What is Fioricet?

Fioricet contains a combination of acetaminophen, butalbital, and caffeine Acetaminophen is a pain reliever and fever reducer. Butalbital is in a group of drugs called barbiturates.

It relaxes muscle contractions involved in a tension headache. Caffeine is a central nervous system stimulant. It relaxes muscle contractions in blood vessels to improve blood flow.

Fioricet is used to treat tension headaches that are caused by muscle contractions.

Fioricet may also be used for purposes not listed in this medication guide.

Fioricet side effects

Get emergency medical help if you have signs of an allergic reaction to Fioricet: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

In rare cases, acetaminophen may cause a severe skin reaction that can be fatal. This could occur even if you have taken acetaminophen in the past and had no reaction. Stop taking this medicine and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling. If you have this type of reaction, you should never again take any medicine that contains acetaminophen.

Stop using this medicine and call your doctor at once if you have:

- confusion, seizure (convulsions);
- shortness of breath;
- a light-headed feeling, like you might pass out; or
- nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common Fioricet side effects may include:

- drowsiness, dizziness;
- feeling anxious or restless;
- drunk feeling; or
- sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

How should I take Fioricet?

Take Fioricet exactly as prescribed. Follow all directions on your prescription label. Do not take more of this medication than recommended. An overdose can damage your liver or cause death. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Butalbital may be habit-forming. Never share Fioricet with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Selling or giving away Fioricet is against the law.

Take Fioricet with food or milk if it upsets your stomach.

Store Fioricet at room temperature away from moisture and heat.

Keep track of the amount of medicine used from each new bottle. Butalbital is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What should I avoid while taking Fioricet?

This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen.

Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Check the label to see if a medicine contains acetaminophen or APAP.

While you are taking this medication, avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor’s advice.

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Patient Reviews on Fioricet for Headache

You will find 87% patient rate fioricet is effective for headache relief. But some patients think it is expensive.

One of headache patient reviews fioricet the best medicine for tension headaches bar none. Big pharma has tried to get it banned for years because it is so cheap and effective which is a treat to their vastly over priced, dangerous and ineffective alternatives.

Acetaminophen / butalbital / caffeine Pregnancy Warnings

Use is not recommended unless clearly needed

US FDA pregnancy category: C

Comment: Monitor for barbiturate withdrawal in neonates

Animal reproduction studies have not been conducted on this combination product. Epidemiologic data for acetaminophen, including a population based case-control study from the National Birth Defects Prevention Study (n= 11,610) and data from 26,424 live singleton births have shown no increased risk of major birth defects in children with first trimester prenatal exposure. In 2015, the US Food and Drug Administration released results of their evaluation on published research studies looking at mothers who took acetaminophen (either over the counter or as a prescription product) at any time during their pregnancy and the risk of attention deficit hyperactivity (ADHD) in their babies.

They found all studies reviewed had potential limitations in their designs that prevented drawing reliable conclusions. Barbiturates have been reported to readily cross the placental barrier.

A 2-day old infant whose mother had taken a butalbital-containing product during the last two months of pregnancy experienced withdrawal seizures; butalbital was found in the infant’s serum. There are no controlled data in human pregnancy.

US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Acetaminophen / butalbital / caffeine Breastfeeding Warnings

Acetaminophen, butalbital, and caffeine are excreted into human milk in small concentrations. The significance of the effects on nursing infants has not been reported, but due to the potential for serious adverse reactions in nursing infants, other agents may be preferred.

A decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother.

Excreted into human milk: Yes (acetaminophen); Yes (barbiturates); Yes (caffeine)

A tablet of Fioricet contains 325 milligrams of acetaminophen, 50 milligrams of butalbital and 40 milligrams of caffeine. Acetaminophen is a pain reliever, butalbital is a barbiturate, and caffeine is a stimulant. The combination of drugs used in Fioricet is also sold under other brand names such as Alagesic, Dolgic, Esgic and Zebutal. All the active ingredients in Fioricet are potentially addictive, especially butalbital.

Physicians usually prescribe Fioricet for headaches caused by muscle contractions. They may also prescribe it for migraine headaches, although the Food and Drug Administration has not indicated it for this purpose. The typical adult dose of Fioricet is one to two tablets every four hours, not to exceed six tablets every 24 hours.

Common Overdose Symptoms

Acetaminophen relieves pain by inhibiting prostaglandin synthetase enzymes, and it has a half-life of no more than three hours. Butalbital depresses the central nervous system and has a half-life of about 35 hours. Caffeine causes the cerebral blood vessels to constrict and has a half-life of about six hours. Mild Fioricet overdose symptoms include the following:

- - Abdominal aches
  - Dizziness
  - Fatigue
  - Euphoria
  - Intestinal problems
  - Sedation
  - Shortness of breath
  - Vomiting

Butalbital can also cause Stevens-Johnson syndrome in rare cases, like all barbiturates. This syndrome is a life-threatening skin condition.

Withdrawal from Fioricet

“Withdrawal symptoms of Fioricet occur when you stop taking this drug after becoming dependent upon it.”Withdrawal symptoms of Fioricet occur when you stop taking this drug after becoming dependent upon it. A physician will typically reduce your dosage slowly in order to minimize the withdrawal symptoms, rather than abruptly discontinuing your usage of Fioricet. You may also receive medication to help you taper off Fioricet. Withdrawal symptoms usually begin between 8 and 36 hours after your last dose and may last up to a week or two. Signs of an overdose on Fioricet include the following:

- - Anxiety
  - Breathing trouble
  - Raised blood pressure
  - Elevated body temperature
  - Delirium
  - Tiredness
  - Headaches
  - Increased heart rate
  - Nausea
  - Ringing in the ears
  - Shaking

Available Treatment Options

In the event of an overdose on Fioricet, call 911 immediately. Emergency treatment is critical to ensure the person remains stable. After the immediate overdose risk is averted, subsequent care is essential to effectively address the drug abuse or addiction issue.

Fioricet rehab treatment normally begins with the detoxification phase. This process reduces the patient’s dosage of Fioricet until they are no longer taking the drug at all. The detoxification phase of the treatment eliminates the patient’s physical dependence on Fioricet. The remainder of a treatment program for Fioricet addiction deals primarily with the psychological aspect of the addiction.

Are There Risks from Taking Fioricet for Migraine?

Fioricet has several risks and may not be suitable for everyone.

The active ingredient butalbital in Fioricet may be habit-forming. Using higher doses for a long time may lead to dependence on Fioricet. Suddenly stopping the medication after regular use may also cause withdrawal symptoms.

Drinking alcohol or taking other sedative medications with Fioricet may be harmful and cause dangerous side effects. Butalbital takes a long time to clear from your body.

Do not take Fioricet with other products that have the same active ingredients. Taking too much of these ingredients together can increase the risk of overdose, cause liver or kidney damage, and may be life-threatening.

Talk with your doctor about any medications and over-the-counter products you’re taking, including vitamins, herbs, and natural supplements.

Some examples include:

- acetaminophen (Tylenol, multi-symptom cough/cold products)
  caffeine (energy drinks, Excedrin migraine, caffeine pills)
  butalbital (barbiturates)\
- Taking Fioricet regularly can increase your risk for rebound headaches or medication overuse headaches. The American Migraine Prevalence and Prevention Study found use of butalbital for 5 days per month would increase the risk of acute migraine becoming chronic migraine.
- Fioricet can raise blood pressure and heart rate, if you have a history of high blood pressure or heart related conditions, ask your doctor about the risks of Fioricet.

Is Fioricet Addictive?

While it seems like opioids get the bulk of the attention right now regarding prescription medication addiction, Fioricet is addictive. When people take Fioricet, they should be warned of the potential for Fioricet abuse and Fioricet addiction. It’s the butalbital that may be habit-forming in Fioricet, and if it contains codeine, that element may also be.

Butalbital is a central nervous system depressant, and it can sedate how a person feels pain. This is combined with the pain-relieving effects of acetaminophen, which works differently than the butalbital.

So how do Fioricet abuse and Fioricet addiction occur?

When someone is addictive to Fioricet, it usually begins as tolerance. With a drug tolerance someone takes the substance for a period of time, and then their body becomes used to it, so they need continuously higher doses to get the same effects.

A tolerance can be developed for butalbital as well as codeine if it’s contained in Fioricet. There is research that shows the average barbiturate addict may need to take 1500 mg of the drug to feel the effects they want. Unfortunately, people who are addicted to Fioricet also often take other opioids and narcotics either to amplify the effects of the Fioricet or when they run out of it to achieve the same effect.

What are the signs of Fioricet addiction?

- One of the first outward signs of Fioricet addiction is often when people start doctor shopping, meaning they try to go to multiple doctors to get more of the drug.
- People may be taking more doses of Fioricet for the treatment of recurring headaches.
- You may have not only a physical dependence but also a Fioricet addiction if you start to experience symptoms of withdrawal when you stop taking it or take a lower dosage.
- People who are addicted to Fioricet may feel like they can’t function normally without it.
- When you’re addicted to Fioricet, you may be obsessed with finding it and taking it.

While all addictions to prescription drugs are worrisome, with Fioricet, there is not only the concern of being addicted to the butalbital, but there are the risks of the acetaminophen component of the drug. Acetaminophen can cause liver damage or failure when high amounts are taken, and it can be an acute situation where it happens very suddenly. It’s important for people who take Fioricet to be aware of this.

Acute liver failure can occur in doses of more than 4,000 mg in a day.

In addition to the dangers of acetaminophen, with Fioricet abuse, there is the risk of overdosing on butalbital as well. Butalbital can cause respiratory depression and excessive sedation, so Fioricet addiction is dangerous in multiple ways.

If you or someone you know may have a Fioricet abuse problem, it’s important to seek professional help, because it’s an addiction that can very easily be dangerous or deadly.

How Should I Take Fioricet?

Take Fioricet exactly as prescribed.

Follow all directions on your prescription label.

Do not take more of this medication than recommended. An overdose can damage your liver or cause death. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Take Fioricet with food or milk if it upsets your stomach.

Store Fioricet at room temperature away from moisture and heat.

Keep track of the amount of medicine used from each new bottle. Butalbital is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Fioricet dosing information

Usual Adult Dose of Fioricet for Headache:

Acetaminophen 300 mg, butalbital 50 mg, and caffeine 40 mg:
1 or 2 capsule(s) orally every 4 hours as needed. Maximum daily dose: 6 doses.

Acetaminophen 325 mg, butalbital 50 mg, and caffeine 40 mg:
1 or 2 tablet(s), capsule(s), or tablespoonful(s) orally every 4 hours.
Maximum daily dose: 6 doses

Acetaminophen 500 mg, butalbital 50 mg, and caffeine 40 mg:
1 tablet or capsule orally every 4 hours.
Maximum daily dose: 6 doses

Acetaminophen 750 mg, butalbital 50 mg, and caffeine 40 mg:
1 tablet orally every 4 hours.
Maximum daily dose: 5 tablets

Usual Pediatric Dose of Fioricet for Headache:

12 years and older:
Acetaminophen 300 mg, butalbital 50 mg, and caffeine 40 mg:
1 or 2 capsule(s) orally every 4 hours as needed. Maximum daily dose: 6 doses.

What is Fioricet and Where to Buy it Online

Butalbital/acetaminophen/caffeine (Esgic, Floricet) is an inexpensive drug used to treat tension headaches. It is more popular than comparable drugs. it is available in multiple generic and brand versions.

Pharmacologic Classifications: Barbiturate

What is Fioricet ?

Butalbital, acetaminophen, and caffeine combination is used to relieve symptoms of tension (or muscle contraction) headaches.

Butalbital belongs to the group of medicines called barbiturates. Barbiturates act in the central nervous system (CNS) to produce their effects.

Acetaminophen is used to relieve pain and reduce fever in patients. It does not become habit-forming when taken for a long time. But acetaminophen may cause other unwanted effects when taken in large doses, including liver damage.

When butalbital is used for a long time, it may become habit-forming, causing mental or physical dependence. However, people who have continuing pain should not let the fear of dependence keep them from using narcotics to relieve their pain.

Physical dependence may lead to withdrawal side effects if treatment is stopped suddenly. However, severe withdrawal side effects can usually be prevented by gradually reducing the dose over a period of time before treatment is stopped completely.

Caffeine is a CNS stimulant that is used with pain relievers to increase their effect. It has also been used for migraine headaches. However, caffeine can also cause physical dependence when it is used for a long time. This may lead to withdrawal (rebound) headaches when you stop taking it.

Fioricet is available only with your doctor’s prescription.

Fioricet Dosing Information

The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage forms (capsules or tablets):
- For tension headaches:
  - Adults and children 12 years of age and older—One or two capsules or tablets every 4 hours as needed. However, the dose is usually not more than 6 capsules or tablets per day. Do not exceed 4 grams (4000 milligrams) of acetaminophen (Tylenol®) per day.
  - Children younger than 12 years of age—Use and dose must be determined by your doctor.

Before taking this medicine

Do not use Fioricet if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

You should not use Fioricet if you are allergic to acetaminophen, butalbital, or caffeine, if you have porphyria, or if you have recently used alcohol, sedatives, tranquilizers, or other narcotic medications.

To make sure Fioricet is safe for you, tell your doctor if you have:

liver disease, cirrhosis, a history of alcoholism or drug addiction, or if you drink more than 3 alcoholic beverages per day;
kidney disease;
asthma, sleep apnea, or other breathing disorder;
stomach ulcer or bleeding;
a history of skin rash caused by any medication;
a history of mental illness or suicidal thoughts; or
if you use medicine to prevent blood clots.

It is not known whether Fioricet will harm an unborn baby. If you use butalbital while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.

Fioricet can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines.

Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of butalbital, acetaminophen, and caffeine combination in children younger than 12 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of butalbital, acetaminophen, and caffeine combination in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving butalbital, acetaminophen, and caffeine combination.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

- - Riociguat

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

- - Alfentanil
  - Alprazolam
  - Amobarbital
  - Anisindione
  - Aprobarbital
  - Butabarbital
  - Carisoprodol
  - Chloral Hydrate
  - Chlordiazepoxide
  - Chlorzoxazone
  - Clarithromycin
  - Clonazepam
  - Clorazepate
  - Dantrolene
  - Darunavir
  - Diazepam
  - Dicumarol
  - Doxorubicin
  - Doxorubicin Hydrochloride Liposome
  - Esketamine
  - Estazolam
  - Ethchlorvynol
  - Etonogestrel
  - Flunitrazepam
  - Flurazepam
  - Halazepam
  - Imatinib
  - Iobenguane I 131
  - Isoniazid
  - Ketazolam
  - Lorazepam
  - Lormetazepam
  - Medazepam
  - Mephenesin
  - Mephobarbital
  - Meprobamate
  - Metaxalone
  - Methocarbamol
  - Methohexital
  - Midazolam
  - Nifedipine
  - Nitrazepam
  - Oxazepam
  - Peginterferon Alfa-2b
  - Pentobarbital
  - Phenindione
  - Phenobarbital
  - Phenprocoumon
  - Piperaquine
  - Pixantrone
  - Pneumococcal 13-Valent Vaccine, Diphtheria Conjugate
  - Prazepam
  - Primidone
  - Quazepam
  - Secobarbital
  - Sodium Oxybate
  - Temazepam
  - Thiopental
  - Trazodone
  - Triazolam
  - Ulipristal

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

- - Acenocoumarol
  - Cannabis
  - Carbamazepine
  - Fosphenytoin
  - Lixisenatide
  - Ospemifene
  - Phenytoin
  - Prednisone
  - Warfarin
  - Zidovudine

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

- - Ethanol
  - Tobacco

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

- - Cabbage
  - Ethanol

What should I avoid while taking Fioricet?

This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen.

While you are taking this medication, avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor’s advice.

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