Key takeaways
Butalbital/aspirin/caffeine (formerly Fiornal) and Zomig (zolmitriptan) are both used to treat headaches, but they work in different ways and are used for different types of headaches. Fiorinal is a combination medication that includes a barbiturate, a nonsteroidal anti-inflammatory drug (NSAID), and caffeine, and it is used to treat tension headaches. It is a Schedule III controlled substance due to the risk of misuse and dependence. Fiorinal is taken every 4 hours as needed, up to 6 pills per day. On the other hand, Zomig is a triptan used for the short-term treatment of migraines. It works by attaching to serotonin receptors to reduce blood vessel swelling and pain signals. Zomig is not a controlled substance and is taken as a single dose at the first sign of a migraine, with a possible second dose after 2 hours if needed. Fiorinal is available only in generic form, while Zomig is available in both brand-name and generic forms, and comes in oral tablets, orally disintegrating tablets, and nasal spray. Common side effects of Fiorinal include sleepiness and dizziness, whereas Zomig can cause dizziness, chest pain, and an unusual taste with the nasal spray.
