Does Fioricet Work for Migraine Headaches?

Migraine headaches can make you feel terrible. Although some people experience them differently, migraines usually feel like strong, pounding headaches on one side of the head. They can make you feel sick to your stomach and are worse when you move around. If you get migraines, you need a strong medication that will quickly get you back to normal. 

Fioricet is a well-known prescription medication used to stop a headache that has already started. It’s intended to be used for tension-type (muscle tension) headaches. 

Although Fioricet can sometimes be effective for migraines, there are better options available for most people.

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What is Fioricet?

Fioricet is a combination medication. That means it contains several different medications that work together to have a stronger effect. 

The active ingredients in Fioricet are:

• Acetaminophen (the main ingredient in Tylenol) 

• Caffeine

• Butalbital

Acetaminophen is a pain reliever. It starts working in less than 1 hour to reduce headache pain. Caffeine is also useful for fighting a headache, and it increases the effectiveness of acetaminophen. Butalbital is a barbiturate, which is a sedating or relaxing type of medication. The butalbital in Fioricet helps reduce anxiety and cuts down on the restlessness caffeine causes.

Is Fioricet effective for migraines?

Sometimes. There is very little scientific research to show Fioricet can stop a migraine. It’s meant to be used for tension-type headaches, which are different from migraines.

Quality research shows that acetaminophen is effective at stopping migraines. Unfortunately, the dose of acetaminophen that works best to stop a migraine is lower than the dose in Fioricet.

What are some of the dangers of taking Fioricet for migraine?

Common side effects of Fioricet include things like dizziness, nausea, and vomiting. Here are some other things you should know before trying Fioricet: 

• Fioricet can be habit forming. Over time, your body can stop responding to a regular dose of Fioricet, which might push you to take a higher dose than you normally would. It’s also possible to develop a dependency on Fioricet. In other words, you might begin to think you can’t feel normal without it. This might cause you to take Fioricet too often.

• Too much Fioricet can make you dangerously sleepy. Butalbital is a relaxant, and it can be harmful when combined with other relaxants, including alcohol. In large doses, this effect can be life-threatening. Because Fioricet contains acetaminophen and caffeine, you should not take it with Tylenol, cold medicines that contain acetaminophen, caffeine pills, or caffeine-containing beverages like coffee, soda, or energy drinks. Both acetaminophen and caffeine are also dangerous at high doses. 

• Stopping Fioricet quickly can cause withdrawal. If you’ve been taking Fioricet for a while and you suddenly stop, you may experience symptoms of withdrawal, including seizures. If this is a problem for you, talk to your provider about finding a way to safely lower your dose.

• Taking Fioricet can increase your risk of headaches. Taking Fioricet frequently can cause a medication-overuse headache. And when the caffeine in Fioricet wears off, some people get a rebound headache. 

• Too much Fioricet can damage the liver. The acetaminophen in Fioricet can cause damage to your liver if you take it too often. Avoid Fioricet if you already have liver problems. 

• Fioricet is not a good choice while pregnant or nursing. If you take Fioricet when you’re pregnant, your baby could experience withdrawal symptoms after they’re born. Acetaminophen and caffeine carry their own risks during pregnancy. Plus, all three ingredients can be passed through the breastmilk to infants who are nursing. Fortunately, if you need to treat migraines, there are other medications you can take if you’re pregnant or nursing. 

When should you take Fioricet for migraine?

Fioricet is best for tension-type headaches, which are different from migraines. 

Tension-type headaches, which are also known as “muscle-contraction headaches,” usually feel like a steady tightness on both sides of the head. They don’t cause nausea or vomiting and don’t get worse with movement. Unlike migraines, tension-type headaches usually don’t get worse with bright lights or loud sounds.

For migraines, safer and more effective medications are available (see next section). If nothing else works for you, Fioricet can be a back-up option.

Regardless of why you’re taking it, Fioricet should only be used occasionally.

Which other medications can you take for migraines instead of Fioricet?

A number of other medications are available for treating migraines. These include over-the-counter (OTC) and prescription options.

Over-the-counter medications

OTC options for migraine treatment include:

• Acetaminophen (Tylenol)

• Ibuprofen (Motrin or Advil)

• Naproxen (Aleve) 

• Acetaminophen, aspirin, caffeine (Excedrin Migraine) 

Prescription medications

Prescription options for migraine treatment include:

• Triptans, such as rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig)

• Gepants, such as ubrogepant (Ubrelvy) or rimegepant (Nurtec)

• Lasmiditan (Reyvow)

There are also a number of daily medications to keep migraines from happening in the first place. Examples include amitriptyline (Amitril, Elavil), propranolol (Inderal LA), and topiramate (Topamax). Botox injections are another good option that can help minimize the number and severity of migraine attacks. Fioricet should never be used as a daily medication for people with chronic migraines.

How long after taking Fioricet can you take Excedrin Migraine and other medications?

After taking Fioricet, wait at least 4 hours before taking anything else that contains caffeine or acetaminophen. This is to avoid overdosing on these ingredients. This includes Excedrin Migraine, Excedrin Extra Strength, Excedrin Tension Headache, and Excedrin PM Headache.

Butalbital stays in the body for about 35 hours after a single dose of Fioricet. It causes sleepiness, and taking more doses of Fioricet in this time will make the sleepiness worse. Avoid alcohol or other relaxant medications while there’s butalbital in your body.

Why trust our experts?

Written by:

Kerry R. McGee, MD, FAAP

Kerry McGee, MD, FAAP, has over a decade of experience caring for babies, children, and teenagers as a primary care pediatrician. She has a special interest in adolescent health, particularly in adolescent mental health.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

Reviewed by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

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Derry, S., et al. (2013). Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults. The Cochrane Database of Systematic Reviews.

Wenzel, R. G., et al. (2002). Do butalbital-containing products have a role in the management of migraine? Pharmacotherapy.