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 is a prescription drug which is used in treatment of headaches. It is actually a combination drug which combines three ingredients that work together and provide a relief of headache pain in tensions headaches, muscle contraction headaches and headaches that occur after post-dural puncture.
Inactive Ingredients: crospovidone, FD&C Blue #1, magnesium stearate, microcrystalline cellulose, povidone, pregelatinized starch, and stearic acid.
The first ingredient in Fioricet is butalbital. This is a barbiturate drug which is very rarely used alone but which has found its way into a number of combination drugs, including Fioricet. Since it is a barbiturate drug, it is a relatively potent analgesic, meaning that it provides relief from pain. It can also be dependency-forming, but in Fioricet it is not present in such large doses so as to cause dependency unless it is used improperly or for too long. Butalbital (5-allyl-5-isobutylbarbituric acid), is a short to intermediate-acting barbiturate.
The second ingredient in Fioricet is acetaminophen, also known as paracetamol. It is one of the most basic and most common drugs in the world. It is also a painkiller which can be used to treat mild to moderate pain. On its own, it can be used in treatment of headaches and it is only logical that it was included in Fioricet. It can cause liver damage if it is used improperly and it is often included in medications to discourage overuse. Acetaminophen (4´-hydroxyacetanilide), is a non-opiate, non-salicylate analgesic andantipyretic.
The third ingredient in Fioricet is a formulation of caffeine which is a common stimulant present in coffee and tea. It is used in Fioricet for two reasons. The first is that it can enhance the effects of the other two ingredients that provide the majority of analgesic effects and the second one is that it has been found to constrict blood vessels, especially in the brain. This can also provide substantial relief from pain that is associated with tension headaches. Caffeine (1,3,7-trimethylxanthine), is a central nervous system stimulant.
Fioricet contains a combination of acetaminophen, butalbital, and caffeine. Acetaminophen is a pain reliever and fever reducer.
Butalbital is in a group of drugs called barbiturates. It relaxes muscle contractions involved in a tension headache. Caffeine is a central nervous system stimulant. It relaxes muscle contractions in blood vessels to improve blood flow.Fioricet is used to treat tension headaches that are caused by muscle contractions.
Fioricet was developed specifically with headaches in mind. It has found other uses, however, although these uses are still considered off-label and investigational. For example, Fioricet is sometimes used in treatment of migraines and there are a lot of people for whom it has done wonders when their migraines are in question. Some people take Fioricet for back pain and other painful conditions. These are not common uses for this drug but we felt that we should mention them as well.
What are the possible side effects of acetaminophen, butalbital, and caffeine?
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using this medication and call your doctor at once if you have any of these serious side effects:
- fast, pounding, or uneven heartbeat;
- feeling light-headed or short of breath;
- nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
- easy bruising or bleeding, unusual weakness, fever, chills, body aches, flu symptoms.
Less serious side effects may include:
- dizziness, confusion or lightheadedness;
- dry mouth;
- nausea, vomiting, stomach pain, loss of appetite;
- feeling anxious or jittery;
- drunk feeling; or
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 is the most important information I should know about acetaminophen, butalbital, and caffeine?
Do not use this medication if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take acetaminophen, butalbital, and caffeine before the MAO inhibitor has cleared from your body.
Do not take more of this medication than is recommended. An overdose of acetaminophen can cause damage to your liver.
Do not use any other cold, allergy, pain, or sleep medication without first asking your doctor or pharmacist. Acetaminophen (sometimes abbreviated as “APAP”) is contained in many combination medicines. If you use certain products together you may accidentally use too much acetaminophen. Read the label of any other medicine you are using to see if it contains acetaminophen or APAP.
Avoid drinking alcohol. It can increase the risk of liver damage while you are taking acetaminophen. If you drink more than three alcoholic beverages per day, do not take acetaminophen without your doctor’s advice, and never take more than 2 grams (2000 mg) per day.
Before taking Fioricet
Do not use Fioricet if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects. Tell your doctor if you have ever had alcoholic liver disease (cirrhosis) or if you drink more than 3 alcoholic beverages per day. You may not be able to take medicine that contains acetaminophen. You should not take Fioricet if you are allergic to acetaminophen, butalbital, or caffeine, or if you have porphyria.
To make sure you can safely take Fioricet, tell your doctor if you have any of these other conditions:
- kidney disease,
- liver disease; or
- a history of mental illness or suicidal thoughts.
Butalbital may be habit forming and should be used only by the person it was prescribed for. 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.
FDA pregnancy category C. It is not known whether Fioricet will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Acetaminophen, butalbital, and caffeine can pass into breast milk and may harm a nursing baby. Do not use Fioricet without telling your doctor if you are breast-feeding a baby.
What should I discuss with my healthcare provider before taking acetaminophen, butalbital, and caffeine?
Butalbital may be habit-forming and should be used only by the person it was prescribed for. This medication should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.
Do not take this medication without first talking to your doctor if you drink more than three alcoholic beverages per day or if you have had alcoholic liver disease (cirrhosis). You may not be able to take medication that contains acetaminophen.
You should not take this medication if you are allergic to acetaminophen, butalbital, or caffeine, or if you have porphyria.
Before using acetaminophen, butalbital, and caffeine, tell your doctor if you are allergic to any drugs, or if you have:
- kidney disease,
- liver disease; or
- a history of mental illness or suicidal thoughts.
If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.
FDA pregnancy category C. It is not known whether acetaminophen, butalbital, and caffeine is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.
Acetaminophen, butalbital, and caffeine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
How should I take acetaminophen, butalbital, and caffeine?
Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Take the medicine with food or milk if it upsets your stomach.
An overdose of acetaminophen can cause serious harm. The maximum amount of acetaminophen for adults is 1 gram (1000 mg) per dose and 4 grams (4000 mg) per day. Taking more acetaminophen could cause damage to your liver. One tablet may contain up to 750 mg of acetaminophen. Know the amount of acetaminophen in the specific product you are taking.
Store this medication at room temperature away from moisture and heat.
Keep track of how much medicine has been used from each new bottle. Butalbital is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.
What other drugs will affect Fioricet?
Tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by butalbital.
Tell your doctor about all other medicines you use, especially:
- an antibiotic;
- a blood thinner such as warfarin (Coumadin, Jantoven);
- isoniazid (for treating tuberculosis);
- zidovudine (Retrovir, AZT);
- seizure medication such as phenytoin (Dilantin) or phenobarbital (Luminal, Solfoton);
- gout medications such as probenecid (Benemid) or sulfinpyrazone;
- steroids such as prednisone, fluticasone (Advair), mometasone (Asmanex, Nasonex), dexamethasone (Decadron, Hexadrol) and others; or
- an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Janimine, Tofranil), and others.
This list is not complete and other drugs may interact with Fioricet. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
It should also be pointed out that the Fioricet formulation has changed. The old formulation included 50 mg of butalbital, 325 mg of acetaminophen and 40 mg a caffeine in the tablet. The new formulation is in form of capsules and it contains 50 mg of butalbital, 300 mg of acetaminophen and 40 mg of caffeine. As you can see, the amount of acetaminophen has been reduced due to new FDA guidelines concerning the limitation of acetaminophen amounts in combination drugs.
What does Fioricet look Like ?
Regular checkups are a must when you follow a treatment with Fioricet.
Talk to your doctor if you have started to use more than the usual dosage, if you notice the headaches to have become worse or if they appear often. Only a healthcare professional can decide if you need dosage adjustment or special tests performed in order to determine the cause of your headaches. Never try to solve these problems by yourself and do not believe the higher doses of this medication will do the trick.
In high doses, acetaminophen can do permanent damage to the liver and an overdose can even lead to death. The important thing to remember is that acetaminophen overdose symptoms take usually two days to appear. The condition is extremely urgent and must be treated immediately. The first two signs one should look for is yellowing of the skin and extreme nausea.
Nevertheless, Fioricet overdosing is a combination of all the symptoms caused by acetaminophen, butalbital and caffeine.
Barbiturate overdosing is likely to cause mental confusion, comatose states, sever fatigue, hallucinations and dyspnea. The treatment must be applied urgently, as butalbital can affect the vital centers of the brain. As for caffeine, high doses can lead to seizures, excessive perspiration and severe diarrhea. You can certainly understand that Fioricet is not something you take without consulting your doctor.
Before taking the medication, it is for the best that you tell your doctor if you have a history of substance abuse, alcohol addiction or if you have ever suffered from respiratory disease. Depression, liver disease and porphyria should also be mentioned.
Porphyria is a severe metabolic disorder and butalbital is not recommended to be used in such cases.
Fioricet can also interact with certain types of medication, including blood thinners, benzodiazepines, narcotic pain medication and tricyclic antidepressants. Be sure to discuss all these aspects with your doctor.
Remember, butalbital has a powerful effect on the central nervous system and this effect might be enhanced if you take MAO inhibitors at the same time.
Things you should know when you buy Fioricet
Doctors usually prescribe one pill of Fioricet to be taken on every four hours. You should not exceed six pills per day. You should not take Fioricet if you are using beta-blockers, because it can reduce or even negate their effect. At the start of treatment, you might feel drowsy, but the effects will disappear as time passes. You might encounter some side effects while on Fioricet treatment, including shaking / tremors, abdominal pain, vomiting, anxiousness and nausea. If you do encounter any of mentioned, you should contact your doctor so you can receive suitable replacement. If Fioricet is prescribed by doctor who knows your full medical history, side effects can be lowered to minimum or may never appear. Consequences of overdosing can be very serious, even fatal. You should not buy Fioricet if you are abusing alcohol or drugs.
There are many stores that offer Fioricet, but as we all know, you can get cheap Fioricet online very easily. Web stores usually have big discounts, and deliver the drug to your house, office or any other place you want it delivered to discreetly and quickly, which are the main reasons this drug has gotten so popular in such a short amount of time. Web stores tend to deliver your order as soon as possible, but it never takes more than one day. If you order Fioricet online today, it will be delivered either during the day or in the morning. When we think of advantages, it is fast, reliable, discreet, and you don’t even have to leave your house. All you have to do is place the order online and web store delivery will get your order sorted out. It is also important to mention that in some web stores you can buy fioricet overnight, so if you are using it for long time, there is no need to visit your doctor and ask him to prescribe it again.