Are you a healthcare professional? Join GoodRx for HCPs

Compare Topamax vs. Fioricet

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

Key takeaways

Topiramate (Topamax, Qudexy XR, Trokendi XR, Eprontia) and Fioricet (butalbital/acetaminophen/caffeine) are both prescription medications, but they are used for different purposes and belong to different drug classes. Topiramate is an antiepileptic medication used to treat seizures and prevent migraines, while Fioricet is a combination medication used to treat tension headaches. Topiramate is available in various forms, including tablets, capsules, and a liquid solution, and can be taken once or twice daily. In contrast, Fioricet is typically taken every 4 hours as needed for pain relief. Topiramate can cause side effects like difficulty thinking clearly, weight loss, and kidney stones, whereas Fioricet can cause drowsiness, dizziness, and potential liver damage due to acetaminophen (Tylenol). Additionally, Fioricet has a risk of misuse and dependence because it contains butalbital, a barbiturate, making it a controlled substance in some states. Topiramate does not have this risk and is not a controlled substance.

Topiramate
Fioricet
Topiramate
Fioricet
Summary of Topamax vs. Fioricet
Summary for Antiepileptic
Prescription only
Topiramate is a prescription medication that can be used alone or in combination with other medications to treat certain types of seizures. It can also be used to prevent migraines. It comes in immediate-release and extended-release tablets and capsules, as well as a liquid. Topiramate is typically taken by mouth once or twice daily, depending on what formulation you're using. Some forms of topiramate are available as lower-cost generic medications.
Summary for Barbiturate / Analgesic / Adenosine antagonist
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 of Topamax vs. Fioricet
Indications for

•Seizures (partial seizures, tonic-clonic seizures, Lennox-Gastaut syndrome)

•Migraine prevention

Indications for

•Tension headaches
Pros and Cons of Topamax vs. Fioricet
Pros and Const for Antiepileptic
Pros

•Can be used on its own or with other medications to control seizures

•Available in short-acting and long-acting forms, so options to take once or twice daily

•Available as a solution (Eprontia), so it's convenient for people who have trouble swallowing

•Can be used to treat different types of seizures

•Can be used to treat seizures in both adults and children

Cons

•Can prevent migraines from happening, but it won't help if you have a migraine attack

•Can cause kidney stones

•Can cause serious eye problems

•Interacts with many medications, such as warfarin (Coumadin), phenytoin (Dilantin), and divalproex (Depakote)

•Children taking this medication for long periods of time will need to have their doses adjusted often due to changes in body weight as they grow

Pros and Const for Barbiturate / Analgesic / Adenosine antagonist
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 of Topamax vs. Fioricet
Common Side Effects for
Please note: These are common side effects reported by children and adults who took immediate-release topiramate. Frequency of side effects can differ based on your age, as well as the dose and formulation of topiramate you're taking.

•Feeling "pins and needles"

•Drowsiness

•Weight loss

•Nervousness

•Fatigue

•Dizziness

•Lack of appetite

•Trouble sleeping

•Upper respiratory tract infection (e.g., cough, stuffy nose, sore throat)

•Fever

•Change in taste

•Trouble moving or keeping balance

Common Side Effects for

•Drowsiness

•Lightheadedness

•Dizziness

•Loss of awareness (sedation)

•Trouble breathing

•Nausea

•Vomiting

•Stomach pain

•Feeling "high" (intoxicated)
Warnings of Topamax vs. Fioricet
Common Side Effects for

•Vision problems

•High body temperature and trouble sweating

•Higher level of acid in blood

•Suicidal thoughts or behavior

•Problems with mood and thinking clearly

•Higher ammonia level in blood

•Serious birth defects

•Skin reactions

•Withdrawal seizures

•Interaction with other medications

Common Side Effects for

•Liver damage

•Difficulty concentrating and extreme sleepiness

•Serious skin or allergic reactions

•Misuse, dependence, and withdrawal
Prices with our coupons for Topamax vs. Fioricet
Learn more about Topiramate
Learn more about Fioricet

Browse medications

View All

Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.

Compare Topamax vs. Fioricet

Key takeaways

Summary of Topamax vs. Fioricet

Indications of Topamax vs. Fioricet

Pros and Cons of Topamax vs. Fioricet

Common Side Effects of Topamax vs. Fioricet

Warnings of Topamax vs. Fioricet

Prices with our coupons for Topamax vs. Fioricet

Compare other Migraine and Tension Headache drugs

Browse medications

Good news for your inbox