What is Fioricet (Butalbital APAP Caffeine) ?

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.

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.

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 side effects can this medication cause?

Acetaminophen, Butalbital, Caffeine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

    • drowsiness
    • upset stomach
    • vomiting
    • stomach pain
    • depression
    • lightheadedness
    • confusion

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 (http://www.fda.gov/Safety/MedWatch) 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 (http://goo.gl/c4Rm4p) 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. http://www.upandaway.org

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 https://www.poisonhelp.org/help. 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.

 

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.

Last Revised – 05/15/2019