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Fiorinal vs. Axert

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

 

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Almotriptan

 

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Summary for Fiorinal

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.

Indications for Fiorinal

Pros and Cons for Fiorinal

Pros

  • Works well to treat tension headaches
  • Combines three medications into a single pill to relieve headache pain in different ways
  • Available as a lower-cost generic

Cons

  • Not recommended as a first-choice option for headaches because of the risk of rebound headaches
  • A controlled medication that can be habit-forming
  • Can cause bothersome withdrawal symptoms if you suddenly stop the medication after taking it for a long time
  • Hasn't been studied in children

Common Side Effects for Fiorinal

  • Sleepiness
  • Dizziness

Warnings for Fiorinal

  • Stomach bleeding and ulcers
  • Kidney problems
  • Reye's syndrome in children
  • Difficulty concentrating and extreme sleepiness
  • Potential for misuse, dependence, and withdrawal
  • Severe allergic reactions and skin reactions

Summary for Axert

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.

Indications for Axert

  • Treatment of migraine attacks in adults with a history of migraine with or without aura
  • Treatment of migraine pain in children age 12 to 17 years with a history of migraine with or without aura that lasts 4 hours or more

Pros and Cons for Axert

Pros

  • A first-choice option for treating a migraine attack in adults
  • Approved for certain children 12 years and older
  • Might start working as soon as 30 minutes after taking the 12.5 mg strength

Cons

  • Might not be a good option for people who have trouble swallowing pills whole during a migraine
  • Not used to prevent migraine or to treat other types of headaches
  • Must wait at least 2 hours to take another tablet if the first dose didn't fully relieve the migraine

Common Side Effects for Axert

Adults:

  • Nausea (1-2%)
  • Dry mouth (1%)
  • "Pins and needles" feeling in the arms or legs (1%)

Children age 12 years and older:

  • Sleepiness (up to 5%)
  • Dizziness (3-4%)
  • Nausea (1-3%)
  • Vomiting (up to 2%)
  • Headache (1-2%)
  • "Pins and needles" feeling in the arms or legs (1%)

Warnings for Axert

  • Heart attack, chest pain (angina), and irregular heart rhythm
  • Stroke or other brain injury
  • Extreme narrowing of blood vessels
  • Serotonin syndrome
  • Worse headaches if you take almotriptan too often
  • High blood pressure
  • Serious allergic reaction

Prices with our coupons for Fiorinal vs. Axert

Price Card Drug Icon
Butalbital/Aspirin/Caffeine30 tablets / 50mg/325mg/40mg
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Price Card Drug Icon
Almotriptan1 dose pack / 12 tablets of 12.5mg
$133.66$410.35
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