Signs And Symptoms of Fioricet Overdose

As you know, 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.

Toxicity from barbiturate poisoning includes drowsiness, confusion, and coma; respiratory depression; hypotension; and hypovolemic shock. Toxicity from codeine poisoning includes the opioid triad of: pinpoint pupils, depression of respiration, and loss of consciousness. Convulsions may occur.

In acetaminophen overdosage: dose dependent, potentially fatal hepatic necrosis is the most serious adverse effect.

Renal tubular necrosis, hypoglycemic coma, and coagulation defects may also occur. Early symptoms following a potentially hepatotoxicoverdose may include: nausea, vomiting, diaphoresis, and general malaise. Clinical and laboratory evidence of hepatic toxicity may not be apparent until 48 to 72 hours postingestion.

Acute caffeine poisoning may cause insomnia, restlessness, tremor, and delirium, tachycardia, and extra systoles.

How Do Overdoses Occur?

Barbiturates are common drugs of misuse. People who have experienced a “Fioricet high” describe it as feeling “goofy” or “loopy.” Misuse of barbiturates, including Fioricet, is incredibly dangerous. Barbiturates are considered sedative-hypnotics that rapidly induce tolerance, meaning that higher doses of the drug are required to achieve the same effect. Tolerance is quickly followed by dependency and addiction. When Fioricet is co-used with other drugs or alcohol, the sedative-hypnotic effect increases and can quickly lead to respiratory depression, coma and even death.

The most dangerous component of Fioricet is the barbiturate butalbital. Fioricet pills contain 50 mg butalbital, and 1 g (20 pills) is considered a toxic dose for adults. In addition, each pill contains 325 mg acetaminophen and 40 mg caffeine. Toxic doses for these drugs are 30 tablets (10 g) and 25 tablets (1 g), respectively. The half-life of Fioricet is 35 hours, so multiple doses over the course of a few days can lead to a toxic buildup of these compounds.

Most Fioricet overdoses are associated with co-use of other drugs or alcohol, but it can be easy to overdose on Fioricet alone. Tension headaches are often treated with a prescription of six tablets per day, which is over 25% of the toxic dose. People who are struggling with severe tension headache pain may be predisposed to overdose in an attempt to ease their pain. People who take Fioricet for headaches may experience medication overuse headaches, or “rebound headaches.” Rebound headaches are as painful as a tension headache but do not respond to additional medication.

Fioricet should be used rarely, as directed and with extreme caution. Never use Fioricet if you have not been prescribed the medication, and do not share your prescription.

Fioricet Overdose Deaths

Barbiturates were commonly prescribed in the 1960s and 1970s. Now, benzodiazepines have mostly replaced barbiturate prescriptions because they are much safer. Because of the reduction in prescription frequency, barbiturate overdose deaths are relatively rare today.

Statistics specific to barbiturate deaths are not readily available. According to the American Association of Poison Control Centers, however, the sedative/hypnotic/antipsychotic drug class (which includes barbiturates) was the fourth leading cause of poisoning in 2017. This drug class was responsible for 5.7% of poisonings, with nearly 150,000 exposures being reported. Some barbiturate deaths are purposeful, including suicide and capital punishment by lethal injection.

Fioricet Overdose Treatment

Fioricet overdose is a medical emergency that must be addressed by medical professionals. Because Fioricet overdose is often associated with respiratory depression, the first thing EMTs or doctors will do is ensure that the patient is able to breathe. Oxygen may be administered, and extreme cases may call for assisted or controlled ventilation. Intravenous fluids will typically be administered to prevent hypovolemic shock. In some cases, activated charcoal will be given to prevent acetaminophen-induced hepatotoxicity (liver failure).

If other drugs (particularly opioids) were also used, emergency protocols must take them into account. Barbiturate overdose treatment must be done by medical professionals.

A single or multiple drug overdose with Fioricet with Codeine is a potentially lethal polydrug overdose, and consultation with a regional poison control center is recommended. Immediate treatment includes support of cardiorespiratory function and measures to reduce drug absorption. Oxygen, intravenous fluids, vasopressors, and other supportive measures should be employed as indicated.

Assisted or controlled ventilation should also be considered. For respiratory depression due to over dosage or unusual sensitivity to codeine, parenteral naloxone is a specific and effective antagonist.

Gastric decontamination with activated charcoal should be administered just prior to N-acetylcysteine (NAC) to decrease systemic absorption if acetaminophen ingestion is known or suspected to have occurred within a few hours of presentation.

Serum acetaminophen levels should be obtained immediately if the patient presents 4 hours or more after ingestion to assess potential risk of hepatotoxicity; acetaminophen levels drawn less than 4 hours post-ingestion may be misleading.

To obtain the best possible outcome, NAC should be administered as soon as possible where impending or evolving liver injury is suspected.

Intravenous NAC may be administered when circumstances preclude oral administration. Vigorous supportive therapy is required in severe intoxication.

Procedures to limit the continuing absorption of the drug must be readily performed since the hepatic injury is dose dependent and occurs early in the course of intoxication.

Fioricet Overdose Prevention

The best way to prevent Fioricet overdose is to not use the drug. If you are prescribed Fioricet by your doctor, take it as prescribed. It should be used rarely and with caution. As with all barbiturates, Fioricet should never be taken daily.

Common side effects of Fioricet include dizziness and mild lethargy. If you (or someone else) have taken Fioricet as prescribed and are concerned with how you feel, call 911.

Barbiturate addiction can be extremely challenging to overcome. If you or a loved one is facing Fioricet dependency or addiction, The Recovery Village Ridgefield can help. Our multidisciplinary team is equipped to help you with the physical and psychological aspects of Fioricet detox and withdrawal. Our residential and outpatient programs have been successful in helping people overcome barbiturate addiction. Contact us today to learn how we can help.

What Happens if I Overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of Fioricet can be fatal.

The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.

Overdose symptoms may also include insomnia, restlessness, tremor, diarrhea, increased shallow breathing, uneven heartbeats, seizure (convulsions), or fainting.

Acetaminophen Overdose Treatment

What Is Acetaminophen Toxicity?

Acetaminophen (Tylenol®) toxicity is a common cause of acute liver failure in children and adolescents. Acetaminophen, also known as paracetamol and N-acetyl-p-aminophenol (APAP), is primary used for the treatment of pain and/or fever, but is also a component in numerous medications, including Percocet®, Alka-Seltzer® Plus Cold & Sinus, Dayquil®, and Excedrin®. Acetaminophen is an effective pain-relieving and fever-reducing agent when taken in the recommended daily dose.

Acetaminophen toxicity or overdose can occur purposefully (when a person knowingly takes more than the recommended maximum daily dose) or accidentally (when a person is unaware they are taking multiple products containing acetaminophen and exceeds the recommended maximum daily dose).

The maximum recommended acetaminophen dosage is 4 grams/day in an adult and 90 mg/kg/day in children. People with underlying liver disease or those with chronic alcohol consumption are at an increased risk of developing hepatotoxicity (liver damage from chemicals) with use of acetaminophen.

Acetaminophen Toxicity Symptoms

Initial symptoms of acetaminophen toxicity can take up to 12 hours to appear. Symptoms and side effects include:

• Abdominal pain
• Irritability
• Generalized weakness
• Loss of appetite
• Jaundice (yellow appearance of skin and eyes)
• Diarrhea
• Nausea
• Vomiting
• Convulsions
• Coma

Acetaminophen Toxicity Diagnosis

A doctor’s first step in diagnosing acetaminophen toxicity is to get a complete history, including the time the medication was ingested, the amount of medication that was ingested, and what form of the medication was ingested. A diagnosis of acetaminophen toxicity is usually confirmed through diagnostic tests, including an acetaminophen level, electrolytes, kidney function tests, amylase, lipase, liver function tests, complete blood count, and coagulation factors. Imaging studies, such as an ultrasound may be used to assess liver enlargement. A liver biopsy may also be ordered.

Acetaminophen Toxicity Treatment

Timing is a vital factor in the treatment of acetaminophen toxicity, and therefore doctors attempt to begin treatment of acetaminophen overdose within eight hours of ingestion in order to achieve the best possible outcome for the patient. The majority of patients survive acetaminophen toxicity with supportive care such as intravenous fluids and anti-nausea medication, activated charcoal, if used within one hour after ingestion, and antidotal therapy, including N-acetylcysteine (Acetadote®, Mucomyst®).

For patients who fail the above therapies and develop liver failure, liver transplantation may be the only treatment option. Doctors will determine if transplantation is necessary if the above tests are significantly abnormal and the patient has developed hepatic encephalopathy, a disorder of the brain caused by a dysfunctional liver.

The Medicines that Contain Acetaminophen

Acetaminophen is the most common drug ingredient in America. More than 600 medicines contain acetaminophen. These include both prescription medicines and medicines available without a prescription, also called “over-the-counter,” or “OTC” medicines. To prevent acetaminophen overdose, you need to be able to read labels and recognize when their medicines contain acetaminophen. The active ingredients in OTC medicines are clearly listed on the label, and the word “acetaminophen,” is listed on the front of the package or bottle and in the Active Ingredient section of the Drug Facts label. On prescription labels, acetaminophen is sometimes listed as “APAP,” “acetam,” or other shorted versions of the word. To know what is in your medicines, read the list of active ingredients on the label each and every time you take a medicine.

You may be surprised to learn just how many medicines contain this acetaminophen: