Aspirin / Butalbital / Caffeine / Codeine
This is a combination analgesic medication containing four active ingredients used primarily for treating tension-type headaches. The combination works synergistically: aspirin and codeine provide pain relief through different mechanisms, butalbital adds sedative effects to relax tension, and caffeine enhances the overall analgesic effect and constricts cerebral blood vessels. This medication is typically reserved for patients who have not responded to simpler analgesics, though its use is limited due to the risks associated with its opioid and barbiturate components.
A prescription combination analgesic for tension headaches containing aspirin, a barbiturate sedative, caffeine, and a low-dose opioid.
Key facts at a glance
- RxNorm
- 214160
- Generic
- Aspirin / Butalbital / Caffeine / Codeine
- Class
- multi-ingredient
- Brands
- Ascomp
- Availability
- rx
- Lactation
- unknown
- Routes
- —
- Forms
- —
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Treatment of tension-type headaches when simpler analgesics have proven ineffective. May also be used for moderate pain involving muscle contraction. Not typically used for migraine-specific treatment.
Aspirin inhibits cyclooxygenase (COX) enzymes, reducing prostaglandin synthesis and inflammation. Butalbital, a barbiturate, enhances GABAergic neurotransmission producing sedation and muscle relaxation. Caffeine constricts cerebral blood vessels and increases the bioavailability of analgesics. Codeine, a prodrug metabolized to morphine, binds mu-opioid receptors to modulate pain perception.
This medication carries significant risks including physical dependence (both codeine and butalbital), respiratory depression, addiction potential, and medication-overuse headache with prolonged use. Contains aspirin, which can cause GI bleeding and is contraindicated in children due to Reye's syndrome risk. Use is typically limited to short-term treatment. Classified as a Schedule III controlled substance in the United States. May cause drowsiness; avoid operating machinery. Inform your physician of all medications to avoid dangerous drug interactions, particularly with other CNS depressants, serotonergic agents, or MAO inhibitors.
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 27, 2026. · Read our editorial policy