Fioricet and Esgic is made from a combination of butalbital (a barbiturate, 50 mg), acetaminophen (325 mg), and caffeine (40 mg). This combination medication is used to treat tension headaches.  Acetaminophen (4´-hydroxyacetanilide), is a non-opiate, non-salicylate analgesic and antipyretic, and Acetaminophen helps to decrease the pain from the headache. Caffeine (1,3,7-trimethylxanthine), is a central nervous system stimulant and Caffeine helps increase the effects of acetaminophen.  Butalbital (5-allyl-5-isobutylbarbituric acid), is a short to intermediate-acting barbiturate, and Butalbital is a sedative that helps to decrease anxiety and cause sleepiness and relaxation.

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 Mechanism of action

Butalbital has generalized depressant effect on central nervous system and, in very high doses, has peripheral effects. Acetaminophen has analgesic and antipyretic effects; its analgesic effects may be mediated through inhibition of prostaglandin synthetase enzyme complex. Caffeine is thought to produce constriction of cerebral blood vessels.

Butalbital has a half-life of about 35 hours. Acetaminophen has a half-life of about 1.25 to 3 hours, but may be increased by liver damage and after an overdose. Caffeine has a half-life of about 3 hours.

Important information about Fioricet

Do not use Fioricet 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 Fioricet before the MAO inhibitor has cleared from your body.

Do not take more Fioricet 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 with Fioricet 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.

Fioricet side effects

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 Fioricet 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 Fioricet side effects may include:

• drowsiness;
• dizziness, confusion or lightheadedness;
• dry mouth;
• nausea, vomiting, stomach pain, loss of appetite;
• feeling anxious or jittery;
• drunk feeling; or
• headache.

What other drugs will affect Fioricet?

The following drugs can interact with Fioricet. Tell your doctor if you are using any of these:

• an antibiotic;
• a blood thinner such as warfarin (Coumadin);
• isoniazid;
• zidovudine (Retrovir, AZT);
• seizure medication such as phenytoin (Dilantin) or phenobarbital (Luminal, Solfoton);
• gout medications such as probenecid (Benemid) or sulfinpyrazone;
• an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate);
• steroids such as prednisone, fluticasone (Advair), mometasone (Asmanex, Nasonex), dexamethasone (Decadron, Hexadrol) and others; or
• an antidepressant such as amitriptyline (Elavil, Etrafon), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Janimine, Tofranil), and others.

Fioricet Patient Review

i am young, about 28 years old.i get tension headaches and severe migraines this medication works if i take it soon as i feel a migraine coming on, unlike other meds this one actually works for me, although it interacts with my other meds i do very well. but don’t over do it if you don’t need it don’t take it. it gives you one hell of a rebound headache then a migraine like you can’t even imagine, and thats what happened to me a couple of years ago, when my doc told me take them for prevention. now more new doc told me take when neccessary, it is a miracle.

I”ve had migraines since age 8,finally went to my DR. at age of 23 and this is what he gave me. It changed my life completly, and I was able to live a fun, full life… Then at age29-30 iwas blessed with a beutifully large baby boy.11.5oz !The headaches drasticly changed 4days after his birth. so I now have Chronic Daily migraine Headaches, and have pain 24//7 for 19yrs,now, Nothing else I have tried works to help the pain. I juggle life around my headaches.It has been a very useful med. for my needs.

I have suffered from severe, debilitating cervigenic migraines every few days, each lasting from 3 to 10 days. Little to no sleep at night. Tried it all; Cervical blocks, occipital blocks, facet injections, tramadol, amitriptylene, protriptylene,soma, halcion, skelaxin, flexeril, codiene, vicodin, physical therapy, deep tissue massage, bio feedback, surgery, etc. This is the only med that touchs them. It must be taken at the first hint of a migraine. In 15+ years I have never had an adiction problem.

I had a headache for three days and was hospitalized. They could find nothing to help me get over the headache. Finally they tried fioricet and it worked. I now have some on hand so when I feel a headache coming on I usually take two pills and it is gone. If a headache gets away from me, I can usually use four pills and that is all I need. I get a headache once a month or less often.

This medicine really worked for my migranes but I began getting rebound headaches when I wasnt taking it. If you get migranes 3 or more times a week I dont recommend taking this medicine.

 
I have been using Fioricet for 10 years for Migraines and have found it to be the best treatment for me. It can sometimes make me feel a little “stoned” but that passes within half an hour and I can move on with my day.