Disadvantages of taking Fiorinal or Fioricet for headaches


For people with tension headaches that do not respond to over-the-counter (OTC) medications, combination medications that include butalbital can help.

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Generally prescribed as Fioricet (butalbital / acetaminophen / caffeine) or Fiorinal (butalbital / aspirin / caffeine), butalbital is a sedative in the barbiturate class of drugs. Although the drug induces great relaxation and relieves tension headaches, it is not without risks.

Tension headaches

The most common type of headache, a tension headache , occurs when the muscles in the neck and scalp tighten or contract – that is, they contract. This causes pain, often described as the sensation of wrapping an elastic band around the head or a sensation of pressure on both sides of the head.

Tension headaches can be caused by a number of factors, including stress, hunger, lack of sleep, anxiety, and changes in temperature. They can occur at any age, but are more common in older adults and adolescents. Some people are more prone or vulnerable to developing tension headaches than others, although the reason for this is not very clear.

Most tension headaches are mild and can be easily relieved with rest, drinking fluids, removing the trigger, and / or over-the-counter medications such as motrin (ibuprofen) or Tylenol (acetaminophen). Behavioral therapy can also be effective, such as physical therapy or cognitive behavioral therapy .


If recurring tension headaches don't respond to other medications, your healthcare provider may prescribe Fiorinal or Fioricet. Codeine can also be added to this combination of drugs. While this drug is very effective in the short term, there are a few things to keep in mind.

Butalbital is a barbiturate, which means that it helps slow down the central nervous system and relax the muscle tension that is believed to be associated with tension headaches.

Before taking medicines containing butalbital, tell your doctor if:

  • You are allergic to any of the ingredients in the medicine, such as acetaminophen or aspirin.
  • You are currently taking blood thinners, antidepressants, antihistamines, or other sedatives such as sleeping pills or tranquilizers.
  • Have or have ever had liver disease, porphyria, or depression.
  • You are pregnant, planning to become pregnant, or are breastfeeding.


Always take these medications as directed by your doctor. According to the manufacturer, the typical dosage for Fioricet or Fiorinal is one to two tablets, every four to six hours as needed, but no more than six tablets per day. These medications should not be taken more than twice a week, as prolonged and repeated use of butalbital can lead to physical dependence.

  • Fioricet contains 50 milligrams (mg) of butalbital, 300 mg of acetaminophen, and 40 mg of caffeine.
  • Fiorinal contains 50 mg of butalbital, 325 mg of aspirin and 40 mg of caffeine.

Side effects

Fioricet and Fiorinal should be taken with food or milk to prevent stomach problems. The following side effects have been reported in people taking medicines containing butalbital:

  • Confusion
  • Depression
  • Drowsiness
  • Daze
  • Abdominal pain
  • Stomach ache
  • Threw up

More serious side effects can occur, which can be signs of allergies or serious complications. Call your doctor immediately if you experience any of the following:

  • Difficulty breathing
  • Itching
  • Rash


Butalbital-containing drugs can be addictive and addictive and other problems. The risks of taking Fioricet and Fiorinal include:


Butalbital slows down the central nervous system, leading to poor coordination, problems with thinking and memory, slow speech, disinhibition, and emotional distress. Do not drive or operate heavy machinery while taking medicines that contain butalbital.

Headache from overuse of medications

Medication overuse headache (MOH), formerly known as recurrent headache, drug-induced headache, or drug abuse headache, is a chronic headache that results from prolonged and frequent use of certain medications for acute headaches. These headaches are a common side effect of several classes of medications used to treat headaches.

According to the International Classification of Headache Disorders, MOH is diagnosed when a person has a headache 15 or more times a day, and in the case of combined pain relievers like Fioricet and Fiorinal, they have been taking the drug for 10 days per month. or longer. three months.

Also, headaches related to over medication often do not respond to prophylactic headache medications. Lack of response to other medications is often a sign to healthcare professionals that they are having a headache due to overuse of medications.

Medicines containing butalbital should be limited to two days a week to avoid this reversal effect.


While taking butalbital, you may experience withdrawal symptoms within eight to 36 hours after your last dose. Withdrawal symptoms can include restlessness, muscle spasms, tremors, weakness, dizziness, nausea and vomiting, insomnia, weight loss, and even seizures after stopping the drug.

Due to the risk of seizures when withdrawing butalbital , treatment is indicated under supervision and under the supervision of a physician.

Tolerance and dependency

Tolerance and addiction can also occur with butalbital. Tolerance means that the person needs more medicine to relieve the headache. Butalbital addiction is characterized by persistent behaviors, such as being forced to take medications that contain butalbital.

This behavior makes your life worse in some way, negatively affecting relationships and / or day-to-day functioning.

Acetaminophen overdose

Do not take Fioricet together with other medications that contain acetaminophen as it can be toxic to the liver.

Get the word of drug information

Fiorinal and Fioricet can be prudent medications at times, such as when other headache medications don't work or can't be used. However, its use should be limited and its use should be closely monitored under the guidance of a healthcare provider.

If you have any questions or concerns about taking medicines that contain butalbital, talk to your doctor. Also, remember that you cannot stop taking medicine or change your dose without first consulting your doctor.

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