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Elavil vs. Fioricet

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Amitriptyline (formerly branded as Elavil) and Fioricet (butalbital/acetaminophen/caffeine) are both prescription medications, but they serve different purposes and belong to different drug classes. Amitriptyline is a tricyclic antidepressant (TCA) primarily used to treat depression, though it is also used off-label for nerve pain and migraine prevention. In contrast, Fioricet is a combination medication used to treat tension headaches and includes a barbiturate (butalbital), an analgesic (acetaminophen), and caffeine. Amitriptyline is taken daily, while Fioricet is taken as needed, typically every 4 hours. Amitriptyline can cause side effects like sleepiness and weight gain, whereas Fioricet can cause drowsiness, dizziness, and has a risk of misuse and dependence. Additionally, Fioricet can lead to liver damage if taken in excess due to its acetaminophen content. Unlike amitriptyline, Fioricet is controlled in some states because of its potential for dependence. Both medications are available in generic forms, making them more affordable options.

Amitriptyline

 

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Fioricet

 

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Summary for Elavil

Prescription only

Amitriptyline is also known by the old brand name Elavil. It's a tricyclic antidepressant (TCA) that's approved to treat depression. But it's not used as often today for depression because it can cause a lot of side effects, like sleepiness and weight gain. It also has many drug interactions. Even so, amitriptyline is often used off label for other reasons, like nerve pain from diabetes and to help prevent migraines. Amitriptyline comes as a generic tablet that you take by mouth. The brand name Elavil is no longer available.

Indications for Elavil

Pros and Cons for Elavil

Pros

  • Can start to work within 2 to 4 weeks
  • Can take with or without food

Cons

  • Has many unpleasant side effects, like dry mouth and sleepiness, and drug interactions
  • Not the best choice for people with heart problems, trouble urinating, or glaucoma or older adults

Common Side Effects for Elavil

  • Sleepiness
  • Dizziness
  • Weakness
  • Fatigue
  • Headache
  • Dry mouth
  • Nausea
  • Vomiting
  • Constipation
  • Weight gain

Warnings for Elavil

  • Worsening depression or suicidal thoughts and behavior
  • Serotonin syndrome
  • Not for use alone for bipolar disorder
  • Risk of heart problems, heart attack, or stroke
  • Low sodium levels
  • Risk of seizure
  • Angle-closure glaucoma in certain people

Summary for Fioricet

Prescription only

Fioricet is a combination medication containing butalbital, acetaminophen, and caffeine. It's taken by mouth as needed, typically every 4 hours, to treat tension headaches. But it's not a first-choice option because it can become habit-forming and can worsen headaches if taken too frequently. In addition, Fioricet can cause side effects, such as sleepiness and dizziness. It's available as pills and an oral syrup.

Indications for Fioricet

  • Tension headaches

Pros and Cons for Fioricet

Pros

  • Available as a lower-cost, generic medication
  • Combination of three medications in a single dosage form (e.g., pill, liquid), which is more convenient
  • Available in a liquid form as a fruit punch-flavored syrup
  • Can be used in people as young as 12 years old

Cons

  • Can cause misuse and physical dependence, so it's a controlled substance in some states
  • Not a first-choice medication for treating tension headaches
  • Might cause liver damage because of the acetaminophen
  • More difficult to customize the dose since it's a combination of three medications

Common Side Effects for Fioricet

  • Drowsiness
  • Lightheadedness
  • Dizziness
  • Loss of awareness (sedation)
  • Trouble breathing
  • Nausea
  • Vomiting
  • Stomach pain
  • Feeling "high" (intoxicated)

Warnings for Fioricet

  • Liver damage
  • Difficulty concentrating and extreme sleepiness
  • Serious skin or allergic reactions
  • Misuse, dependence, and withdrawal

Prices with our coupons for Elavil vs. Fioricet

Price Card Drug Icon
Amitriptyline30 tablets / 25mg
$4.00$4.00
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Price Card Drug Icon
Butalbital/Acetaminophen/Caffeine30 tablets / 50mg/325mg/40mg
$13.04$23.92
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