Head-to-head comparisons of medication uses, side effects, warnings, and more.
Key takeaways
Butalbital / aspirin / caffeine (Lanorinal, formerly Fiorinal) and almotriptan are both medications used to treat headaches, but they belong to different medication classes and have distinct uses. Butalbital / aspirin / caffeine is a combination medication that treats tension headaches in adults and includes a barbiturate, an nonsteroidal anti-inflammatory drug (NSAID), and caffeine. Almotriptan, on the other hand, is a triptan used to treat migraine attacks with or without aura in adults and children aged 12 to 17. While both medications are available as generics, butalbital / aspirin / caffeine is a Schedule III controlled substance due to its potential for misuse and dependence, whereas almotriptan is not controlled. Butalbital / aspirin / caffeine is taken every 4 hours as needed, with a maximum of 6 pills per day, while almotriptan is taken as a single dose when a migraine starts, with a possible second dose after 2 hours if needed, but not exceeding 25 mg in 24 hours. Common side effects of butalbital / aspirin / caffeine include sleepiness and dizziness, while almotriptan may cause nausea, dizziness, and sleepiness. You should avoid taking butalbital / aspirin / caffeine with other NSAIDs, and almotriptan should not be taken with certain heart conditions or within 24 hours of other triptans.
Fiorinal
Almotriptan
Fiorinal
Almotriptan
Summary of Fiorinal vs. Axert
Summary for Barbiturate / NSAID / Adenosine antagonist
Prescription only
Fiorinal is a combination medication that contains three active ingredients: butalbital (a barbiturate), aspirin (an NSAID), and caffeine (an adenosine antagonist). It's used to treat symptoms of tension headaches in adults. The brand name Fiorinal has been discontinued, but there are still lower-cost generic pills available. The medication is taken by mouth every 4 hours. The most common side effects are sleepiness and dizziness. This medication is a schedule III controlled substance because it has a risk of misuse and dependence.
Summary for Triptan
Prescription only
Almotriptan is a type of migraine medication called a triptan. It treats migraine with or without aura in adults and certain children age 12 to 17 years. Its brand name Axert has been discontinued, so almotriptan is now only available as a generic. Almotriptan is a tablet that's swallowed whole when a migraine starts. You can take another tablet at least 2 hours later if the medication doesn't completely relieve your migraine. Side effects include sleepiness and headache.