Fioricet

Fioricet Information

Brand Name: Fioricet

Fioricet is a barbiturate sedative (butalbital) mixed with a non-aspirin pain medication (acetaminophen) and caffeine. This non-narcotic pain medication and relaxant is often prescribed for tension headaches caused by contractions of the muscles in the neck and shoulder area, and migraine.

Fioricet Ingredients and Composition

How To Take Fioricet and Fioricet Dosage and Administration

Take one to two tablets or capsules every four hours.
325-500 mg of acetaminophen per capsule or tablet; take a maximum of six capsules or tablets per day.
650 mg of acetaminophen per capsule or tablet; take a maximum of four capsules or tablets per day.

Higher doses of acetaminophen could increase the risk of severe liver toxicity. Do not exceed these guidelines without the express recommendation of your doctor.

Extended and repeated use of this product is not recommended because of the potential for physical dependence (addiction).

If you suspect a Fioricet Overdose

A Fioricet overdose, or combining this medication with alcohol or other central nervous system depressant, may lead to unconciousness or perhaps death. Butalbital overdose is indicated by severe drowsiness, confusion, extreme weakness, hallucination, shortness of breath, too slow or troubled breathing, slurred speech, lack of coordination, vomiting with blood, unusually slow heartbeat. Caffeine overdose is characterized by convulsions, diarrhea, sweating, frequent urination, ringing sounds in ears, muscle twitching or trembling, or seeing 'zig-zag' lights. Acetaminophen overdose can result in severe liver poisoning, but rarely has this effect in doses under 10g. An overdose of acetaminophen may not show symptoms for two to four days, but must be treated within twenty-for hours to prevent liver damage or death. Be alert to any signs of yellowing skin or eyes, or a sense of whole-body nausea.

Fioricet Side Effects

Fioricet Precautions and Contraindications

While Fioricet is a highly effective pain reliever, it has been associated with an increased risk of addiction when used improperly, or for too long. Never take Fioricet in greater doses, or for a longer period of time, than recommended by your doctor.

Fioricet may not be suitable for some patients, and some conditions require that this medication be taken in lower doses or with other precautions. Discuss a history of any of the following conditions with your doctor so that your treatment will be as safe as possible.

Alcohol or drug abuse: You may be at an increased risk for liver damage or dependence.
Allergic reaction to any barbiturate, acetaminophen, or caffeine: Do not take Fioricet.
Asthma: Increased risk of serious side effects
Depression: Butalbital may worsen this condition
Diabetes (sugar): Butalbital may worsen this condition
Heart disease: Caffeine may make certain heart conditions worse
Hepatitis or other liver damage: Increased risk of serious side effects
Hyperactivity (children): Increased risk of serious side effects
Kidney disease: Increased risk of serious side effects
Overactive thyroid: Butalbital may worsen this condition
Porphyria: Butalbital is listed as an unsafe drug for porphyria, an enzyme deficiency that can cause fragile skin that is sensitive to sunlight, digestive difficulties, anxiety, and reddish-brown urine.

Fioricet Drug Interactions

Fioricet contains the central nervous system depressant butalbital, and may react strongly with other medication that has a similar effect. Be cautious about taking Fioricet with any medication that warns it 'may cause drowsiness' or cautions you against driving or operating heavy machinery. The acetaminophen in Fioricet should not be mixed with certain ingredients in other pain medication.

Alcohol - Butalbital and alcohol can accelerate central nervous system depression. Avoid mixing Fioricet with alcohol, as this could result in a fatal overdose. Excessive drinking during Fioricet treatment may also increase the likelihood of serious liver damage or stomach bleeding.
Antidiabetic drugs or insulin - Can cause hypoglycemia in combination, dosage adjustments may be required.
Antihistamines like Benadryl or Tavist
Anticoagulants or blood thinners
Aspirin (or any salicylate, such as salicylamide, or salicylic acid) can cause kidney or liver damage when taken in high doses, and over long periods of time, in combination with acetaminophen. When taken in the recommended doses, for a short time, it has not been seen to produce this effect.
Benzodiazepines (a class of antidepressants, anti-panic agents, and muscle relaxants) such as Ativan (lorazepam), Valium (diazepam), Halcion (triazolam), Restoril (temazepam), Librium(chlordiazepoxide), Xanax (alprazolam), Tranxene-SD (clorazepate), Paxipam (halazepam), ProSom (estazolam), Klonopin (clonazepam), and others, should be used cautiously with Fioricet.
Beta Blockers - Drugs like Inderal (propranolol), Lopressor (metoprolol), Tenormin (atenolol), and others may become less effective treatments when used with barbiturates such as butalbital.
Caffeine - As Fioricet contains caffeine, you should limit your intake of caffeine through coffee or over the counter stimulants such as Vivarin or NoDoz. Too much caffeine can cause rebound headaches and constipation as withdrawal symptoms.
Corticosteroids (cortisone) - Fioricet may make these medications less effective.
Corticotropin (ACTH) - Fioricet may make this medication less effective.
Desyrel (trazodone) - Risk of additive CNS depression.
MAO inhibitors - Fioricet must not be mixed with MAO (monoamine oxidase) inhibitors such as the antidepressants Nardil, Marplan, or Parnate.
Narcotic pain medication, like Codeine, Demerol (meperidine), Buprenex (buprenorphine), Darvon (propoxyphene), Dilaudid (hydromorphone), MS Contin or Kadian (morphine), nalbuphine, OxyContin (oxycodone), Percocet (oxycodone, acetaminophen), Stadol (butorphanol), Talwin compound (pentazocine), Vicodin (hydrocodone, acetaminophen), or Vicoprofen (hydrocodone, ibuprofen) should not be mixed with Fioricet.
Norflex (orphenadrine) - Risk of oversedation.
Oral contraceptives - Butalbital may make these medications less effective.
Sedatives like Fiorinal, Phenobarbitol, Seconal, or barbiturates of any other kind, should not be mixed with butalbital.
Sleep medication like Ambien (zolpidem), Sonata (zaleplon), or over the counter sleeping pills should be used with butalbital only as, and if, advised by your doctor.
Skeletal muscle relaxants - such as Flexeril (cyclobenzaprine), Skelaxin (metaxalone), Soma (carisoprodol), or Robaxin (methocarbamol) should not be mixed with Fioricet.
Street drugs, such as barbiturates or opiates, must never be mixed with Fioricet as this could result in a fatal overdose.
Tegretol (carbamazepine)
Tranquilizers such as Haldol (haloperidol), Mellaril (thioridazine), or Thorazine (chlorpromazine) may cause oversedation; they should not be mixed with butalbital.
Tricyclic antidepressants such as Elavil (amitriptyline), Asendin (amoxapine), Anafranil (clomipramine), Pertofrane or Norpramin (desipramine), Sinequan (doxepin), Tofranil (imipramine), Aventyl or Pamelor (nortriptyline), Vivactil (protriptyline), and Surmontil (trimipramine), may increase the central nervous system suppressant effects from either the antidepressant, or the Fioricet.
Valproic acid, also Depakote, Depakene, divalproex.
Wellbutrin/Zyban (bupropion) - Barbiturates such as butalbital may decrease levels of bupropion in the body.

The CNS effects of butalbital may be enhanced by monoamine oxidase (MAO) inhibitors. Butalbital, acetaminophen and caffeine may enhance the effects of: other narcotic analgesics, alcohol, general anesthetics, tranquilizers such as chlordiazepoxide, sedative-hypnotics, or other CNS depressants, causing increased CNS depression.

Drug/Laboratory Test Interactions

Acetaminophen may produce false-positive test results for urinary 5-hydroxyindoleacetic acid.

Taking Fioricet during Pregnancy or Breast-feeding

Fioricet is not recommended for pregnant or nursing women, as its components can affect a developing infant. Barbiturates have been shown to increase the risk of birth defects and brain tumors in the fetus. Caffeine in large doses may interfere with the baby's heart rhythm and growth.

If you become pregnant while taking this medication, inform your doctor immediately. If you are breastfeeding, your doctor will advise you to stop breastfeeding if you must take Fioricet.

Fioricet Addiction and Dependency

Storing Fioricet

Store below 30°C (86°F).

Additional Notes

Fioricet has not been tested for safety in children under the age of 12. Older children might be prescribed a reduced dose.

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