Safety of Firocet in Patients with Myasthenia Gravis

Medication Considerations

Firocet (butalbital and acetaminophen) should be avoided in patients with myasthenia gravis due to potential exacerbation of muscle weakness and respiratory compromise, as recommended by the American Society of Clinical Oncology 1, 2
Butalbital, a barbiturate component of Firocet, can worsen neuromuscular transmission and potentially exacerbate muscle weakness in myasthenia gravis patients, according to the American Society of Clinical Oncology guidelines 1, 3

Patients with active, symptomatic myasthenia gravis should have their current symptom control and disease stability assessed, as well as their respiratory function (vital capacity and negative inspiratory force), before considering any medication that may exacerbate their condition 1, 4
If Firocet is used, close monitoring is required for worsening muscle weakness, respiratory compromise, changes in bulbar function (speech, swallowing), and the need for rescue therapy, as recommended by the American Society of Clinical Oncology 1, 4

For moderate to severe pain requiring medication, consultation with neurology is recommended before initiating any new medication, to determine the safest analgesic alternatives for myasthenia gravis patients 1, 4