Butalbital (5-allyl-5-isobutylbarbituric acid), is a short to intermediate-acting barbiturate. It has the following structural formula:
The average daily dose for the barbiturate addict is usually about 1500 mg. That is 1500mg Butalbital will make you addictive to butalbital.
One tablet fioricet contains 325 mg acetaminophen. FDA attempt to cut down on incidences of potentially fatal liver damage associated with acetaminophen. The max dosage of acetaminophen is 3000mg per day. But we recommend the max dosage of acetaminophen is 2000mg. Especially for a patient who drink alcohol.
- Alcohol consumption substantially increases the risk of acute liver failure from acetaminophen overdose.
- Liver damage may occur with consumption of only 2,600 mg of acetaminophen in the course of a day in people who have consumed varying amounts of alcohol.
Acetaminophen effectively lowers fever and relieves minor aches and pains without stomach discomfort and heart issues associated with ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs).
It is strongly recommended that people who consume alcohol on a regular basis limit acetaminophen intake to a maximum of 1,000 to 2,000 mg per day. The preference is to stay at the lower end of that range.
If you do not want to hurt yourself, the max dosage of fioricet is six pills per day. We donot suggest a drunk man to take fioricet.
One tablet fioricet contains 50mg butalbital. The average daily dose for the barbiturate addict is usually about 1500 mg (30 Fioricet tablets). That is five times of acetaminophen max dosage. At this dosage, you will kill yourself by acetaminophen.
Fioricet contains: 325 mg of acetaminophen (APAP), 50 mg of butalbital, and 40 mg of caffeine.
New capsule reformulation of Fioricet contains: 300 mg of acetaminophen (APAP), 50 mg of butalbital, and 40 mg of caffeine.
Fiorinal contains: 325 mg of aspirin (ASA), 50 mg of butalbital, and 40 mg of caffeine.
The only difference between these two is the aspirin in Fiorinal vs acetaminophen in Fioricet.
The interesting thing is that Fiorinal is a scheduled class III substance, while Fioricet has a non-scheduled status. It seems really strange because both combinations contain equal amount of the controlled substance butalbital.
Exceptions from the scheduling have been made if the drug meets the requirements of section 811(g) (3) (A) of the Controlled Substances Act. The exemption requires that one of the active ingredients be a non-narcotic controlled substance and one of the others be a non-scheduled compound. The potential for abuse is decreased if a sufficient amount of a non-controlled substance (e.g., aspirin or acetaminophen) is added.
According to the FDA, the issue boils down to a specific ratio of aspirin or acetaminophen to butalbital. Fiorinal® is required to have at least 188 mg of aspirin for every 15 mg of butalbital (188:15) to meet CSA exemption. The ratio needed for Fioricet® is 70 mg of acetaminophen for every 15 mg of butalbital (70:15). These ratios were based on what the FDA believed were adequate amounts of nonnarcotic to reduce the abuse potential of butalbital.
The acetaminophen to butalbital ratio in new and old formulation of Fioricet:
Old formulation:
325 mg Acetaminophen / 50 mg Butalbital
97 mg Acetaminophen to 15 mg Butalbital (To be exempt, ration requires at least 70 mg or more Acetaminophen for every 15 mg Butalbital included in formulation.
New Formulation:
300 mg Acetaminophen / 50 mg Butalbital
90 mg Acetaminophen to 15 mg Butalbital (To be exempt, ration requires at least 70 mg or more Acetaminophen for every 15 mg Butalbital included in formulation.
So both new and old formulation of Fioricet by law shall be exempt from controlled substance requirements.
The aspirin to butalbital ratio in Fiorinal:
325 mg Aspirin / 50 mg Butalbital
97 mg Aspirin to 15 mg Butalbital (To be exempt, ration requires at least 188 mg or more Aspirin for every 15 mg Butalbital included in formulation.
Therefore Fiorinal is classified as a Schedule III substance.
Citation:
1. Section 811(g)(3)(A) Controlled Substances Act
2. http://www.deadiversion.usdoj.gov/schedules/exempt/exempt_rx_list.pdf
3. http://www.communitymedical.org/sites/default/files/library/files/2014_04_physicians_edition.pdf
**Please note: Under the following states law, Fioricet is classified as a Schedule III controlled drug. **
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- Georgia
- Maryland
- New Mexico
- Utah
- Illinois
- Rhode Island
- West Virginia
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It is very hard to separate butalbital from fioricet or generic fioricet, so fioricet is not controlled substance.
Fiorinal contains a combination of aspirin, butalbital, and caffeine. Aspirin is a pain reliever, as well as an anti-inflammatory and a fever reducer. Butalbital is a barbiturate. 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.
Fiorinal is used to treat tension headaches. This medicine is not for treating headaches that come and go.
It is easy to separate butalbital from Fiorinal, That is why Fiorinal is a controlled substance.