What Are The Ingredients In Fioricet?

A Combination Medication is a drug which includes two or more pharmaceutical ingredients in a fixed dose. There are three ingredients in standard Fioricet: Acetaminophen, Butalbital, and Caffeine. All three ingredients have different effects which combine to soothe headaches.

  • Acetaminophen is a medication which alleviates pain and reduces fever. It’s more widely known by the brand name Tylenol. Acetaminophen works by impairing the production of the prostaglandin chemical in the brain. This chemical activates pain signals in the nervous system.
  • Butalbital is a Sedative Barbiturate which stimulates the brain’s production of GABA. This neurotransmitter calms the nervous system by blocking signals among neurons. It also relaxes muscle tension in the head, thereby alleviating headaches. Butalbital is a Schedule III controlled substance in the United States.
  • Caffeine is a Stimulant which raises a person’s blood pressure. While high blood pressure is not necessarily healthy, low blood pressure worsens headaches by causing blood vessels to expand and push against the brain. By raising blood pressure, Caffeine causes blood vessels to constrict and increases blood flow. This effect helps relieve headaches.

The most common side effects include sleepiness, dizziness, trouble breathing, and abdominal pain. Other severe side effects may include liver problems, confusion, addiction, and allergic reactions. Frequent use may result in medication overuse headache. Barbiturate withdrawal may occur if rapidly stopped following long term use. Use is not generally recommended during pregnancy or breastfeeding.

The combination was approved for medical use in the United States in 1984. It is available as a generic medication. In 2020, the combination butalbital/acetaminophen/caffeine was the 201st most commonly prescribed medication in the United States, with more than 2 million prescriptions.

In the United States it is a schedule III controlled substance in some states but not federally. It is banned in a number of European countries.

Fioricet (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.

Acetaminophen, butalbital, and caffeine is a combination medicine used to treat tension headaches that are caused by muscle contractions.

What is the most important information I should know about Fioricet (Acetaminophen, Butalbital, And Caffeine)?

Do not use this medicine 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 acetaminophen, butalbital, and caffeine if you are allergic to it, if you have porphyria, or if you have recently used alcohol, sedatives, tranquilizers, or other opioids.

Tell your doctor if you have ever had:

  • liver disease, cirrhosis, a history of alcoholism or drug addiction, or if you drink more than 3 alcoholic beverages per day;
  • kidney disease;
  • stomach ulcer or bleeding;
  • a history of skin rash caused by any medication; or
  • a history of mental illness or suicidal thoughts.

It is not known whether this medicine 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.

This medicine can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breastfeeding a baby.

Not approved for use by anyone younger than 12 years old.

What are the side effects of Fioricet (Acetaminophen, Butalbital, And Caffeine)?

Get emergency medical help if you have signs of an allergic reaction: 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, a seizure;
  • 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 side effects may include:

  • drowsiness, dizziness;
  • feeling light-headed;
  • nausea, vomiting, stomach pain;
  • drunk feeling; or
  • shortness of breath.

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.

Can I take Fioricet (Acetaminophen, Butalbital, And Caffeine) if I’m pregnant or breastfeeding?

It is not known whether this medicine 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.

This medicine can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breastfeeding a baby.

What drugs and food should I avoid while taking Fioricet (Acetaminophen, Butalbital, And Caffeine)?

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.

How to take Fioricet (Acetaminophen, Butalbital, And Caffeine)?

Use Fioricet (Acetaminophen, Butalbital, And Caffeine) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

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 this medicine 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 this medicine is against the law.

Store 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 happens if I overdose on Fioricet (Acetaminophen, Butalbital, And Caffeine)?

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.

If you think you or someone else may have overdosed on: Fioricet (Acetaminophen, Butalbital, And Caffeine),  call your doctor or the Poison Control center
(800) 222-1222
If someone collapses or isn’t breathing after taking Fioricet (Acetaminophen, Butalbital, And Caffeine), call 911

Is Fioricet Addictive?

Although it’s only a prescription headache medication, Fioricet has the potential to cause addiction. If a person follows their prescription guidelines and uses the medication correctly, the risks of addiction are low. However, if someone takes too much Fioricet, they may develop tolerance to its effects. A person with tolerance to a certain dose of Fioricet will require higher doses of the medication to alleviate their headaches.

When a person with tolerance starts to take more Fioricet, possibly by obtaining more prescriptions, they may eventually become dependent on it. In other words, they may feel unable to get through the day without taking Fioricet; if they stop, they will experience symptoms of withdrawal. These symptoms arise because their body has grown accustomed to Fioricet in high doses.

If a Fioricet-dependent person attempts to weather withdrawal alone, it’s likely they will take Fioricet again just to relieve the symptoms of withdrawal. This is a hallmark characteristic of addiction. Anyone who compulsively abuses Fioricet to avoid withdrawal likely has an addiction to Fioricet. Additionally, people with an addiction to Fioricet will experience cravings for the medication which further compel them to keeping using it.

Moreover, the ingredient Butalbital is an addictive substance in its own right. Butalbital can cause someone to get “high” because it’s a Central Nervous System (CNS) Depressant. Since Butalbital is part of Fioricet, it is possible for someone to abuse Fioricet as a recreational drug. At high doses, Fioricet can intoxicate a person in a manner similar to alcohol. People who abuse Fioricet for this purpose have as much of a risk of developing an addiction as they would have if they repeatedly used an illegal drug.

The Symptoms Of Fioricet Withdrawal

In most cases, Fioricet withdrawal lasts anywhere from 8 hours to three days after the last dose. Withdrawal is the biggest obstacle to overcoming dependence on Fioricet, which is why rehab centers provide detox programs so that people can safely undergo the withdrawal cycle without the risk of relapse. According to research, it is best to undergo withdrawal under medical supervision because some withdrawal symptoms are dangerous.

Rebound headaches are the most common symptoms of Fioricet withdrawal. Other symptoms of withdrawal include:

  • Anxiety
  • Dizziness
  • Insomnia
  • Muscle spasms
  • Nausea and vomiting
  • Rapid emotional changes
  • Seizures (in rare cases)
  • Weakness

What Are The Symptoms Of A Fioricet Overdose?

While Butalbital is the addictive ingredient in Fioricet, Acetaminophen is the ingredient which is liable to cause an overdose. Unfortunately, people who misuse Fioricet as a recreational drug or as a way to suppress withdrawal are most likely to suffer an overdose.

When a person overdoses on Fioricet, the Acetaminophen will damage their liver. In severe cases, an overdose can even provoke fatal liver failure. For this reason, it is dangerous to take Fioricet together with another medication which contains Acetaminophen because it increases the risk of overdose and death. Furthermore, drinking alcohol while taking Fioricet may also inflict liver damage.

A Fioricet overdose is a medical emergency, so it’s important to know the symptoms. An overdose on Fioricet may cause jaundice, a yellowing of the skin and eyes. Other symptoms of an overdose include:

  • Confusion
  • Convulsions and seizures
  • Fainting
  • Irregular heartbeat
  • Lack of appetite
  • Nausea and vomiting
  • Restlessness
  • Stomach pain
  • Sweating
  • Tremors

Fioricet And Codeine

Some formulas for Fioricet contain Codeine, a potent and addictive Opioid. Codeine enhances the pain-relieving effects of Fioricet, but it also poses additional risks for overdose and addiction. Fioricet is the property of the pharmaceutical firm Actavis, one of three generic drug companies which contributed substantially to the Opioid Epidemic according to DEA data.

Patients who receive prescriptions for Fioricet should know whether their prescription contains Codeine. If Codeine is an ingredient in your Fioricet prescription, consider asking for Opioid-free medication. If a person misuses Fioricet with Codeine, either accidentally or intentionally, they might suffer lethal respiratory depression. Shallow breathing, a slow heart rate, extreme drowsiness, chest pain, and intense confusion are some of the symptoms of overdose on Fioricet with Codeine.

Find Treatment Today For Fioricet Addiction

If you or someone you know has an addiction to Fioricet, reach out for help. Throughout the country and the world, there are rehab centers which provide substance abuse treatment to individuals of all ages and backgrounds. Please contact a treatment provider today for more information. Treatment providers are available 24/7 and can answer your rehab-related questions.

Fioricet Addiction vs. Chronic Headaches

The active ingredient in Fioricet is a barbiturate called Butalbital. It is an effective medication for relaxing the muscles that lead to tension headaches. While the medication also includes caffeine and acetaminophen, these drugs do not lead to Fioricet addiction. Fioricet is effective because it is a one-two punch against a tension headache. The Butalbital relaxes the muscles and relieves anxiety, which is causing the headache, while the acetaminophen relieves the pain. That makes the drug also effective for more severe migraine-type headaches.

The problem is that Fioricet addiction can occur. Migraine.com points out the habit-forming nature of the medication. Headache sufferers that use Fioricet frequently can also suffer from a rebound headache, which is a side effect of using the drug. Very Well Health calls this the “medication overuse headache.” They also call it the “withdrawal headache.”

Other side effects include:

  • Drowsiness
  • Upset stomach
  • Vomiting
  • Stomach pain
  • Depression
  • Confusion
  • Skin rash
  • Itching
  • Difficulty breathing

Fioricet addiction can occur if you are taking the drug three times a week or 10 or more days per month. The withdrawal symptoms from Fioricet addiction can hit just 8 to 36 hours after the last dose.

Withdrawal symptoms from Fioricet addiction include:

  • Nausea and vomiting
  • Anxiety
  • Tremor
  • Weakness
  • Dizziness
  • Seizures
  • Weight loss
  • Insomnia

The risk of seizures is so high that a doctor should always supervise the process of detoxing from Fioricet. Discuss these and all risks with your doctor as part of the initial consultation about the headaches you have been experiencing. Medications like Fioricet may be fine for short-term use, but should always be monitored because of the high risk of addiction.

Additionally, the risk of intoxication while taking Fioricet is high. Fioricet intoxication can look like being high on alcohol, with coordination and memory problems, emotionalism and a lack of coordination. That makes taking this medication in combination with any other drugs or while operating machinery very risky.

Generally, because of the risk factors of taking Fioricet, this drug should be taken only in moderation. A physician should always monitor this medication because of the high risk of Fioricet addiction.