Butalbital, Acetaminophen, Caffeine AND Codeine Phosphate · Regulatory label update
U.S. Food and Drug Administration · June 18, 2026
An action by a regulator. Authoritative on labelling and availability.
The FDA approved a supplemental application for a Risk Evaluation and Mitigation Strategy (REMS) for a fixed-dose combination capsule containing butalbital, acetaminophen, caffeine, and codeine phosphate (Hikma). This is a regulatory compliance action and does not report clinical trial results, efficacy, or safety outcomes.
Regulatory label update. Patients eligible to receive butalbital, acetaminophen, caffeine, and codeine phosphate combination therapy; specific clinical indications not stated in this regulatory record.. Intervention: Butalbital 50 mg + acetaminophen (325 mg or 300 mg) + caffeine 40 mg + codeine phosphate 30 mg, oral capsule.
REMS supplement approved for butalbital, acetaminophen, caffeine, and codeine phosphate on 2026-06-18 Two oral capsule formulations approved: 325 mg acetaminophen + 50 mg butalbital + 40 mg caffeine + 30 mg codeine phosphate, and 300 mg acetaminophen + 50 mg butalbital + 40 mg caffeine + 30 mg codeine phosphate
This record does not contain clinical trial data, efficacy outcomes, safety results, or comparative effectiveness. No adverse event data, trial results, or postmarket surveillance findings are reported in this regulatory record.
This approval action establishes that the sponsor has implemented a REMS program as required by the FDA for this opioid-containing combination product. Healthcare professionals and patients should be aware of any restrictions, monitoring requirements, or patient education materials mandated by the REMS program; however, this record does not specify the REMS requirements themselves.
FDA supplemental approval of a Risk Evaluation and Mitigation Strategy (REMS) for an existing combination analgesic; this is a regulatory action, not a clinical efficacy study.
As stated by the source record.
Quoted from the source exactly as published.
This approval action establishes that the sponsor has implemented a REMS program as required by the FDA for this opioid-containing combination product. Healthcare professionals and patients should be aware of any restrictions, monitoring requirements, or patient education materials mandated by the REMS program; however, this record does not specify the REMS requirements themselves.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Drugs@FDA record for application ANDA215138. This is a regulatory action record, not a clinical study. Brand name: BUTALBITAL, ACETAMINOPHEN, CAFFEINE AND CODEINE PHOSPHATE. Active ingredient: BUTALBITAL, ACETAMINOPHEN, CAFFEINE AND CODEINE PHOSPHATE. Sponsor: HIKMA. Submission type: SUPPL (supplement). Submission class: REMS. Approval status date: 2026-06-18. Products: BUTALBITAL, ACETAMINOPHEN, CAFFEINE AND CODEINE PHOSPHATE, CAPSULE, ORAL, ACETAMINOPHEN 325MG + BUTALBITAL 50MG + CAFFEINE 40MG + CODEINE PHOSPHATE 30MG; BUTALBITAL, ACETAMINOPHEN, CAFFEINE AND CODEINE PHOSPHATE, CAPSULE, ORAL, ACETAMINOPHEN 300MG + BUTALBITAL 50MG + CAFFEINE 40MG + CODEINE PHOSPHATE 30MG.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.