Fioricet is a prescription medication used to relieve tension headaches. It works by relaxing muscle contractions that can result in mild to moderate head pain.
Fioricet is a well-known prescription medication used to stop a headache that has already started. It is intended to be used for tension-type (muscle tension) headaches. Although it can sometimes be effective against migraines, there are better options available for most people.
Fioricet (butalbital, acetaminophen, and caffeine capsule) is a combination of a barbiturate, a non-salicylate analgesic and antipyretic, and a central nervous system stimulant indicated for the relief of the symptom complex of tension (or muscle contraction) headache. Common side effects of Esgic include:
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- drowsiness
- lightheadedness
- dizziness, sedation
- shortness of breath
- nausea
- vomiting
- abdominal pain, and
- intoxicated feeling
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The dose of Fioricet is one or two capsules every four hours. The total daily dosage of Fioricet should not exceed 6 capsules.
Fioricet may interact with monoamine oxidase (MAO) inhibitors, other narcotic analgesics, alcohol, general anesthetics, tranquilizers such as chlordiazepoxide, sedative-hypnotics, or other CNS depressants. Tell your doctor all medications and supplements you use. During pregnancy, Fioricet should be taken only if prescribed. It is unknown if it would affect a fetus. All the drugs in Fioricet pass into breast milk, and breastfeeding while taking Fioricet is not recommended. Withdrawal symptoms may occur if you suddenly stop taking Fioricet.
Barbiturates may be habit-forming: Tolerance, psychological dependence, and physical dependence may occur especially following prolonged use of high doses of barbiturates. The average daily dose for the barbiturate addict is usually about 1500 mg.
As tolerance to barbiturates develops, the amount needed to maintain the same level of intoxication increases; tolerance to a fatal dosage, however, does not increase more than two-fold. As this occurs, the margin between an intoxication dosage and fatal dosage becomes smaller.
The lethal dose of a barbiturate is far less if alcohol is also ingested. Major withdrawal symptoms (convulsions and delirium) may occur within 16 hours and last up to 5 days after abrupt cessation of these drugs. Intensity of withdrawal symptoms gradually declines over a period of approximately 15 days. Treatment of barbiturate dependence consists of cautious and gradual withdrawal of the drug.
Barbiturate-dependent patients can be withdrawn by using a number of different withdrawal regimens. One method involves initiating treatment at the patient’s regular dosage level and gradually decreasing the daily dosage as tolerated by the patient.
Acetaminophen
Acetaminophen is rapidly absorbed from the gastrointestinal tract and is distributed throughout most body tissues. The plasma half-life is 1.25 to 3 hours, but may be increased by liver damage and following overdosage. Elimination of acetaminophen is principally by liver metabolism (conjugation) and subsequent renal excretion of metabolites. Approximately 85% of an oral dose appears in the urine within 24 hours of administration, most as the glucuronide conjugate, with small amounts of other conjugates and unchanged drug.
Caffeine
Like most xanthines, caffeine is rapidly absorbed and distributed in all body tissues and fluids, including the CNS, fetal tissues, and breast milk.
Caffeine is cleared through metabolism and excretion in the urine. The plasma half-life is about 3 hours. Hepatic biotransformation prior to excretion, results in about equal amounts of 1-methylxanthine and 1-methyluric acid. Of the 70% of the dose that is recovered in the urine, only 3% is unchanged drug.
Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Rare
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- Bleeding or crusting sores on lips
- chest pain
- fever with or without chills
- hive-like swellings (large) on eyelids, face, lips, and/or tongue
- muscle cramps or pain
- red, thickened, or scaly skin
- shortness of breath, troubled breathing, tightness in chest, or wheezing
- skin rash, itching, or hives
- sores, ulcers, or white spots in mouth (painful)
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Symptoms of overdose
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- Anxiety, confusion, excitement, irritability, nervousness, restlessness, or trouble in sleeping (severe, especially with products containing caffeine)
- convulsions (seizures) (for products containing caffeine)
- diarrhea, especially if occurring together with increased sweating, loss of appetite, and stomach cramps or pain
- dizziness, lightheadedness, drowsiness, or weakness, (severe)
- frequent urination (for products containing caffeine)
- hallucinations (seeing, hearing, or feeling things that are not there)
- increased sensitivity to touch or pain (for products containing caffeine)
- muscle trembling or twitching (for products containing caffeine)
- nausea or vomiting, sometimes with blood
- ringing or other sounds in ears (for products containing caffeine)
- seeing flashes of “zig-zag” lights (for products containing caffeine)
- shortness of breath or unusually slow or troubled breathing
- slow, fast, or irregular heartbeat
- slurred speech
- staggering
- swelling, pain, or tenderness in the upper abdomen or stomach area
- unusual movements of the eyes
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Check with your doctor as soon as possible if any of the following side effects occur:
Less common
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- Confusion (mild)
- mental depression
- unusual excitement (mild)
Rare
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- Bloody or black, tarry stools
- bloody urine
- pinpoint red spots on skin
- swollen or painful glands
- unusual bleeding or bruising
- unusual tiredness or weakness (mild
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
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- Bloated or “gassy” feeling
- dizziness or lightheadedness (mild)
- drowsiness (mild)
- nausea, vomiting, or stomach pain (occurring without other symptoms of overdose)
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.