Fioricet Uses, Dosage, Side Effects & Warnings

Generic name: acetaminophen, butalbital, and caffeine [ a-SEET-a-MIN-oh-fen, bue-TAL-bi-tal, and-KAF-een ]
Drug class: Analgesic combinations

Medically reviewed by Sanjai Sinha, MD. Last updated on Mar 16, 2022.

What is Fioricet?

Fioricet capsules contain 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.

Extended and repeated use of Fioricet is not recommended because of the potential for physical dependence.

Warnings

You should not use Fioricet if you have porphyria, or if you have recently used alcohol, sedatives, tranquilizers, or other narcotic medications.

Do not use Fioricet if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, and tranylcypromine.

Do not take more Fioricet than is recommended. An overdose of acetaminophen can damage your liver or cause death. Call your doctor at once if you have nausea, pain in your upper stomach, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of your skin or eyes).

In rare cases, acetaminophen may cause a severe skin reaction. Stop taking Fioricet and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.

Before taking this medicine

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 it, if you have porphyria, or if you have recently used alcohol, sedatives, tranquilizers, or other opioids.

To make sure Fioricet is safe for you, 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 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 several weeks. Tell your doctor if you are pregnant or plan to become pregnant.

Acetaminophen, butalbital, and caffeine can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breastfeeding a baby.

Fioricet is not approved for use by anyone younger than 12 years old.

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 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.

Dosing information

Usual Adult Dose for Headache:

Butalbital 50 mg/acetaminophen 300 mg/caffeine 40 mg: 1 or 2 capsules orally every 4 hours as needed not to exceed 6 capsules per day

Uses: For the relief of the symptom complex of tension (or muscle contraction) headache.

Usual Pediatric Dose for Headache:

12 years or older: Butalbital 50 mg/acetaminophen 300 mg/caffeine 40 mg: 1 or 2 capsules orally every 4 hours as needed not to exceed 6 capsules per day

Comments:
-Due to high rate of physical dependence, the extended use of this drug is not recommended.
-The safety and efficacy of treating multiple recurrent headaches with this product is not known.

Uses: For the relief of the symptom complex of tension (or muscle contraction) headache.

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 acetaminophen, butalbital, and caffeine 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, 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 Fioricet side effects may include 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.

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, opioid 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 your doctor about all other medicines you use.

Popular FAQ

According to the Drug Enforcement Administration (DEA), Fioricet is not a controlled substance. However, butalbital belongs to a class of drugs known as barbiturates. These drugs are habit-forming and can be abused. For this reason, it’s not recommended to take Fioricet long-term.

Fioricet is not the same as Excedrin. Fioricet contains butalbital, which is available by prescription only. Excedrin products are available over the counter and contain different combinations of aspirin, acetaminophen, caffeine and diphenhydramine:

Because butalbital is habit-forming, it is not recommended to take Fioricet every day. It’s possible to build up a tolerance to butalbital. Over time, higher doses may be needed to have the same effect, leading to drug dependence. Taking higher doses of Fioricet can also increase the chance of an overdose.

Fioricet is intended for occasional use every 4 hours when symptoms occur.

Butalbital affects the central nervous system and can make you sleepy. It can also cause lightheadedness, dizziness and mental confusion. Drowsiness is also one of the first signs of an overdose from barbiturates.

Fioricet contains three different drugs. Each drug is estimated to stay in your body for a different amount of time.

• Acetaminophen is eliminated after about 6 to 15 hours
• Caffeine is eliminated after about 15 hours
• Butalbital is eliminated after about 7 days

Fioricet contains 40 mg of caffeine, similar to a cup of tea. The following shows the average amount of caffeine in some common beverages:

• 8 oz of coffee: 80 to 100 mg of caffeine
• 8 oz green or black tea: 30 to 50 mg of caffeine
• 12 oz caffeinated soda: 30 to 40 mg of caffeine

In clinical studies, weight loss was not a reported side effect from Fioricet. However, it can cause nausea, vomiting and stomach pain. Having those side effects may lead to a decreased appetite and lead to weight loss.

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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.

Medical Disclaimer

Copyright 1996-2023 Cerner Multum, Inc. Version: 8.01.

Acetaminophen, Butalbital, and Caffeine: MedlinePlus Drug Information

pronounced as (a set a mee’ noe fen) (byoo tal’ bi tal) (kaf’ een)

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This combination of drugs is used to relieve tension headaches.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

The combination of acetaminophen, Butalbital, Caffeine comes as a capsule and tablet to take by mouth. It usually is taken every 4 hours as needed. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take acetaminophen, Butalbital, Caffeine exactly as directed. Do not take more than six tablets or capsules in 1 day. If you think that you need more to relieve your symptoms, call your doctor.

This medication can be habit-forming. Do not take a larger dose, take it more often, or for a longer period than your doctor tells you to.

Before taking acetaminophen, Butalbital, Caffeine,

• tell your doctor and pharmacist if you are allergic to acetaminophen, butalbital, caffeine, or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially anticoagulants (‘blood thinners’) such as warfarin (Coumadin), antidepressants, antihistamines, pain medications, sedatives, sleeping pills, tranquilizers, and vitamins. Many nonprescription pain relievers contain acetaminophen. Too much of this drug can be harmful.
• tell your doctor if you have or have ever had liver disease, porphyria, or depression.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking this medication, call your doctor.
• you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
• remember that alcohol can add to the drowsiness caused by this drug.

Acetaminophen, Butalbital, Caffeine may cause an upset stomach. Take this medicine with food or milk.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Acetaminophen, Butalbital, Caffeine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• drowsiness
• upset stomach
• vomiting
• stomach pain
• depression
• lightheadedness
• confusion

If you experience any of the following symptoms, call your doctor immediately:

• skin rash
• itching
• difficulty breathing

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www. fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature, away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.

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• Orbivan^® (containing Acetaminophen, Butalbital, Caffeine)^¶
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• Phrenilin^® with Caffeine and Codeine (containing Acetaminophen, Butalbital, Caffeine, Codeine)

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Last Revised – 05/15/2019

Browse Drugs and Medicines

Drugs that reduce memory. Five groups of drugs that affect memory

Memory loss is most commonly reported as a sign of aging, a consequence of substance use, or a symptom of diseases such as Alzheimer’s disease. Many people do not know that episodes of forgetfulness can occur as a side effect of certain medications.

“Scientists now know that memory decline with aging is not at all inevitable,” writes Dr. Armon B. Neel, geriatric pharmacist, “In fact, the brain is capable of growing new nerve cells and rewiring connections between neurons throughout life.

In order to educate patients about the unknown side effects of certain medications, Dr. Neal has compiled a list of medications that can cause forgetfulness.

Is memory loss interfering with your life? The “culprit” may be one of these drugs.

Anti-anxiety drugs (benzodiazepines)

Representatives of : alprazolam (Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), diazepam (Valium), flurazepam (Dalmane), lorazepam (Ativan).

These medicines are usually prescribed for anxiety, agitation, muscle spasms, delirium. They suppress the activity of certain areas of the brain, due to which they can disrupt the transfer of data from short-term to long-term memory. This is why benzodiazepines are so commonly used by anesthesiologists.

To avoid these side effects, pharmacists recommend taking benzodiazepines in short courses. If you suffer from complications associated with increased anxiety, such as insomnia, then it is better to opt for alternative treatments.

Cholesterol-lowering drugs (statins)

Representatives of : atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), and simvastatin (Zocor).

Statins lower blood cholesterol, but can also lower cholesterol levels in the brain where it is needed. If this happens, the connections between nerve cells are disrupted.

If you are on a statin for a slight increase in blood cholesterol levels, but you do not have a diagnosis of coronary disease, a vitamin shake is a better choice.

“Talk to your doctor about this. You may be given a combination of sublingual (under the tongue) vitamin B12 (1,000 micrograms per day), folic acid (800 micrograms per day), and vitamin B6 (200 mg per day),” recommends Dr. Neil.

Antidepressants (tricyclic antidepressants)

Representatives of : amitriptyline (Elavil), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil).

These drugs are prescribed for patients suffering from depression, as well as eating disorders, chronic pain, and obsessive-compulsive disorders. More than a third of adults taking these drugs complain of memory impairment and about half of problems with concentration.

To avoid these side effects, it is worth talking to your doctor about the possibility of using non-drug treatments. Venlafaxine (Effexor) is also a good alternative because it has minimal negative effects on memory.

Hypertension medicines (beta-blockers)

Representatives of : atenolol (Tenormin), carvedilol (Coreg), metoprolol (Lopressor, Toprol), propranolol (anaprilin), sotalol (Betapace), timolol (Timoptic) .

Beta-blockers are used to slow the heart rate and lower blood pressure. At the same time, they can block the effects of important substances such as adrenaline and norepinephrine, leading to memory problems.

Calcium channel blockers, which are derivatives of benzothiazepine, are safer in this respect. In addition, they are often more efficient.

Hypnotics (non-benzodiazepine hypnotics and sedatives)

Representatives : eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien).

These drugs help you sleep. But just like the aforementioned sedatives, they can interfere with the link between short-term and long-term memory.

“There are alternative drugs and non-drug treatments for insomnia. Talk to your doctor about them. For example, melatonin at night at a dose of 3 to 10 mg helps restore healthy sleep. However, be aware that abrupt withdrawal of sleeping pills can lead to side effects, so any changes in the course of treatment should be carried out by the attending physician, ”says Dr.