What is the Max Dosage of Acetaminophen ?

Acetaminophen, which is also known as paracetamol, is a commonly used OTC (over-the-counter) pain reliever (analgesic) and fever reducer (antipyretic). People use it for headaches, and minor aches and pain. Liver injury from acetaminophen overdose remains a serious public health problem despite ongoing regulatory and educational efforts over the past several years to improve the safe use of medicines that contain acetaminophen.

Fioricet contains acetaminophen 325 mg per tablet. The max dosage of an adult for acetaminophen goes down from 4000mg to 3000mg per day (http://www.medicalnewstoday.com/articles/231915.php). So only acetaminophen, you should not take more than eight tablet fioricet per day. IF you take more than eight fioricet tablet per day, you will hurt your liver.

acetaminophen

From tylenol website, they lowered the maximum daily dose for single-ingredient Extra Strength TYLENOL® (acetaminophen) products sold in the U.S. from 8 pills per day (4,000 mg) to 6 pills per day (3,000 mg). The dosing interval has also changed from 2 pills every 4 – 6 hours to 2 pills every 6 hours.

What Is the Max Dosage of Acetaminophen ?

The maximum recommended dosage of acetaminophen varies depending on factors such as age, weight, and individual health conditions. However, for most healthy adults, the maximum daily dose of acetaminophen should not exceed 4,000 milligrams (mg) per day.

Here are some general guidelines for the maximum daily dosage of acetaminophen:

  1. Adults: The maximum recommended dose for adults is typically 1,000 mg to 2,000 mg every 4 to 6 hours as needed, with a maximum of 4,000 mg per day.
  2. Elderly: Older adults and individuals with liver disease or liver impairment may be advised to take a lower maximum daily dose of acetaminophen to reduce the risk of liver damage. It’s important to consult a healthcare provider for personalized recommendations based on individual health status.
  3. Children: The maximum daily dose of acetaminophen for children depends on their age and weight. Pediatric dosages are typically lower than adult dosages and are based on weight or age ranges. Parents or caregivers should carefully follow the dosing instructions provided by a healthcare provider or on the medication label.
  4. Special Populations: Pregnant or breastfeeding individuals should consult their healthcare provider before taking acetaminophen, as the maximum recommended dosage may vary during pregnancy and lactation.

What is Fioricet?

Fioricet contains a combination of acetaminophen, butalbital, and caffeine.

Each tablet contains the following active ingredients:
butalbital USP . . . . . . . . . . . .50 mg
acetaminophen USP . . . . . . 325 mg
caffeine USP . . . . . . . . . . . . .40 mg

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 is a prescription medication commonly used for the treatment of tension headaches, migraines, and other types of headaches. It contains a combination of three active ingredients:

  1. Butalbital: This is a barbiturate, which acts as a central nervous system depressant and muscle relaxant. It helps to alleviate tension and relax muscles in the head and neck.
  2. Acetaminophen (Paracetamol): Acetaminophen provides analgesic (pain-relieving) and antipyretic (fever-reducing) effects. It helps to relieve pain associated with headaches and also reduces fever.
  3. Caffeine: Caffeine acts as a mild stimulant and can enhance the effects of pain-relieving medications. It is also believed to help constrict blood vessels in the brain, which can be beneficial in migraine treatment.

Fioricet is available in various formulations, typically as capsules or tablets, and is usually taken orally. The dosage and frequency of Fioricet administration should be determined by a healthcare provider based on the individual patient’s condition and response to treatment.

It’s important for patients to use Fioricet as directed by their healthcare provider and to be aware of the potential risks and side effects associated with its use. Because Fioricet contains butalbital, a barbiturate, there is a risk of misuse, dependence, and withdrawal symptoms, so healthcare providers typically exercise caution when prescribing it, particularly for patients with a history of substance abuse or dependence.

Patients should also avoid using Fioricet in combination with alcohol or other central nervous system depressants, as this can increase the risk of dangerous side effects, such as respiratory depression and overdose.

Are There any Negative Side Effects of the Pain Killer Fioricet (Butalbital APAP Caffeine)?

Fioricet is a medication commonly prescribed for the treatment of tension headaches.

Fioricet Side Effects
Fioricet Side Effects

It contains three active ingredients: acetaminophen (a pain reliever and fever reducer), butalbital (a barbiturate that relaxes muscle contractions), and caffeine (which enhances the effects of acetaminophen and butalbital). While Fioricet can be effective for managing headaches, it also carries the risk of side effects. Common side effects of Fioricet may include:

      1. Dizziness: Feeling lightheaded or unsteady.
      2. Drowsiness: Feeling sleepy or tired.
      3. Nausea: Feeling sick to your stomach.
      4. Vomiting: Throwing up.
      5. Stomach upset: Indigestion or discomfort in the stomach.
      6. Constipation: Difficulty passing stools.
      7. Shaking or tremors: Involuntary shaking movements.
      8. Shortness of breath: Difficulty breathing.
      9. Increased heart rate: Feeling your heart beating faster than usual.
      10. Feeling anxious or nervous: Experiencing restlessness or worry.

In rare cases, Fioricet can also cause more serious side effects, such as allergic reactions, liver problems, or dependence if used for an extended period. It’s essential to take Fioricet exactly as prescribed by your doctor and to be aware of potential side effects.

Fioricet Drug and Food Interaction

Fioricet contains Butalbital, Acetaminophen, and caffeine.  A lot of other pain relievers contain Butalbital, Acetaminophen, and caffeine too.

I can only list some common over the counter medicines that contain Acetaminophen:  Actifed, Alka-Seltzer, Plus Liquid Gels, Anacin, Cepacol, Contac, Coricidin, Dayquil, Dimetapp, Dristan, Excedrin, Feverall …

Some prescriptions that contain acetaminophen are: Ultrace, Fioricet, Oxycodone, Endocet, Tylox …

You also must know what drugs contain Butalbital:  Bupap, Phrenilin, Tencon, Cephadyn; Fioricet, Esgic, Esgic-Plus; Fioricet with Codeine, Floricet with Codeine, Phrenilin with Caffeine and Codeine; Axotal; Fiorinal, Butalbital Compound, Farbital, Idenal; Fiorinal with Codeine, Fiorinal with Codeine III, Ascomp with Codeine, Fiortal with Codeine.

When you take more than one pain killer, you must read very carefully about their components.  Never exceed the max dosage of acetaminophen and butalbital of all the medicines you are taking.   Normally All the packages sent to you have the drug introduction and doctor names and phone number.  Read the drug introduction very carefully and never share the medicines with your sisters, your brothers,  your parents, or any friends. Always do not let the children touch the medicines.

Please donot drink any alcohol (Ethanol) with your Fioricet Because Ethanol together with acetaminophen will cause serious side effects that affect your liver, and Ethanol together with Butalbital will cause side effects of dizziness, drowsiness.

Please don’t take herb while you are taking Fioricet. Even Vitamins will have some interaction with Fioricet.

Be honest to place the current medicines you are taking in the health questionnaire  form. The doctor will check whether you are OK to take Fioricet.  If they think your current drugs or herbs have some interaction with Fioricet, they will phone you to discuss the situation with you. So please always leave us the correct phone number. We will never call you to promote you anything.

Most frequently checked interactions

View interaction reports for Fioricet (acetaminophen / butalbital / caffeine) and the medicines listed below.

  • Adderall (amphetamine / dextroamphetamine)
  • Advil (ibuprofen)
  • Ambien (zolpidem)
  • aspirin
  • Ativan (lorazepam)
  • baclofen
  • caffeine
  • clonazepam
  • codeine
  • Cymbalta (duloxetine)
  • Excedrin (acetaminophen / aspirin / caffeine)
  • Flexeril (cyclobenzaprine)
  • gabapentin
  • hydrocodone
  • ibuprofen
  • ibuprofen
  • Imitrex (sumatriptan)
  • Klonopin (clonazepam)
  • levothyroxine
  • Lexapro (escitalopram)
  • lisinopril
  • Lyrica (pregabalin)
  • meloxicam
  • naproxen
  • Norco (acetaminophen / hydrocodone)
  • omeprazole
  • oxycodone
  • Percocet (acetaminophen / oxycodone)
  • prednisone
  • Suboxone (buprenorphine / naloxone)
  • Topamax (topiramate)
  • tramadol
  • trazodone
  • Tylenol (acetaminophen)
  • Vitamin D3 (cholecalciferol)
  • Xanax (alprazolam)
  • Zofran (ondansetron)

Fioricet (acetaminophen / butalbital / caffeine) disease interactions

There are 25 disease interactions with Fioricet (acetaminophen / butalbital / caffeine) which include:

  • alcoholism
  • liver disease
  • acute alcohol intoxication
  • drug dependence
  • liver disease
  • porphyria
  • rash
  • respiratory depression
  • cardiac disease
  • hypertension
  • liver disease
  • PUD
  • PKU
  • adrenal insufficiency
  • depression
  • hematologic toxicity
  • osteomalacia
  • paradoxical reactions
  • cardiotoxicity
  • bipolar disorders
  • psychiatric disorders
  • psychotic disorders
  • renal dysfunction
  • seizure disorders
  • GERD

FIORICET (Brand for BUTALBITAL-ACETAMINOPHEN-CAFFE) Lifestyle Interactions

Butalbital 50mg, Acetaminophen 300mg, Caffeine 40mg, Oral capsule

Alcohol

· Severity: Major

· Notes for Consumers: Do not drink alcohol while taking this medication. Drinking alcohol while taking this medication increases the risk of liver injury. Contact your care team right away if you experience right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, or unusual weakness or fatigue.

· Notes for Professionals: The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.

Caffeine-containing Foods/Beverages

· Severity: Moderate

· Notes for Consumers: Caffeine may cause sleeplessness, so if you are taking a Barbiturate to help you sleep, you may wish to avoid taking caffeine and caffeine-containing foods like colas, coffee, teas, or chocolates within several hours prior to bedtime. Barbiturates may also decrease the actions of Caffeine; if you have a high intake of caffeinated foods or beverages you may experience a headache or irritability from decreased caffeine levels while taking these drugs until your body adjusts. If you take Caffeine for other purposes, notify your health care provider if you think Caffeine is not working as well for you.

· Notes for Professionals: Caffeine has been reported to increase the metabolism of barbiturates, and barbiturates increase caffeine elimination. Higher caffeine doses may be needed after barbiturate administration.

Cannabis

· Severity: Major

· Notes for Consumers: Discuss cannabis use with your care team. The effects of cannabis may be altered if used with your medication. Call emergency services right away if you experience slow or shallow breathing, shortness of breath, feeling faint, dizziness, confusion, or trouble staying awake.

· Notes for Professionals: Advise patients to avoid cannabis use during barbiturate treatment due to the risk for additive CNS depression and other adverse reactions. Concomitant use may also decrease the concentration of some cannabinoids and alter their effects. The cannabinoids delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are CYP3A substrates and barbiturates are strong CYP3A inducers. Concomitant use of a cannabinoid product containing THC and CBD at an approximate 1:1 ratio with another strong CYP3A inducer decreased THC, 11-OH-THC, and CBD peak exposures by 36%, 87%, and 52% respectively.

Butalbital 50mg, Acetaminophen 300mg, Caffeine 40mg, Oral capsule

Grapefruit juice

· Severity: Mild

· Notes for Consumers: Do not significantly alter your grapefruit juice intake while taking medicines containing caffeine. Some reports suggest that intake of grapefruit juice can increase side effects from caffeine. Too much Caffeine can cause effects like nausea, tremor, nervousness, or sleeplessness. If these occur, consider ingesting less caffeine daily.

· Notes for Professionals: Data are limited and conflicting as to whether grapefruit juice significantly alters the serum concentrations and/or AUC of caffeine. Caffeine is primarily a CYP1A2 substrate, and grapefruit juice appears to have but a small effect on this enzyme in vivo. One report suggests that grapefruit juice decreases caffeine elimination by inhibition of flavin-containing monooxygenase, a P450 independent system. This interaction might increase caffeine levels and mildly potentiate the clinical effects and common side effects of caffeine. If side effects appear, patients may need to limit either caffeine or grapefruit juice intake.

Butalbital 50mg, Acetaminophen 300mg, Caffeine 40mg, Oral capsule

Tobacco

· Severity: Major

· Notes for Consumers: Do not smoke or use tobacco products while taking this medication. When used together, your medication may not work as well for you.

· Notes for Professionals: Advise patients who are taking caffeine to avoid smoking tobacco. Smoking tobacco has been observed to increase caffeine clearance by 50% to 70%. Caffeine is a CYP1A2 substrate and smoking tobacco induces CYP1A2.

How to Treat Fioricet Overdose

The treatment of Fioricet overdose is complicated by the presence of two substances which are highly toxic when taken in excessive amounts. Fioricet overdoses generally result in toxic amounts of both acetaminophen and butalbital being consumed at once, requiring both overdoses to be treated at once.

Fioricet overdose by anyone and/or any consumption by persons to whom it is not prescribed (particularly children) is always a medical emergency and medical attention must be sought immediately if an overdose or consumption by other persons is suspected.fioricet

Fioricet overdose is often fatal and symptoms may not present for hours following consumption, once initial overdose symptoms present they can progress rapidly and there may not be time to reach appropriate medical care after this point.

Acetaminophen over-exerts its toxicity through the production of a toxic metabolite which produces liver damage in doses of 3,000mg or more per day and acute liver failure in doses above that. The specific antidote to acetaminophen overdose is N-acetyl-cysteine. Kidney failure and stomach bleeding may also occur.

Butalbital overdoses exerts its toxicity through excessive sedation resulting in respiratory depression and ultimately death via hypoxia. Nonlethal overdoses may also result in coma and death. There is no specific antidote to butalbital overdose and treatment is supportive, common treatment regimens generally include the administration of intravenous administration of saline, naloxone, thiamine, glucose, NaHCO3 to alkalize the urine to increase rate of excretion, and activated charcoal via nasogastric tube. It is not uncommon for doctor to recommend observation of the patient in the Emergency Department for a number of hours or admission to the hospital for several days of observation if symptoms are severe and to counsel the patient on drug abuse and/or refer them for psychiatric evaluation.

How to Treat Fioricet Overdosage ?

Treating Fioricet overdosage requires prompt medical attention and intervention to prevent serious complications. Fioricet contains three active ingredients: butalbital, acetaminophen, and caffeine. Overdosing on Fioricet can lead to toxicity from any of these components, with acetaminophen overdose being particularly concerning due to its potential to cause liver damage. Here are some steps for treating Fioricet overdosage:

  1. Seek Emergency Medical Assistance: If you suspect that you or someone else has overdosed on Fioricet, call emergency services immediately or go to the nearest emergency room. Time is critical in cases of overdose, and prompt medical intervention can help prevent serious complications.
  2. Provide Information: Provide healthcare providers with as much information as possible about the amount of Fioricet ingested, the time of ingestion, and any other medications or substances taken concurrently.
  3. Gastric Decontamination: In cases of recent ingestion, healthcare providers may perform gastric decontamination to remove the remaining medication from the stomach. This may involve inducing vomiting or administering activated charcoal to absorb the medication and prevent further absorption into the bloodstream.
  4. Acetaminophen Antidote: If the overdose involves a significant amount of acetaminophen, healthcare providers may administer N-acetylcysteine (NAC), an antidote that helps protect the liver from acetaminophen toxicity. NAC is most effective when administered within 8-10 hours of acetaminophen ingestion but can still provide benefit if given later.
  5. Monitoring and Supportive Care: Patients who have overdosed on Fioricet may require close monitoring of vital signs, liver function tests, and other laboratory parameters. Supportive care may include intravenous fluids, oxygen therapy, and medications to manage symptoms such as nausea, vomiting, and pain.
  6. Treatment of Complications: Depending on the severity of the overdose and associated complications, additional treatments may be necessary. For example, patients with liver damage may require further medical interventions, such as liver transplantation in severe cases.
  7. Psychological Support: Overdosing on medication can be distressing and may indicate underlying mental health issues. Patients who overdose on Fioricet should receive psychological support and counseling to address any underlying issues and prevent future occurrences.

What is Fioricet and Why it can Relieve Headaches ?

Fioricet (Butalbital, Acetaminophen, and Caffeine Tablets, USP) is supplied in tablet form for oral administration.

Each tablet contains the following active ingredients:
butalbital USP . . . . . . . . . .50 mg
acetaminophen USP . . . . 325 mg
caffeine USP . . . . . . . . . . .40 mg

Fioricet contains Butalbital, Acetaminophen, 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.

Butalbital

Butalbital is well absorbed from the gastrointestinal tract and is expected to distribute to most tissues in the body. Barbiturates in general may appear in breast milk and readily cross the placental barrier. They are bound to plasma and tissue proteins to a varying degree and binding increases directly as a function of lipid solubility.

Elimination of butalbital is primarily via the kidney (59% to 88% of the dose) as unchanged drug or metabolites. The plasma half-life is about 35 hours. Urinary excretion products include parent drug (about 3.6% of the dose), 5-isobutyl-5-(2, 3-dihydroxypropyl) barbituric acid (about 24% of the dose), 5-allyl-5(3-hydroxy-2-methyl-1-propyl) barbituric acid (about 4.8% of the dose), products with the barbituric acid ring hydrolyzed with excretion of urea (about 14% of the dose), as well as unidentified materials. Of the material excreted in the urine, 32% is conjugated.

The in vitro plasma protein binding of butalbital is 45% over the concentration range of 0.5-20 mcg/mL. This falls within the range of plasma protein binding (20%-45%) reported with other barbiturates such as phenobarbital, pentobarbital, and secobarbital sodium. The plasma-to-blood concentration ratio was almost unity, indicating that there is no preferential distribution of butalbital into either plasma or blood cells.

Acetaminophen

Acetaminophen is rapidly absorbed from the gastrointestinal tract and is distributed throughout most body tissues. The plasma half-life is 1.25 to 3 hours, but may be increased by liver damage and following overdosage. Elimination of acetaminophen is principally by liver metabolism (conjugation) and subsequent renal excretion of metabolites. Approximately 85% of an oral dose appears in the urine within 24 hours of administration, most as the glucuronide conjugate, with small amounts of other conjugates and unchanged drug.

Caffeine

Like most xanthines, caffeine is rapidly absorbed and distributed in all body tissues and fluids, including the CNS, fetal tissues, and breast milk.

Caffeine is cleared through metabolism and excretion in the urine. The plasma half-life is about 3 hours. Hepatic biotransformation prior to excretion results in about equal amounts of 1-methylxanthine and 1-methyluric acid. Of the 70% of the dose that is recovered in the urine, only 3% is unchanged drug.

Fioricet Mechanism of Action

Fioricet is a brand name consisting of a combination of butalbital (a barbiturate), APAP and caffeine which is indicated for the treatment of tension headaches, muscle contraction headaches and post-dural puncture headaches. 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.

Each tablet contains the following active ingredients:

      • butalbital USP . . . . . . . . . .50 mg
      • acetaminophen USP . . . . 325 mg
      • caffeine USP . . . . . . . . . . .40 mg

Butalbital (5-allyl-5-isobutylbarbituric acid), is a short to intermediate-acting barbiturate. Butalbital belongs to the group of medicines called barbiturates.

Barbiturates act in the central nervous system (CNS) to produce their effects. 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. It has the following structural formula:

Acetaminophen (4´-hydroxyacetanilide), is a non-opiate, non-salicylate analgesic and antipyretic. 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.

It has the following structural formula:Caffeine (1,3,7-trimethylxanthine), is a central nervous system stimulant.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.

What is Fioricet and What is Fioricet Side Effects ?

Fioricet and Esgic are brand names of a combination of butalbital (a barbiturate), acetaminophen and caffeine which is indicated for the treatment of tension headaches, muscle contraction headaches and post-dural puncture headaches.

Although not indicated, they are commonly used to treat migraines and other pain related ailments.

Fioricet® (Butalbital, Acetaminophen, and Caffeine Tablets USP) is supplied in tablet form for oral administration.

Each tablet contains the following active ingredients:
butalbital USP . . . . . . . . . . . .50 mg
acetaminophen USP . . . . . . 325 mg
caffeine USP . . . . . . . . . . . . .40 mg

Inactive Ingredients: crospovidone, FD&C Blue #1, magnesium stearate, microcrystalline cellulose, povidone, pregelatinized starch, and stearic acid.

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.

Before Taking Fioricet

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 sever

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.

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 happens if I miss a dose?

Since this medicine is used when needed, you may not be on a dosing schedule. If you are on a schedule, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

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.

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.

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.

What Other Drugs Will Affect Fioricet?

Taking this medicine with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking Fioricet with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Other drugs may interact with acetaminophen, butalbital, and caffeine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Fioricet only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.