Butalbital and pediatric headache: stay off the downward path
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Updated: Oct 25, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Alessandra Caruso1, Lori Lazdowsky, Jonathan Rabner
1Pediatric Headache Program, Department of Anesthesiology, Perioperative, and Pain Medicine, Boston Children's Hospital, Waltham, MA, USA.
Abstract:
Despite limited evidence from the literature surrounding safety or efficacy, butalbital-containing medicines (BCMs) have maintained their rank as "go-to" prescribed migraine and headache relief drugs in the United States, despite bans on these barbiturates in Germany and other European countries. Providers at the Pediatric Headache Program at Boston Children's Hospital recommend that clinicians prescribe triptan-based medications instead of BCMs, given the known negative side effects of BCMs on the general population, and the uncertain longitudinal trajectory of BCMs on developing brains.
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