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The chemical name of butalbital, which is a barbituric acid derivative, is a result of substitution of the hydrogen atoms at position 5 with an allyl group and an isobutyl group. It is a short to intermediate acting barbiturate that has muscle relaxing and anti-anxiety effects, which result in a depression of the central nervous system (CNS), varying from slight sedation to a generalized anesthesia.1 It is considered to have a low degree of selectivity, with a narrow therapeutic margin.1 It is generally used for the treatment of tension (muscle contraction) headaches, but butalbital is commonly used in a fixed-dose combination with one or more active medications, namely, acetylsalicylic acid, acetaminophen, aspirin, and caffeine. No clinical trials have been conducted to analyze the clinical effectiveness of butalbital in migraines,1 hence it is not used as a treatment for migraines. Like other barbiturates, butalbital has a possibility of abuse, misuse, intoxication, hangover, tolerance, dependence, overdoses, with a potential fatal consequence.10 It also has a potentiality to cause a drug-induced headache, apart from tolerance and dependence. Because of these reasons, butalbital fixed-dose combinations are commonly restricted to use in cases when the patient’s symptoms are considered to be not responsive to other medications, which should also be used with utmost carefulness.1