Does Fioricet Work for Migraine Headaches?
Fioricet is a prescription med for migraines containing acetaminophen, caffeine, and butalbital, with limited effectiveness and potential side effects.
butalbital / acetaminophen / caffeine
Used for Tension Headache
Used for Tension Headache
Fioricet is a headache medication that contains butalbital (a barbiturate), acetaminophen (a pain reliever), and caffeine (a stimulant). It's used to treat tension headaches in adults and children ages 12 and older. Fioricet comes as brand-name capsules as well as generic tablets, capsules, and oral solution. It's usually taken by mouth every 4 hours as needed. Common side effects include sleepiness and dizziness. Fioricet isn't a first-choice treatment because it can be habit-forming and cause "rebound headaches" if used too often.
What is Fioricet?
What is Fioricet used for?
How Fioricet works
Fioricet contains three medications that work together to help relieve headache pain.
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Butalbital is a barbiturate. It works by helping to calm activity in your brain.
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Acetaminophen is an analgesic. It blocks certain chemicals in your brain to help ease pain.
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Caffeine is a type of stimulant called an adenosine antagonist. It blocks a natural chemical in your body called adenosine, which might play a role in headache pain. While it's not clear exactly how caffeine helps with headaches, it might also help acetaminophen work better to relieve pain.
When does Fioricet start working?Time passed since treatment started:
Drug facts
| Common Brands | Fioricet |
|---|---|
| Drug Class | Barbiturate / Analgesic / Adenosine antagonist |
| Controlled Substance Classification | Controlled in some states. See FAQs below. |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
Side effects of Fioricet
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Drowsiness or sleepiness
- Lightheadedness
- Dizziness
- Trouble breathing
- Nausea
- Vomiting
- Stomach pain
- Feeling drunk (intoxicated)
Less Common Side Effects
- Headache
- Heavy eyelids
- Dry mouth
- Trouble swallowing
- Heavy sweating
- Shaky feeling
- Muscle weakness
- Fast heart rate
- Agitation
- Confusion
Fioricet serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Overdose: extreme sleepiness, slow or troubled breathing, confusion, shaking, restlessness, not responding to sound or touch
- Liver damage: nausea, vomiting, stomach pain, dark urine, yellowing of your skin or eyes
- Withdrawal symptoms after stopping suddenly: shakiness, restlessness, seizures, severe confusion, trouble sleeping
- Serious allergic reaction: hives; swelling of your face, mouth, tongue, or throat; feeling your throat closing; trouble breathing
- Serious skin reaction: painful skin rash, skin redness, blisters, skin peeling
When do Fioricet possible side effects begin and end?
Time passed since treatment started:
M
H
D
W
M
Drowsiness
Dizziness
Nausea
Trouble breathing
Confusion
Seek immediate medical care if you experience this side effect.
The following Fioricet side effects have also been reported
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:
More common
Lightheadedness
shortness of breath
Incidence not known
Abdominal or stomach pain
black, tarry stools
bleeding gums
blistering, peeling, or loosening of the skin
blood in the urine or stools
blurred vision
change in the frequency of urination or amount of urine
chills
difficulty with breathing
difficulty with swallowing
dizziness
drowsiness
fainting
fast, pounding, or irregular heartbeat or pulse
flushed or dry skin
fruit-like breath odor
increased hunger
increased thirst
increased urination
joint or muscle pain
loss of appetite
nausea or vomiting
pinpoint red spots on the skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red skin lesions, often with a purple center
red, irritated eyes
seizures
shakiness in the legs, arms, hands, or feet
sores, ulcers, or white spots in the mouth or on the lips
sweating
swelling of the feet or lower legs
tightness in the chest
trembling or shaking of the hands or feet
troubled breathing
unexplained weight loss
unusual bleeding or bruising
unusual tiredness or weakness
weakness
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Confusion as to time, place, or person
dark urine
difficult or painful urination
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
general feeling of discomfort or illness
hallucinations
headache
holding false beliefs that cannot be changed by fact
increased sweating
irregular, fast or slow, or shallow breathing
light-colored stools
loss of appetite
pale or blue lips, fingernails, or skin
restlessness
sudden decrease in the amount of urine
sweating
trouble sleeping
unpleasant breath odor
unusual excitement, nervousness, or restlessness
vomiting of blood
yellow eyes or skin
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
Relaxed and calm
sleepiness
Incidence not known
bloated
continuing ringing or buzzing or other unexplained noise in the ears
excess air or gas in the stomach or intestines
false or unusual sense of well-being
full feeling
hearing loss
heavy eyelids
high energy
hot spells
hyperventilation
irritability
numbness
pain in the leg
passing gas
sluggishness
tingling sensation
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.
Pros and cons of Fioricet
Pros
- Can start relieving headache pain within 30 to 60 minutes
- Combines three medications into one pill or liquid
- Available as an oral liquid for people who have trouble swallowing pills
Cons
- Can be habit-forming and cause physical dependence
- Can cause more headaches if taken too often
- Has a risk of liver damage
Pharmacist tips for Fioricet
- Take Fioricet exactly as your prescriber tells you to. Don't take more than prescribed or take it more often than directed. Taking too much can cause serious side effects, including overdose.
- Avoid taking Fioricet too often. Taking it for 10 days or more per month can raise your risk of rebound headaches. This means your headaches can happen more often or get worse. Tell your prescriber if you need Fioricet more often than usual. They can help you find better options for headache relief.
- For Fioricet and generic pills: Take Fioricet capsules and tablets as directed. Swallow capsules whole; don't open or crush them. Ask your prescriber or pharmacist before cutting or crushing tablets.
- For the generic liquid form: Measure each dose with a medication cup or oral syringe from your pharmacy. Don't use kitchen spoons because you might take the wrong dose.
- Fioricet can make you feel sleepy, dizzy, or lightheaded. Don't drive or use any heavy machines until you know how the medication affects you.
- Avoid alcohol while taking Fioricet. Alcohol can make you more sleepy or dizzy. This can raise your risk of accidents, overdose, and liver damage.
- It's a good idea to limit other sources of caffeine while taking Fioricet. Each capsule or tablet contains 40 mg of caffeine. The liquid contains 40 mg of caffeine per 15 mL. Too much caffeine can cause a fast heartbeat, shaking, or trouble sleeping. Keep track of how much caffeine you get from things like coffee, tea, and energy drinks.
- Tell your prescriber and pharmacist about all the medications you take and plan to take. Taking Fioricet with medications like opioids or sleep medications can cause severe sleepiness or slow breathing. Antidepressants called monoamine oxidase inhibitors (MAOIs) can also raise your risk of side effects. Check with your care team before starting any new medications.
- Check medication labels before taking other pain, headache, or cold medications with Fioricet. Many of these products contain acetaminophen, which is also in Fioricet. Look for “acetaminophen” or “APAP” on the label. Taking more than one product with acetaminophen can raise your risk of liver damage. Ask your prescriber or pharmacist before taking these products together.
- Don't stop taking Fioricet suddenly if you've been using it regularly. Talk to your prescriber first. Stopping too quickly can cause withdrawal symptoms, like restlessness or even seizures. Your prescriber can help you stop taking Fioricet safely.
- Store Fioricet in a safe place at room temperature, away from children. Accidental use can cause a life-threatening overdose. If you don't need to take Fioricet anymore, use a medication take-back program to get rid of it safely.
- Get emergency medical help if someone takes too much Fioricet. You can also call Poison Control at 1-800-222-1222 for help. Don't wait for symptoms to appear.
Risks and warnings for Fioricet
Fioricet can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Liver damage
- Risk factors: Drinking alcohol with acetaminophen | Taking more than one medication containing acetaminophen | Taking too much Fioricet | Liver problems
Fioricet contains acetaminophen (Tylenol). Taking too much acetaminophen can cause serious and sometimes life-threatening liver damage. For healthy adults, the maximum amount of acetaminophen is usually 4,000 mg in 24 hours. But some people might meed a lower limit, such as 2,000 mg, depending on their risk of liver damage.
Check with your prescriber or pharmacist before taking other medications that contain acetaminophen. Look for "acetaminophen" or "APAP" on medication labels. Taking more than one product with acetaminophen can make it easier to take too much. Avoid alcohol while taking Fioricet because it can raise your risk of liver damage. Tell your prescriber if you have liver problems before taking Fioricet.
Get medical help right away if you take too much acetaminophen, even if you feel fine. Also get medical help right away if you notice signs of liver problems. These can include dark urine, severe tiredness, nausea, stomach pain, or yellow skin or eyes.
Extreme sleepiness and trouble concentrating
- Risk factors: Age 65 years or older | Drinking alcohol | Taking high doses of Fioricet | Taking other medications that can cause sleepiness or slow your body down
Fioricet can make you feel very sleepy. It can also make it harder to think, react quickly, and focus. Medications that make you sleepy, like sedatives and muscle relaxants, can make the effects worse. Alcohol can also make these side effects stronger.
Don't drive or do anything that requires you to be alert until you know how Fioricet affects you. Avoid drinking alcohol or taking other medications that can cause "brain fog" unless your prescriber says it's safe. Tell your care team right away if you feel very sleepy while taking Fioricet.
Serious allergic reactions or skin reactions
- Risk factors: Allergy to acetaminophen (Tylenol) | Allergy to butalbital | Allergy to caffeine
Fioricet contains acetaminophen (Tylenol). This ingredient can cause serious allergic reactions. Don't take Fioricet if you're allergic to acetaminophen or any of Fioricet's other ingredients.
Get emergency help right away if you have signs of a severe allergic reaction called anaphylaxis. Signs include swelling of your face, lips, or tongue, trouble breathing, tightness in your throat, or hives.
Acetaminophen can also cause rare but serious skin reactions. Stop taking Fioricet and get medical help right away if you notice a painful rash, red skin, blisters, or peeling skin.
Risk of dependence and withdrawal
- Risk factors: Taking Fioricet longer than prescribed | Taking higher doses of Fioricet than prescribed | Taking Fioricet more often than prescribed
Fioricet contains butalbital, which can be habit-forming. Taking Fioricet for a long time, especially at high doses, can lead to physical dependence. This means your body gets used to the medication and needs it to feel normal.
Over time, you might also build tolerance to Fioricet. This means you might need higher doses to get the same effect. This raises your risk of taking too much Fioricet. It can raise your risk of overdose and death. Get emergency medical help if you have signs of an overdose, such as extreme sleepiness, confusion, or trouble breathing. To lower these risks, don't take Fioricet more often, at higher doses, or for longer than prescribed.
If you suddenly stop taking Fioricet after taking it for a long time, you might have withdrawal symptoms. These include restlessness, trouble sleeping, shaking, or seizures. Talk to your prescriber first before stopping Fioricet. They can help you stop the medication safely.
Fioricet dosage
The average cost for 30 tablets of 50mg/325mg/40mg of Fioricet is $13.04 with a free GoodRx coupon. This is 44.03% off the average retail price of $23.30. 
Bottle of oral solution
Capsule
Tablet
Bottle of oral solution| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 473ml of 50mg/325mg/40mg/15ml | 1 bottle | $799.70 | $799.70 |
Capsule| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 50mg/325mg/40mg | 30 capsules | $34.52 | $1.15 |
| 50mg/300mg/40mg | 30 capsules | $23.66 | $0.79 |
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 50mg/325mg/40mg | 30 tablets | $13.04 | $0.43 |
Interactions between Fioricet and other drugs
Fioricet may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Fioricet. Please note that only the generic name of each medication is listed below.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Riociguat
- Viloxazine
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alfentanil
- Alprazolam
- Amobarbital
- Anisindione
- Aprobarbital
- Butabarbital
- Calcium Oxybate
- Capmatinib
- Carisoprodol
- Chloral Hydrate
- Chlordiazepoxide
- Chlorzoxazone
- Clarithromycin
- Clonazepam
- Clorazepate
- Dantrolene
- Darunavir
- Diazepam
- Dicumarol
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Esketamine
- Estazolam
- Ethchlorvynol
- Etonogestrel
- Flunitrazepam
- Flurazepam
- Givosiran
- Halazepam
- Imatinib
- Iobenguane I 131
- Isoniazid
- Ketazolam
- Lorazepam
- Lormetazepam
- Magnesium Oxybate
- Medazepam
- Mephenesin
- Mephobarbital
- Meprobamate
- Metaxalone
- Methocarbamol
- Methohexital
- Midazolam
- Nifedipine
- Nitrazepam
- Oxazepam
- Peginterferon Alfa-2b
- Pentobarbital
- Phenindione
- Phenobarbital
- Phenprocoumon
- Piperaquine
- Pixantrone
- Pneumococcal 13-Valent Vaccine, Diphtheria Conjugate
- Potassium Oxybate
- Prazepam
- Primidone
- Quazepam
- Secobarbital
- Sodium Oxybate
- Temazepam
- Thiopental
- Trazodone
- Triazolam
- Ulipristal
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acenocoumarol
- Cannabis
- Carbamazepine
- Fosphenytoin
- Lixisenatide
- Ospemifene
- Phenytoin
- Prednisone
- Warfarin
- Zidovudine
How much does Fioricet cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Fioricet contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Fioricet will not be safe for you to take.
- Porphyria (a rare genetic condition that causes certain chemicals to build up in your body)
What are alternatives to Fioricet?
There are a number of medications that your doctor can prescribe in place of Fioricet. Compare a few possible alternatives below.
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