Fioricet and Esgic are brand names of a combination of butalbital (a barbiturate), acetaminophen and caffeine which is indicated for the treatment of tension headaches, muscle contraction headaches and post-dural puncture headaches.
Although not indicated, they are commonly used to treat migraines and other pain related ailments.
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Fioricet is indicated for the treatment of muscle tension or muscle contraction headaches. It is also commonly prescribed for migraines although it is not FDA indicated for this use in the United States. The usual adult dose is 1-2 tablets every four hours as needed, not exceeding six tablets in a 24-hour period.
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Before taking Fioricet
Do not use Fioricet if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.
You should not use Fioricet if you are allergic to acetaminophen, butalbital, or caffeine, if you have porphyria, or if you have recently used alcohol, sedatives, tranquilizers, or other narcotic medications.
To make sure Fioricet is safe for you, tell your doctor if you have:
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- liver disease, cirrhosis, a history of alcoholism or drug addiction, or if you drink more than 3 alcoholic beverages per day;
- kidney disease;
- asthma, sleep apnea, or other breathing disorder;
- stomach ulcer or bleeding;
- a history of skin rash caused by any medication;
- a history of mental illness or suicidal thoughts; or
- if you use medicine to prevent blood clots.
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It is not known whether Fioricet will harm an unborn baby. If you use butalbital while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.
This medicine can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
Fioricet precautions :
Tell your doctor your medical history, especially of :
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- serious liver disease;
- alcohol or narcotic dependence;
- emotional/mental conditions;
- heart disease (arrhythmias, recent MI);
- stomach/intestinal ulcers;
- any allergies.
Acetaminophen may cause liver damage. Daily use of alcohol, especially when combined with acetaminophen, may increase your risk for liver damage. Check with your doctor or pharmacist for more information.
To prevent oversedation, avoid using alcohol and other sedative type medications while taking Fioricet. Fioricet may make you dizzy or drowsy; use caution engaging in activities requiring alertness such as driving or using machinery. Avoid alcoholic beverages.
Fioricet contains caffeine. Avoid drinking large amounts of caffeinated beverages while taking this medication as excessive nervousness and irritability can occur.
Fioricet should be used during pregnancy only if clearly needed. Small amounts of this medication appear in breast milk. Consult your doctor before breast-feeding.
What should I avoid while taking Fioricet?
This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
Avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen.
Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Check the label to see if a medicine contains acetaminophen or APAP.
While you are taking this medication, avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor’s advice.
Typical dosing for Fioricet
Oral tablets: Each tablet contains 50 mg of butalbital, 325 mg of acetaminophen, and 40 mg of caffeine.
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- Adults and children 12 years and older: The typical dose is 1 to 2 tablets by mouth every 4 hours as needed for pain. Don’t take more than 6 tablets in a 24-hour period.
Oral capsules: Each capsule contains 50 mg of butalbital, 300 mg of acetaminophen, and 40 mg of caffeine.
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- Adults and children 12 years and older: The typical dose is 1 to 2 capsules by mouth every 4 hours as needed for pain. Don’t take more than 6 capsules in a 24-hour period.
Oral solution: Each tablespoonful (15 mL) contains 50 mg of butalbital, 325 mg of acetaminophen, and 40 mg of caffeine.
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- Adults and children 12 years and older: The typical dose is 15 mL (1 tablespoon) to 30 mL (2 tablespoons) by mouth every 4 hours. Don’t take more than 90 mL (6 tablespoons) in a 24-hour period.
Fioricet side effects :
Fioricet may cause the following side effects the first few days as your body adjusts to the medication:
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- lightheadedness;
- dizziness;
- drowsiness;
- stomach upset;
- nausea;
- sleeping disturbances.
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If these symptoms persist or become bothersome, inform your doctor. Notify your doctor immediately if you develop a rapid/ irregular heartbeat.
An allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include :
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- rash;
- itching;
- swelling;
- severe dizziness;
- trouble breathing.
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If you notice other effects of Fioricet not listed above, contact your doctor or pharmacist.
Fioricet – Drug interactions :
Tell your doctor of all prescription and nonprescription drugs you may use, especially of: “blood thinners” Tell your doctor or pharmacist of all prescription and nonprescription drugs you may use that cause drowsiness such as :
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- medicine for sleep (e.g., sedatives);
- tranquilizers;
- anti-anxiety drugs (e.g., diazepam);
- narcotic pain relievers (e.g., codeine);
- psychiatric medicines (e.g., phenothiazines such as chlorpromazine, or tricyclics such as amitriptyline);
- anti-seizure drugs (e.g., carbamazepine);
- muscle relaxants;
- antihistamines that cause drowsiness (e.g., diphenhydramine).
Because Fioricet contains acetaminophen, check with your doctor or pharmacist before taking other medications containing acetaminophen which is commonly found in nonprescription pain relievers and cough-and-cold products. Read labels carefully to check ingredients.
Fioricet may interfere with the effectiveness of birth control pills. Discuss using other methods of birth control with your doctor. Do not start or stop any medicine without doctor or pharmacist approval.
Fioricet overdose :
If Fioricet overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of Fioricet overdose may include :
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- vomiting;
- unusual drowsiness;
- lack of feeling alert;
- slow or shallow breathing;
- cold or clammy skin;
- loss of consciousness;
- dark urine;
- stomach pain;
- extreme fatigue.
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What Are The Symptoms Of A Fioricet Overdose?
While Butalbital is the addictive ingredient in Fioricet, Acetaminophen is the ingredient which is liable to cause an overdose. Unfortunately, people who misuse Fioricet as a recreational drug or as a way to suppress withdrawal are most likely to suffer an overdose.
When a person overdoses on Fioricet, the Acetaminophen will damage their liver. In severe cases, an overdose can even provoke fatal liver failure. For this reason, it is dangerous to take Fioricet together with another medication which contains Acetaminophen because it increases the risk of overdose and death. Furthermore, drinking alcohol while taking Fioricet may also inflict liver damage.
A Fioricet overdose is a medical emergency, so it’s important to know the symptoms. An overdose on Fioricet may cause jaundice, a yellowing of the skin and eyes. Other symptoms of an overdose include:
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- Confusion
- Convulsions and seizures
- Fainting
- Irregular heartbeat
- Lack of appetite
- Nausea and vomiting
- Restlessness
- Stomach pain
- Sweating
- Tremors
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Fioricet – Missed dose :
If you miss Fioricet dose, take it as soon as remembered; do not take if it is almost time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not “double-up” the Fioricet dose to catch up.
Fioricet Storage :
Store Fioricet at room temperature away from moisture and sunlight. Do not store Fioricet in the bathroom.
Fioricet FAQs
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What is the active ingredients of Fioricet ?
Fioricet is a prescription drug often used to treat tension headaches that contains the following active ingredients:
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- Acetaminophen 300 mg
- Butalbital 50 mg
- Caffeine 40 mg
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Each of these three ingredients stays in the body for different lengths of time, meaning that Fioricet can stay in the system for up to eight days.
Is Fioricet Addictive?
Although it’s only a prescription headache medication, Fioricet has the potential to cause addiction. If a person follows their prescription guidelines and uses the medication correctly, the risks of addiction are low. However, if someone takes too much Fioricet, they may develop tolerance to its effects. A person with tolerance to a certain dose of Fioricet will require higher doses of the medication to alleviate their headaches.
When a person with tolerance starts to take more Fioricet, possibly by obtaining more prescriptions, they may eventually become dependent on it. In other words, they may feel unable to get through the day without taking Fioricet; if they stop, they will experience symptoms of withdrawal. These symptoms arise because their body has grown accustomed to Fioricet in high doses.
If a Fioricet-dependent person attempts to weather withdrawal alone, it’s likely they will take Fioricet again just to relieve the symptoms of withdrawal. This is a hallmark characteristic of addiction. Anyone who compulsively abuses Fioricet to avoid withdrawal likely has an addiction to Fioricet. Additionally, people with an addiction to Fioricet will experience cravings for the medication which further compel them to keeping using it.
Moreover, the ingredient Butalbital is an addictive substance in its own right. Butalbital can cause someone to get “high” because it’s a Central Nervous System (CNS) Depressant. Since Butalbital is part of Fioricet, it is possible for someone to abuse Fioricet as a recreational drug. At high doses, Fioricet can intoxicate a person in a manner similar to alcohol. People who abuse Fioricet for this purpose have as much of a risk of developing an addiction as they would have if they repeatedly used an illegal drug.
Can I stop taking Fioricet if my headache goes away?
If you’ve been taking Fioricet regularly, don’t stop taking it without talking to your healthcare provider first. Suddenly stopping it can lead to serious withdrawal symptoms, such as seizures, hallucinations, and worsening of headaches. Talk to your healthcare provider to slowly and safely lower your dose to help limit withdrawal symptoms.
Can I drink alcohol while taking Fioricet?
No, it’s not recommended to drink alcohol while taking this medication. Combining alcohol and Fioricet can further slow down your brain activity and lead to breathing problems, excessive sleepiness, confusion, dizziness, coma, and even death. Drinking alcohol can also raise your risk of liver injury with this medication. Let your healthcare provider know if you have a history of alcohol use before starting Fioricet.
Is it safe to use Fioricet during pregnancy?
There isn’t enough information available to know if Fioricet is safe to take during pregnancy. It’s also unknown if this medication can cause harm to your unborn baby or affect your chances of becoming pregnant. If you’re pregnant or planning on becoming pregnant, discuss the risks and benefits of using Fioricet with your healthcare provider.
What makes Fioricet a controlled medication in some states?
Fioricet is a controlled medication in some states, because it contains butalbital. Because butalbital can make people feel relaxed, there’s a risk of misuse, meaning people might take the medication for a different reason or in a different way than it’s prescribed. Taking butalbital for a long time can also cause physical dependence, where more medication is needed to get the same relaxed feeling. Physical dependence can lead to serious withdrawal symptoms if you lower the dose too quickly or if you stop the medication suddenly. These symptoms include seizures, delusions, restlessness, trouble sleeping, and shakiness. Because of these dangerous risks with butalbital use, some state governments place strict regulations on Fioricet to lower the risk of misuse, dependence, and related consequences.
Why is Fioricet a controlled medication in some states and not others?
State laws can differ when categorizing Fioricet as a controlled medication. In some states, whether Fioricet is controlled or not depends on how much butalbital it contains compared to other ingredients and how likely the medication can cause the dangerous risk of misuse and dependence. In other states, Fioricet is categorized as a controlled medication solely based on the fact that butalbital alone is a controlled medication.
Duration of Effects of Fioricet
The effects of Fioricet last for about 2–4 hours. It is normally prescribed as one or two capsules taken by mouth every 4 hours.
Fioricet Half-Life
The half-life of a drug refers to the time it takes for half of the dose to be eliminated from the bloodstream. Each ingredient in Fioricet has a unique half-life:
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- Acetaminophen: 2 hours
- Butalbital: 36 hours
- Caffeine: 6 hours
The body takes about five half-lives to eliminate a drug fully. Acetaminophen leaves the body in 10 hours and caffeine in 30 hours.
Butalbital has the longest half-life of the ingredients in Fioricet, so the elimination time of the drug is dependent on butalbital. Butalbital takes 180 hours, or almost eight days, to leave the body.
How Long Will Fioricet Show in a Drug Test?
Most standard drug tests will look for barbiturates, including the butalbital in Fioricet. Different types of drug tests may show traces of Fioricet for varying lengths of time.
Urine
Several factors affect the detection window of Fioricet, but most urine tests will pick up butalbital use 3–7 days from the last dose.
Blood
Butalbital has a very long half-life and is detectable in blood for roughly 8 days. However, blood tests are not frequently used to detect drug use because they are expensive and invasive.
Saliva
Butalbital, one of the main active ingredients in Fioricet, is detectable in saliva for 2–3 days.
Hair
All drugs have a similar window of detection in hair tests. During use, butalbital deposits into hair follicles and becomes locked in the hair. Most tests take 1.5 centimeters (cm) of hair because Fioricet can be detected in hair for 90 days.
Factors Affecting How Long Fioricet Stays in Your System
There are several factors that influence how long Fioricet stays in your system, including:
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- Amount used
- Frequency of use
- Age
- Overall health
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The detection window for Fioricet is most affected by how much of the drug someone uses and how often. Butalbital takes a long time to metabolize, so it will accumulate after only a few doses and remain detectable in the body for sometimes over a week.
False Positives for Fioricet
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can trigger false positives for butalbital, but this happens less than 1% of the time.
A positive drug test will usually be sent to another lab for a confirmation test called gas chromatography-mass spectrometry (GC-MS). GC-MS tests are very sensitive and specific, so they will not typically report false-positives.
How Fioricet Is Broken Down in the Body
Butalbital is mostly filtered out of the blood by the kidneys and removed in the urine. Acetaminophen and caffeine are both metabolized and removed by the liver.
How to Get Fioricet Out of Your System
The only way to remove drugs from the body is to wait the appropriate amount of time. Metabolizing organs, like the kidney for butalbital, require time to eliminate drugs.
Key Points: How Long Does Fioricet Stay in Your System?
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- Fioricet contains the three drugs acetaminophen, butalbital and caffeine
- Butalbital can be detected in drug screening tests
- Butalbital takes many days to leave the body, sometimes over a week
- Most drug tests can detect butalbital for one week or longer
The only guaranteed way to pass a drug test is by not taking the drug. If you or a loved one struggle with an addiction to Fioricet, call The Recovery Village Ridgefield to learn more about treatment options.
The Symptoms Of Withdrawal
In most cases, Fioricet withdrawal lasts anywhere from 8 hours to three days after the last dose. Withdrawal is the biggest obstacle to overcoming dependence on Fioricet, which is why rehab centers provide detox programs so that people can safely undergo the withdrawal cycle without the risk of relapse. According to research, it is best to undergo withdrawal under medical supervision because some withdrawal symptoms are dangerous.
Rebound headaches are the most common symptoms of Fioricet withdrawal. Other symptoms of withdrawal include:
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- Anxiety
- Dizziness
- Insomnia
- Muscle spasms
- Nausea and vomiting
- Rapid emotional changes
- Seizures (in rare cases)
- Weakness
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