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 Manage Your Tension Headache ?

tension-headache
tension-headache

A lot of customers order fioricet online for relief of tension headache. A tension headache is pain or discomfort in your head, scalp, or neck. A tension headache occurs when neck and scalp muscles become tense, or contract. The muscle contractions can be a response to stress, depression, a head injury, or anxiety. A tension headache (tension-type headache) is the most common type of headache, and yet its causes aren’t well understood.

Tension-type headache  is a significant cause of sickness absence and impaired ability at work.  Tension Headache is classified as a primary headache according to the International Classification of Headache Disorders. It is a very common form of headache and can be:

    • Episodic Tension Headache (affects 78% of the population). This occurs on fewer than 15 days each month. It can evolve into the chronic variety.
    • Chronic Tension Headache (affects 3% of the population). This occurs on more than 15 days each month and has all the features of the episodic Tension Headache.

Tension headaches can last from 30 minutes to 7 days.

If you have a headache on 15 or more days each month over a 3-month period, you may have chronic tension headaches. This type of headache can lead to stress and depression, which in turn can lead to more headaches.

A tension headache is the most common type of headache, characterized by mild to moderate pain and pressure in the head. It typically feels like a tight band or pressure around the forehead or the back of the head and neck. Tension headaches are often described as dull, achy, or squeezing in nature and can last from 30 minutes to several days.

Here are some key features of tension headaches:

  1. Location: Tension headaches often involve both sides of the head and may affect the forehead, temples, back of the head, or neck. The pain is usually described as a constant pressure or tightness rather than a throbbing sensation.
  2. Duration: Tension headaches can last anywhere from a few minutes to several days. They are often episodic, occurring sporadically, but some individuals may experience chronic tension headaches that occur frequently or even daily.
  3. Triggers: Various factors can trigger or exacerbate tension headaches, including stress, anxiety, poor posture, fatigue, hunger, and eye strain. Certain lifestyle factors such as lack of sleep, dehydration, and excessive caffeine or alcohol consumption may also contribute to tension headaches.
  4. Symptoms: In addition to head pain, tension headaches may be accompanied by other symptoms such as muscle tenderness, neck stiffness, sensitivity to light or sound, and mild nausea. However, they typically do not cause severe symptoms or neurological deficits.
  5. Management: Treatment for tension headaches often involves over-the-counter pain relievers such as acetaminophen (paracetamol), ibuprofen, or aspirin. Relaxation techniques, stress management strategies, regular exercise, adequate hydration, and maintaining good posture may also help prevent or alleviate tension headaches. In some cases, prescription medications or interventions such as physical therapy, massage, or acupuncture may be recommended for individuals with chronic or severe tension headaches.

The Cause of Tension Headache

The exact cause of tension headaches is not fully understood, but they are believed to result from a combination of physical, environmental, and psychological factors. Here are some common contributors to tension headaches:

  1. Muscle Tension and Contractions: Tension headaches are often associated with muscle tension and contractions in the head, neck, and scalp. Prolonged contraction of these muscles can lead to the development of tension headaches. Factors such as poor posture, repetitive movements, and physical strain can exacerbate muscle tension.
  2. Stress and Anxiety: Emotional stress, anxiety, and psychological factors play a significant role in triggering tension headaches. Stressful life events, work-related pressure, relationship issues, and other stressors can contribute to muscle tension and heightened sensitivity to pain, increasing the risk of tension headaches.
  3. Poor Ergonomics: Spending long hours in front of a computer or desk with improper ergonomics can strain the muscles of the neck, shoulders, and upper back, leading to tension headaches. Poor posture, awkward positioning, and inadequate support for the head and neck can exacerbate muscle tension and discomfort.
  4. Eye Strain: Activities that require prolonged focus, such as reading, working on a computer, or using electronic devices, can strain the muscles around the eyes and contribute to tension headaches. Uncorrected vision problems, glare, and inadequate lighting may also increase the risk of eye strain and tension headaches.
  5. Sleep Disturbances: Lack of sleep, poor sleep quality, and irregular sleep patterns can disrupt the body’s natural rhythms and increase susceptibility to tension headaches. Sleep deprivation can exacerbate stress, impair cognitive function, and heighten pain sensitivity, all of which can contribute to the development of tension headaches.
  6. Caffeine and Alcohol: Excessive consumption of caffeine or alcohol can trigger or worsen tension headaches in some individuals. Caffeine withdrawal headaches may occur in individuals who abruptly reduce their caffeine intake, while alcohol-induced headaches may result from dehydration, vasodilation, or chemical triggers in alcoholic beverages.
  7. Environmental Factors: Environmental factors such as loud noises, strong odors, bright lights, and changes in weather conditions can trigger tension headaches in susceptible individuals. Sensory stimuli and environmental stressors can activate the trigeminal nerve and contribute to headache development.

Triggers of Tension Headaches

A variety of foods, activities, and stress can cause these types of contractions. Some people develop tension headaches after staring at a computer screen for long hours or driving for long periods. Cold temperatures may also trigger a tension headache in some people.

Other factors that may trigger a tension headache include:

  • drinking alcohol
  • anxiety
  • depression
  • Poor posture
  • Poor sleep
  • Stress
  • Muscular tightness
  • eye strain
  • fatigue
  • smoking
  • a cold or flu
  • a sinus infection
  • caffeine
  • Usually relieved by simple analgesics.

57% Headaches are tension headaches. You can follow the steps here to prevent your headache. What you need more details about prevent tension headache  or cure your tension headaches?

Treatment and Medicines of Tension Headaches

Some people with tension headaches don’t seek medical attention and try to treat the pain on their own. Unfortunately, repeated use of over-the-counter (OTC) pain relievers can actually cause overuse headaches.

A variety of medications, both OTC and prescription, are available to reduce the pain of a headache, including:

    • Pain relievers. Simple OTC pain relievers are usually the first line of treatment for reducing headache pain. These include the drugs aspirin, ibuprofen (Advil, Motrin IB, Diclofenac, Paracetamol:others) and naproxen (Aleve). Prescription medications include naproxen (Naprosyn), indomethacin (Indocin) and ketorolac (Ketorolac Tromethamine).
    • Combination medications. Aspirin or acetaminophen or both are often combined with caffeine or a sedative drug in a single medication. Combination drugs may be more effective than are single-ingredient pain relievers. Many combination drugs are available OTC.
    • Triptans and narcotics. For people who experience both migraines and episodic tension headaches, a triptan can effectively relieve the pain of both headaches. Opiates, or narcotics, are rarely used because of their side effects and potential for dependency.
fioricet
Fioricet is very effective for tension headache relief
  • Fioricet fioricet is a very effective headache reliever. Fioricet is consist of butalbital, apap, 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

Even if you are taking tension headache medicines, you still need manage your headaches. Home treatment may help you avoid headaches. You can:

      • Try to reduce stress.
      • Make sure you sleep, exercise, and eat on a regular schedule.
      • Make sure you practice good posture. Stand and sit up straight.
      • Try not to strain your eyes when you use your computer.
      • Get treatment for depression or anxiety if you have those health problems.
      • Try using a headache diary. Every time you get a headache, write down the date, the time, and what you were doing and feeling before your headache started. This may help you and your doctor find out what is causing your headaches. Then your doctor can use the diary to plan your treatment.

How to Prevent Tension Headache ?

Preventing tension headaches involves adopting lifestyle modifications and implementing stress management strategies to reduce triggers and promote overall well-being. Here are some tips for preventing tension headaches:

  1. Maintain Good Posture: Practice proper posture while sitting, standing, and engaging in activities to reduce strain on the muscles of the head, neck, and shoulders. Avoid slouching and maintain a neutral spine alignment.
  2. Manage Stress: Incorporate stress reduction techniques into your daily routine, such as deep breathing exercises, meditation, yoga, progressive muscle relaxation, or mindfulness practices. Identify sources of stress and develop coping strategies to manage them effectively.
  3. Establish Regular Sleep Patterns: Prioritize adequate sleep and establish a consistent sleep schedule. Aim for 7-9 hours of quality sleep each night and create a relaxing bedtime routine to promote restful sleep.
  4. Stay Hydrated: Drink plenty of water throughout the day to stay hydrated and maintain optimal bodily functions. Dehydration can exacerbate headache symptoms, so aim to consume adequate fluids, especially in hot or dry environments.
  5. Limit Caffeine and Alcohol: Monitor your consumption of caffeine and alcohol, as excessive intake can trigger or worsen tension headaches in some individuals. Gradually reduce caffeine intake if you experience withdrawal headaches, and limit alcohol consumption to moderate levels.
  6. Take Breaks from Screen Time: If you spend long hours working on a computer, reading, or using electronic devices, take regular breaks to rest your eyes and stretch your muscles. Follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for at least 20 seconds.
  7. Exercise Regularly: Engage in regular physical activity to promote overall health and reduce muscle tension. Choose low-impact exercises such as walking, swimming, cycling, or yoga to improve circulation, reduce stress, and relieve tension in the muscles.
  8. Maintain a Balanced Diet: Eat a nutritious diet rich in fruits, vegetables, whole grains, and lean proteins. Avoid skipping meals, as low blood sugar levels can trigger headaches. Limit consumption of processed foods, sugary snacks, and foods containing artificial additives or preservatives.
  9. Practice Relaxation Techniques: Incorporate relaxation techniques into your daily routine to reduce muscle tension and promote relaxation. Techniques such as progressive muscle relaxation, guided imagery, or aromatherapy can help alleviate stress and prevent tension headaches.
  10. Seek Professional Help: If tension headaches persist despite self-care measures, consider seeking guidance from a healthcare provider. They can assess your symptoms, provide personalized recommendations, and offer additional treatments such as medication, physical therapy, or behavioral therapy to manage tension headaches effectively.

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 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.