Fioricet (butalbital/acetaminophen/caffeine)

Fioricet is a prescription medication used to treat migraines and tension headaches. The drug contains acetaminophen which relieves pain, butalbital which relaxes muscles, and caffeine to speed up its effectiveness and relieve blood pressure. Fioricet use can be dangerous when combined with other substances and can lead to physical dependence if abused.

What Is Fioricet?

Fioricet is a prescription medication used to treat people suffering from chronic tension headaches and migraines. Tension headaches are relatively common and can be a result of stress, poor diet, dehydration, and other medical conditions. Migraines are far stronger forms of headaches that can cause severe pain in one side of the brain as well as increased sensitivity to light and sound. A doctor may prescribe Fioricet if chronic headaches occur more than 10 times per month.[1]

Fioricet is a combination medication, meaning different parts of its chemical composition help relieve headache pain in different ways. Fioricet is made up of three individual pharmaceutical medications.

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What is Fioricet made of?

Butalbital, Acetaminophen, and caffeine are the primary ingredients of Fioricet. These different elements of Fioricet help alleviate headaches in different ways. 

Butalbital - Butalbital is a sedative barbiturate that helps relax muscle tension and calm the nervous system. It achieves this by stimulating GABA production in the brain, a neurotransmitter that blocks signals among neurons in the central nervous system (CNS).[1]

Acetaminophen - More commonly known by the brand name Tylenol, Acetaminophen reduces pain and fever by reducing the production of prostaglandin, a naturally occurring chemical in the brain that activates pain signals.[1]

Caffeine - A common and legal form of stimulant, found in fizzy beverages and coffee, caffeine helps alleviate headaches by raising blood pressure. Raised blood pressure causes blood vessels to constrict as they decrease blood flow, relieving pressure on the brain. 

Whilst Fioricet’s ability to reduce headaches and migraine pain makes it an effective prescription, there is a risk of abuse, adverse side effects, overdose, dependence, and addiction.

Fioricet dosage

The amount of each chemical element in Fioricet is usually:

  • Butalbital - 50mg

  • Acetaminophen - 325mg

  • Caffeine - 40mg

Fioricet comes in tablet form and is intended to be taken in one or two tablets every four hours, with no more than six tablets taken every day.[2]

Side effects of Fioricet abuse

Fioricet, like most medications, can cause some unwanted side effects. Some of these are fairly common while others only occur in rare cases, often due to misuse or combining medications. As with all types of prescription medication, abusing Fioricet greatly increases the risk of experiencing adverse side effects.[4]

Possible Fioricet side effects include:

  • Perceived feeling of intoxication

  • Lightheadedness

  • Anxiety

  • Vomiting/nausea

  • Tremors

  • Shortness of breath

  • Dizziness

  • Drowsiness

  • Abdominal pain

  • Sleeplessness

In some cases, a person who takes Fioricet may develop an allergic reaction to the drug. The symptoms of an allergic reaction are trouble breathing, itching, rashes, intense dizziness, and swelling in the face, throat, and tongue.

Can you overdose from Fioricet abuse?

The acetaminophen in Fioricet can cause severe liver damage when abused in high doses. This can lead to fatal liver damage and overdose.

While it is difficult to take a dangerous amount of acetaminophen from Fioricet on its own, taking the drug with other substances that contain acetaminophen greatly increases the risk of overdose

Knowing the signs of a Fioricet overdose can ensure that anyone going through it can get medical attention.

Signs of a Fioricet overdose include:

  • Jaundice (yellowing of the skin)

  • Confusion

  • Convulsions 

  • Sweating

  • Tremors

  • Irregular heartbeat

  • Nausea and vomiting

Is Fioricet addictive?

Many do not consider Fioricet to be addiction-forming as it is a widely used prescription medication for treating headaches. However, the drug does contain butalbital, a sedative barbiturate that can affect the central nervous system and affects neurotransmitters in the brain. In high amounts, this can cause mildly euphoric effects. 

When someone abuses Fioricet or takes it in higher than recommended amounts, their brain can begin to develop a tolerance to its effects, meaning more of the drug is required to alleviate headaches. This can in turn lead to dependence, whereby the person requires the drug to feel normal. 

Once someone has become dependent on Fioricet, they will need to take the drug constantly and often in higher than recommended doses. This can lead to people doctor shopping in order to get more prescriptions, or obtaining the drug through other means. 

There is also the possibility that someone will begin to experience withdrawal symptoms when use stops. This can cause the symptoms that were originally being treated to become far worse, causing many to be unable to stop taking Fioricet.

Fioricet withdrawal symptoms

Fioricet withdrawal is often short-lived, lasting between eight hours and three days, but can be incredibly intense. The most common withdrawal symptom from Firoicet is rebound headaches, often far more intense than those felt when the prescription was first offered. 

This is why many people with Fioricet dependence require a medically assisted detox in a rehab treatment center. This way the symptoms of Fioricet withdrawal can be safely managed and the chance of relapse is greatly diminished. 

Other symptoms of Fioricet withdrawal include:

  • Anxiety

  • Insomnia

  • Muscle spasms

  • Seizures (rare)

  • Nausea and vomiting

  • Mood swings

  • Fatigue

Treatment for Fioricet abuse

If you or someone you care about is suffering from a Fioricet dependence or if they are abusing the drug as part of a larger substance use disorder, then help is available. There are addiction specialists and rehab centers across the country that specialize in helping those with drug and alcohol use disorders get clean and begin recovery. 

Fioricet FAQs

Here are some of the most commonly asked questions we receive about Fioricet (butalbital/acetaminophen/caffeine):

How quickly does Fioricet work?

As Fioricet contains multiple substances, each with its own purpose for soothing headaches, the amount of time it takes to work varies on what is being affected by which drug. Click here to find out more about the effectiveness of Fioricet.

How long does Fioricet stay in your system?

Like all drugs, the amount of time Fioricet will stay in the human system depends on multiple factors and what kind of tests are being carried out. Read more on how long Fioricet stays in your system.

Is Fioricet available over the counter?

There are a wide range of medications on the market that are designed to target tension headaches and migraines. Some of these are available over-the-counter as they contain less harmful substances and are less regulated. Some medications are only available with a prescription. Read here to find out whether you can get Fioricet over the counter

What is Fioricets Schedule status?

Like all forms of prescription medications available on the market, Fioricet is regulated by the Drug Enforcement Administration (DEA) under the Controlled Substances Act (CSA). Click here to find out where Fioricet falls under the CSA and what schedule it holds.