how to handle Rxs for butalbital-containing meds (Fiorinal, Fioricet, Esgic-Plus, etc)

We're getting questions about how to handle Rxs for butalbital-containing meds (Fiorinal, Fioricet, Esgic-Plus, etc).

Butalbital is often combined with caffeine and a mild pain med (aspirin, acetaminophen, etc) to treat headaches. And in some cases, codeine is added to the mix to treat more severe headaches.

These combos often lead to confusion and dispensing issues. Laws often differ when it comes to classifying these meds as controlled substances. Plus, most butalbital combo meds look and sound alike.