
Par Pharmaceutical Inc
|
49884081105 |
| 500.0's |
$165.10 |
GENERIC
Axiom Pharmaceutical Corporation
|
67870011105 |
| 500.0's |
$171.25 |
GENERIC
West- Ward Pharmaceutical Corporation
|
00143178705 |
| 500.0's |
$237.26 |
GENERIC
United Research Laboratories/ Mutual Pharmaceutical Company
|
00677174805 |
| 500.0's |
$247.52 |
GENERIC
Mikart Inc
|
46672005350 |
| 500.0's |
$253.42 |
GENERIC
Able Laboratories Inc
|
53265023650 |
| 500.0's |
$294.50 |
GENERIC
Watson Pharmaceuticals
|
52544048505 |
| 500.0's |
$301.40 |
GENERIC
Major Pharmaceuticals Inc
|
00904328040 |
| 500.0's |
$305.05 |
GENERIC
Qualitest Pharmaceuticals Inc
|
00603254728 |
| 500.0's |
$305.98 |
GENERIC
Mallinckrodt Medical Inc
|
00406097005 |
| 500.0's |
$503.25 |
Fioricet
Novartis Pharmaceuticals
|
00078008408 |
| 500.0's |
$702.82 |
Esgic
Forest Pharmaceuticals
|
00535001102 |
| 1000.0's |
$143.88 |
GENERIC
Alpharma USPD
|
63874044802 |
|
PRODUCT LISTING - EQUIVALENTS NOT AVAILABLE
|
| |
| capsule - oral - 325 mg- 50 mg- 40 mg -
|
| 100.0 |
$31.11 |
Tenake
Seatrace Pharmaceuticals
|
00551018101 |
| 100.0 |
$37.75 |
Triad
Forest Pharmaceuticals
|
00785230501 |
| 100.0 |
$62.25 |
Ezol
Stewart- Jackson Pharmacal Inc
|
45985057801 |
| tablet - oral - 500 mg- 50 mg- 40 mg -
|
| 30.0's |
$28.85 |
GENERIC
Allscripts Healthcare Solutions
|
54569493500 |
| 30.0's |
$45.38 |
GENERIC
Direct Dispensing Inc
|
57866485701 |
| tablet - oral - 325 mg- 50 mg- 40 mg -
|
| 10.0's |
$4.78 |
GENERIC
Southwood Pharmaceuticals Inc
|
58016099510 |
| 12.0's |
$3.85 |
GENERIC
Pharma Pac
|
52959037012 |
| 12.0's |
$5.73 |
GENERIC
Southwood Pharmaceuticals Inc
|
58016099512 |
| 12.0's |
$5.98 |
GENERIC
Allscripts Healthcare Solutions
|
54569253801 |
| 14.0's |
$6.69 |
GENERIC
Southwood Pharmaceuticals Inc
|
58016099514 |
| 15.0's |
$7.16 |
GENERIC
Southwood Pharmaceuticals Inc
|
58016099515 |
| 20.0's |
$6.25 |
GENERIC
Pharma Pac
|
52959037020 |
| 20.0's |
$9.55 |
GENERIC
Southwood Pharmaceuticals Inc
|
58016099520 |
| 20.0's |
$9.96 |
GENERIC
Allscripts Healthcare Solutions
|
54569253804 |
| 21.0's |
$10.03 |
GENERIC
Southwood Pharmaceuticals Inc
|
58016099521 |
| 24.0's |
$11.46 |
GENERIC
Southwood Pharmaceuticals Inc
|
58016099524 |
| 25.0's |
$6.56 |
GENERIC
Pharma Pac
|
52959037025 |
| 28.0's |
$13.37 |
GENERIC
Southwood Pharmaceuticals Inc
|
58016099528 |
| 30.0's |
$6.90 |
GENERIC
Pharma Pac
|
52959037030 |
| 30.0's |
$14.33 |
GENERIC
Southwood Pharmaceuticals Inc
|
58016099530 |
| 30.0's |
$14.94 |
GENERIC
Allscripts Healthcare Solutions
|
54569253800 |
| 30.0's |
$23.14 |
GENERIC
Physicians Total Care
|
54868103601 |
| 40.0's |
$19.10 |
GENERIC
Southwood Pharmaceuticals Inc
|
58016099540 |
| 50.0's |
$9.65 |
GENERIC
Pharma Pac
|
52959037050 |
| 50.0's |
$37.47 |
GENERIC
Physicians Total Care
|
54868103603 |
| 60.0's |
$9.89 |
GENERIC
Pharma Pac
|
52959037060 |
| 60.0's |
$28.66 |
GENERIC
Southwood Pharmaceuticals Inc
|
58016099560 |
| 60.0's |
$29.88 |
GENERIC
Allscripts Healthcare Solutions
|
54569253805 |
| 75.0's |
$35.82 |
GENERIC
Southwood Pharmaceuticals Inc
|
58016099575 |
| 100.0's |
$16.98 |
GENERIC
Pharma Pac
|
52959037000 |
| 100.0's |
$28.08 |
Repan
Everett Laboratories Inc
|
00642016410 |
| 100.0's |
$35.10 |
Repan
Everett Laboratories Inc
|
00642016210 |
| 100.0's |
$44.00 |
Americet
MCR American Pharmaceuticals Inc
|
58605050101 |
| 100.0's |
$47.76 |
GENERIC
Southwood Pharmaceuticals Inc
|
58016099500 |
| 100.0's |
$49.81 |
GENERIC
Allscripts Healthcare Solutions
|
54569253803 |
| 100.0's |
$56.43 |
GENERIC
Physicians Total Care
|
54868103602 |
| 100.0's |
$85.95 |
GENERIC
Imiren Pharmaceuticals Inc
|
61808011001 |
| 500.0's |
$35.40 |
Nonbac
Truxton Company Inc
|
00463632605 |
|
|