What should I avoid while taking acetaminophen, butalbital, caffeine?

how should I avoid while taking acetaminophen, butalbital, caffeine?

Use caution when driving, operating machinery, or performing other hazardous activities. Butalbital will cause drowsiness or dizziness. If you experience drowsiness or dizziness, avoid these activities.

Avoid sleeping pills, antihistamines, sedatives, and tranquilizers except under the supervision of your doctor. These may also make you drowsy.

Avoid alcohol. Alcohol taken during therapy with acetaminophen and butalbital can be very damaging to your liver and can increase drowsiness and dizziness.

Check the acetaminophen content of other over-the-counter and prescription products while taking this medication. You should not exceed 4 grams (4000 mg) of acetaminophen per day.

Avoid taking too much caffeine. Check the caffeine content of other over-the-counter and prescription products as well as beverages (coffee, tea, and colas) while taking this medication.

How well does acetaminophen work and compare to anti-inflammatories to treat osteoarthritis and is it safe?
Fifteen studies of moderate to high quality were reviewed and provide the best evidence we have today. The studies tested almost 6000 people with osteoarthritis of the hip or knee. The studies compared people who took 4000 mg of acetaminophen (Tylenol, Paracetamol) a day to people who took a placebo (fake pill) or non-steroidal anti-inflammatory drugs (NSAIDs). Most studies lasted on average about 6 weeks.

What is osteoarthritis and what drugs are used to treat it?
Osteoarthritis (OA) is the most common form of arthritis that can affect the hands, hips, shoulders and knees. In OA, the cartilage that protects the ends of the bones breaks down and causes pain and swelling. There are two main types of drug treatments in OA: acetaminophen which is used to relieve pain but does not affect swelling; and NSAIDs, such as ibuprofen, diclofenac and cox IIs (celecoxib), which are used to decrease pain and swelling. It is not clear which type is best to use or which causes more side effects: high doses of acetaminophen may cause stomach problems, such as ulcers, and NSAIDs may cause stomach, kidney or heart problems.

What did the studies show?
Acetaminophen compared to placebo
The studies show that people who took acetaminophen has less pain (when resting, moving, sleeping and overall) and felt better overall than people who took a placebo. Pain (when measured on a different scale), physical function and stiffness were about the same.
? Pain decreased by 4 more points on a scale of 0-100 for people who took acetaminophen instead of a placebo.

Acetaminophen compared to NSAIDs
The studies show that people who took NSAIDs had less pain and stiffness and had greater physical function than people who took acetaminophen.
? Pain decreased by 6 more points on a scale of 0-100 in people who took NSAIDs instead of acetaminophen.

How safe is acetaminophen and NSAIDs?
When comparing people who took acetaminophen or a placebo, or people who took acetaminophen or an NSAID, the type and amount of side effects were about the same.
This was also true when comparing cox-II NSAIDs to acetaminophen. However, people taking traditional NSAIDs, such as ibuprofen or naproxen, were more likely to have a stomach problems (diarrhoea, nausea, heartburn or stomach pain) than people taking acetaminophen.

? 19 out of 100 had side effects with traditional NSAIDs
? 13 out of 100 had side effects with acetaminophen

What is the bottom line?
The level of quality of the evidence is 'platinum'. In people with osteoarthritis of the hip or knee, acetaminophen improves pain more than no treatment. Non-steroidal anti-inflammatory drugs improve pain, function and stiffness more than acetaminophen, especially in people with moderate to severe pain. There does not appear to be a major difference in side effects between acetaminophen and NSAIDs, although people taking traditional NSAIDs were more likely to have stomach problems.
The benefits between the drugs are modest and the studies were only about 6 weeks long. Therefore, it is important to consider preferences, risks, costs, availability of the drugs and the doctors' judgement when making a decision.