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What is Fioricet (Butalbital APAP Caffeine)? Is It for Tension Headache ?

Posted in Fioricet, Migraines

If you’re struggling with constant headaches, your doctor might prescribe you a medication called Fioricet(Butalbital APAP Caffeine). This proprietary, brand name medication is actually a combination of other medications.

Butal/APAP/Caf 50-325-40mg Tab American Health Packaging Pill Identification: 2355 | V
Butal/APAP/Caf 50-325-40mg Tab
American Health Packaging
Pill Identification: 2355 | V

Many people experience tension headaches, which are characterized by pain on the sides, front, or back of the head. Unfortunately, some people may suffer from a dozen or more of these headaches in a single month. People who get chronic tension headaches may rely on Fioricet for relief from the pain.

Fioricet is a prescription combination drug that contains acetaminophen, butalbital, and caffeine. It is used to treat chronic tension headaches and works by relaxing muscle contractions that cause headache pain, stimulating the brain’s production of gamma-aminobutyric acid (also called GABA), increasing blood pressure to improve blood flow, and reducing the activation of pain signals in the nervous system.

Butalbital, one of the main active ingredients in Fioricet, is classified as a barbiturate and acts as a sedative in the body. It is a Schedule II drug in America, meaning it has a relatively high potential for abuse, dependence, and addiction. The other active ingredients in Fioricet are caffeine, which is a central nervous system stimulant, and acetaminophen, which is a pain and fever reducer.

Fioricet is generally taken by mouth with or without food every four hours as needed.2 People who take Fioricet may be at risk of developing tolerance, physical dependence, or addiction, especially if they take the drug excessively.  It can also cause dangerous side effects or an overdose if it is abused. Due to the high risk of addiction, many doctors will prescribe other over-the-counter headache relief medications before prescribing Fioricet.

Butalbital is also sold under the brand name Fiorinal (aspirin, butalbital, and caffeine) and may sometimes be used to treat migraines.

The basic component is, surprisingly enough, acetaminophen, a common pain relieving medication that you can easily get over the counter. Because it’s mixed with another powerful medication, though, it’s something that you can only get by prescription.

The second ingredient in this medication is Butalbital, which is a barbiturate, commonly used to relieve muscle tension. Since many of the worst headaches that you can get are actually caused by tense muscles in the neck and shoulders, this is a very helpful addition to a very helpful pain killer.

The formulation of this medication is accentuated with a dose of caffeine. Although caffeine doesn’t necessarily stop headaches, it does have an effect on the central nervous system.

It stimulates the veins and relaxes them, allowing blood to flow more freely. This, in and of itself, can have a mild pain relieving effect on headaches. However, it’s mainly useful because it can help the other two drugs to be delivered to the body’s various systems more easily.

Fioricet is a medication that you need a prescription for, but you don’t necessarily have to buy it through traditional pharmacies. These days, online pharmacies are very popular for buying medications like these. It’s easy because you don’t have to actually go anywhere to get your medications. They can be delivered right to your door for a minimal cost.

Before you purchase Fioricet ( Butalbital APAP Caffeine ) online, though, make sure that you’re getting it from a reputable Internet On Line Drugstore where you are assured of the quality of your medication and the quantity you’re going to get. One of the main advantages of buying online is that you can save money, too, but make sure you’re getting what you pay for with this medication.

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Many people who purchase Fioricet( Butalbital APAP Caffeine ) online find that they enjoy the utter privacy of it. No one needs to know that you’re suffering from headaches, but you can get relief easily and quickly by having your medication delivered to your door. One you start taking this medication, you’ll see just how quickly and effectively it works on headaches of all sorts, and you’ll be able to get rid of your headaches more efficiently than ever before.

What special precautions should I follow?

Before taking acetaminophen, Butalbital, Caffeine,

    • tell your doctor and pharmacist if you are allergic to acetaminophen, butalbital, caffeine, or any other drugs.
    • tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially anticoagulants (‘blood thinners’) such as warfarin (Coumadin), antidepressants, antihistamines, pain medications, sedatives, sleeping pills, tranquilizers, and vitamins. Many nonprescription pain relievers contain acetaminophen. Too much of this drug can be harmful.
    • tell your doctor if you have or have ever had liver disease, porphyria, or depression.
    • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking this medication, call your doctor.
    • you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
    • remember that alcohol can add to the drowsiness caused by this drug.

What special dietary instructions should I follow?

Acetaminophen, Butalbital, Caffeine may cause an upset stomach. Take this medicine with food or milk.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What Are Fioricet Side Effects ?

Fioricet, a medication commonly prescribed for tension-type headaches and migraines, can have several potential side effects. It’s important to be aware of these side effects and to discuss them with your healthcare provider. Common Fioricet side effects include:

  1. Drowsiness: Fioricet contains butalbital, a barbiturate that can cause drowsiness or sedation. It’s important to avoid activities that require mental alertness, such as driving or operating heavy machinery, while taking Fioricet if you experience drowsiness.
  2. Dizziness: Some people may experience dizziness or lightheadedness when taking Fioricet.
  3. Nausea and Vomiting: Fioricet can cause gastrointestinal upset, leading to nausea and, in some cases, vomiting.
  4. Abdominal Pain: Stomach discomfort or abdominal pain is a possible side effect of Fioricet.
  5. Tolerance and Dependence: Long-term or frequent use of Fioricet can lead to tolerance, meaning the medication becomes less effective over time. Additionally, it contains butalbital, which has the potential for dependence and addiction, so it should be used as prescribed.
  6. Overuse Headaches: Overusing Fioricet can lead to medication overuse headaches or rebound headaches, where headaches become more frequent and severe.
  7. Rash: Skin rash is a rare side effect but should be reported to a healthcare provider if it occurs.
  8. Shortness of Breath: In rare cases, Fioricet can cause respiratory depression, which can lead to difficulty breathing. Seek immediate medical attention if you experience this symptom.
  9. Allergic Reactions: While rare, some individuals may experience allergic reactions to Fioricet, which can include hives, itching, swelling, severe dizziness, and difficulty breathing. Seek emergency medical help if you experience these symptoms.
  10. Liver Problems: Fioricet contains acetaminophen, and in high doses or with prolonged use, it can potentially lead to liver problems. It’s essential not to exceed the recommended dosage.
  11. Kidney Problems: There have been reports of kidney issues associated with long-term Fioricet use.
  12. Cardiovascular Effects: Fioricet may cause changes in heart rate or blood pressure, although this is less common.
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It’s crucial to use Fioricet only as prescribed by your healthcare provider and to discuss any side effects or concerns with them. If you experience severe or unusual side effects, seek medical attention promptly. Additionally, if you find that you need to use Fioricet frequently to manage your headaches, it’s essential to consult with your healthcare provider, as this may indicate the need for a different treatment approach to prevent medication overuse headaches.

If you experience any of the following symptoms, call your doctor immediately:

    • skin rash
    • itching
    • difficulty breathing

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online ( or by phone (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature, away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website ( for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach.

In case of emergency/overdose

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.

What other information should I know?

Keep all appointments with your doctor.

Do not let anyone else take your medication. This medication is a controlled substance. Prescriptions may be refilled only a limited number of times; ask your pharmacist if you have any questions.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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Brand names

  • Alagesic®
  • Americet®
  • Anolor®
  • Anoquan®
  • Arcet®
  • Dolgic®
  • Dolmar®
  • Endolor®
  • Esgic®
  • Ezol®
  • Femcet®
  • Fioricet®
  • Fiorpap®
  • G-1®
  • Ide-cet®
  • Isocet®
  • Margesic®
  • Medigesic®
  • Minotal®
  • Mygracet®
  • Nonbac®
  • Pacaps®
  • Pharmagesic®
  • Quala Cet®
  • Repan®
  • Tenake®
  • Tencet®
  • Triad®
  • Two-Dyne®
  • Zebutal®

Brand names of combination products

  • Esgic® Plus (containing Acetaminophen, Butalbital, Caffeine, Codeine)
  • Geone® (containing Acetaminophen, Butalbital, Caffeine)
  • Orbivan® (containing Acetaminophen, Butalbital, Caffeine)
  • Fioricet® with Codeine (containing Acetaminophen, Butalbital, Caffeine, Codeine)
  • Phrenilin® with Caffeine and Codeine (containing Acetaminophen, Butalbital, Caffeine, Codeine)

This branded product is no longer on the market. Generic alternatives may be available.

What Are the Drug Interactions of Fioricet ?

Fioricet, a combination medication containing acetaminophen, butalbital, and caffeine, can interact with other drugs, potentially leading to adverse effects or reduced effectiveness. It’s crucial to inform your healthcare provider about all the medications, supplements, and herbal products you are taking before starting Fioricet. Here are some drug interactions to be aware of:

  1. Alcohol: Combining Fioricet with alcohol can increase the risk of drowsiness, dizziness, and liver damage. It’s best to avoid alcohol while taking Fioricet.
  2. Other Central Nervous System Depressants: Fioricet contains butalbital, which is a central nervous system depressant. Taking it with other medications or substances that depress the central nervous system, such as sedatives, tranquilizers, or certain antipsychotic drugs, can enhance the sedative effects and increase the risk of drowsiness and respiratory depression.
  3. Monoamine Oxidase Inhibitors (MAOIs): Combining Fioricet with MAOIs or within 14 days of discontinuing MAOIs can lead to severe reactions, including high blood pressure, hyperactivity, and confusion.
  4. Anticoagulants (Blood Thinners): The caffeine in Fioricet may interact with anticoagulant drugs like warfarin, potentially affecting blood clotting. Monitoring and dosage adjustments may be necessary.
  5. Anticonvulsants: Some anticonvulsant medications may reduce the effectiveness of Fioricet. Consult with your healthcare provider if you are taking anticonvulsants.
  6. Certain Antidepressants: Fioricet may interact with certain antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), potentially increasing the risk of serotonin syndrome, a rare but serious condition. Symptoms of serotonin syndrome may include confusion, hallucinations, rapid heartbeat, fever, and muscle stiffness.
  7. Blood Pressure Medications: The caffeine in Fioricet can interact with blood pressure medications, potentially leading to increased blood pressure. It’s essential to monitor your blood pressure regularly.
  8. Medications That Affect Liver Enzymes: Some drugs can affect liver enzymes, potentially influencing the way the body metabolizes acetaminophen in Fioricet. This can impact the safety and efficacy of Fioricet.
  9. Certain Antibiotics: Some antibiotics may interact with caffeine, potentially affecting its metabolism and leading to increased caffeine levels in the body.
  10. Oral Contraceptives: Some studies suggest that the caffeine in Fioricet may affect the metabolism of oral contraceptives, potentially reducing their effectiveness.

These are examples of potential drug interactions with Fioricet, but the list is not exhaustive. Always consult with your healthcare provider or pharmacist before starting or stopping any medications while taking Fioricet to ensure safety and appropriate monitoring.

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