What is Fioricet?

If you’re struggling with constant All kinds of Headache, your doctor might prescribe you a medication called Fioricet.

This proprietary, brand name medication is actually a combination of other medications. The basic component is, surprisingly enough, acetaminophen, a common pain relieving medication that you can easily get over the counter. Since it’s mixed with another powerful medication, though, it’s something that you can only get by prescription.

Fioricet Generic
Fioricet Generic

The second ingredient in this medication is Butalbital, which is a barbiturate, commonly used to relieve muscle tension. Since many of the worst All kinds of Headache 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.

Firoicet CLINICAL PHARMACOLOGY

Fioricet is intended as a treatment for tension headache.

It consists of a fixed combination of butalbital, acetaminophen, and caffeine. The role each component plays in the relief of the complex of symptoms known as tension headache is incompletely understood.

Pharmacokinetics

The behavior of the individual components is described below.

Butalbital Butalbital is well absorbed from the gastrointestinal tract and is expected to distribute to most tissues in the body. Barbiturates in general may appear in breast milk and readily cross the placental barrier. They are bound to plasma and tissue proteins to a varying degree and binding increases directly as a function of lipid solubility. Elimination of butalbital is primarily via the kidney (59% to 88% of the dose) as unchanged drug or metabolites. The plasma half-life is about 35 hours. Urinary excretion products include parent drug (about 3.6% of the dose), 5-isobutyl-5-(2, 3-dihydroxypropyl) barbituric acid (about 24% of the dose), 5-allyl-5(3-hydroxy-2-methyl-1-propyl) barbituric acid (about 4.8% of the dose), products with the barbituric acid ring hydrolyzed with excretion of urea (about 14% of the dose), as well as unidentified materials. Of the material excreted in the urine, 32% is conjugated. The in vitro plasma protein binding of butalbital is 45% over the concentration range of 0.5-20 mcg/mL. This falls within the range of plasma protein binding (20%-45%) reported with other barbiturates such as phenobarbital, pentobarbital, and secobarbital sodium. The plasma-to-blood concentration ratio was almost unity, indicating that there is no preferential distribution of butalbital into either plasma or blood cells. Acetaminophen Acetaminophen is rapidly absorbed from the gastrointestinal tract and is distributed throughout most body tissues. The plasma half-life is 1.25 to 3 hours, but may be increased by liver damage and following overdosage. Elimination of acetaminophen is principally by liver metabolism (conjugation) and subsequent renal excretion of metabolites. Approximately 85% of an oral dose appears in the urine within 24 hours of administration, most as the glucuronide conjugate, with small amounts of other conjugates and unchanged drug. Caffeine Like most xanthines, caffeine is rapidly absorbed and distributed in all body tissues and fluids, including the CNS, fetal tissues, and breast milk. Caffeine is cleared through metabolism and excretion in the urine. The plasma half-life is about 3 hours. Hepatic biotransformation prior to excretion results in about equal amounts of 1-methylxanthine and 1-methyluric acid. Of the 70% of the dose that is recovered in the urine, only 3% is unchanged drug.

Fioricet INDICATIONS AND USAGE

Fioricet (Butalbital, Acetaminophen, and Caffeine Tablets, USP) is indicated for the relief of the symptom complex of tension (or muscle contraction) headache.

Evidence supporting the efficacy and safety of Fioricet in the treatment of multiple recurrent headaches is unavailable. Caution in this regard is required because butalbital is habit-forming and potentially abusable.

Fioricet PRECAUTIONS and Warnings

General

Butalbital, acetaminophen, and caffeine tablets should be prescribed with caution in certain special-risk patients, such as the elderly or debilitated, and those with severe impairment of renal or hepatic function, or acute abdominal conditions.

Information for Patients

Fioricet may impair mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery. Such tasks should be avoided while taking this product.

Alcohol and other CNS depressants may produce an additive CNS depression when taken with Fioricet, and should be avoided. Butalbital may be habit-forming. Patients should take the drug only for as long as it is prescribed, in the amounts prescribed, and no more frequently than prescribed.

Laboratory Tests

In patients with severe hepatic or renal disease, effects of therapy should be monitored with serial liver and/or renal function tests.

Fioricet Drug Interactions

Fioricet Interaction
Fioricet Interaction

SEVERE INTERACTIONS

These medications are not usually taken together. Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation.

      • SEDATIVE HYPNOTICS; ALCOHOL/SODIUM OXYBATE
      • XANTHINE DERIVATIVES/DIPYRIDAMOLE INJECTABLE

SERIOUS INTERACTIONS

These medications may interact and cause very harmful effects. Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation.

      • THEOPHYLLINE DERIVATIVES/CIMETIDINE
      • SELECTED ANTICONVULSANTS; BARBITURATES/CONTRACEPTIVES
      • STRONG CYP3A4 INDUCERS/ARIPIPRAZOLE LAUROXIL SUBMICRONIZED
      • SELECTED BARBITURATES/SELECTED ANTICONVULSANTS
      • SELECTED BARBITURATES/LAMOTRIGINE
      • SELECTED BARBITURATES/ESLICARBAZEPINE
      • SELECTED BARBITURATES/CARBAMAZEPINE
      • STRONG CYP3A4 INDUCERS/TRABECTEDIN
      • STRONG CYP3A4 INDUCERS/FLIBANSERIN
      • STRONG CYP3A4 INDUCERS/QUETIAPINE (> 150 MG)
      • STRONG CYP3A4 INDUCERS/TOLVAPTAN
      • STRONG CYP3A4 INDUCERS/SELECTED IMMUNOSUPPRESSANTS
      • ACETAMINOPHEN/SODIUM FUSIDATE
      • XANTHINE DERIVATIVES/ADENOSINE; HEXOBENDINE; REGADENOSON
      • BARBITURATES/METHOXYFLURANE
      • BARBITURATES/SELECTED ANTICOAGULANTS (VIT K ANTAGONISTS)

MODERATE INTERACTIONS

These medications may cause some risk when taken together. Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation.

      • BARBITURATES; HYDANTOINS/QUINIDINE
      • THEOPHYLLINE DERIVATIVES/LITHIUM
      • SELECTED ANTICONVULSANTS/ESTROGENS
      • SELECTED XANTHINE DERIVATIVES/FLUVOXAMINE
      • ACETAMINOPHEN/ISONIAZID
      • BARBITURATES/PHENOTHIAZINES
      • BARBITURATES/RIFAMPIN
      • ACETAMINOPHEN/BUSULFAN
      • ACETAMINOPHEN/SELECTED ANTICOAGULANTS
      • STRONG CYP3A4 INDUCERS/SELECTED ANTIPSYCHOTICS
      • SELECTED ANTICONVULSANTS/FELODIPINE
      • BARBITURATES/METRONIDAZOLE
      • BARBITURATES; HYDANTOINS/THEOPHYLLINE
      • CYP3A4 INDUCERS/DOXYCYCLINE
      • SELECTED CYP3A4 INDUCERS/CORTICOSTEROIDS
      • BARBITURATES/SELECTED BETA-BLOCKERS

The CNS effects of butalbital may be enhanced by monoamine oxidase (MAO) inhibitors.

Butalbital, acetaminophen, and caffeine may enhance the effects of: other narcotic analgesics, alcohol, general anesthetics, tranquilizers such as chlordiazepoxide, sedative-hypnotics, or other CNS depressants, causing increased CNS depression.

Drug/Laboratory Test Interactions

Acetaminophen may produce false-positive test results for urinary 5-hydroxyindoleacetic acid.

Carcinogenesis, Mutagenesis, Impairment of Fertility

No adequate studies have been conducted in animals to determine whether acetaminophen or butalbital have a potential for carcinogenesis, mutagenesis or impairment of fertility.

Pregnancy

Teratogenic Effects

Pregnancy Category C: Animal reproduction studies have not been conducted with Fioricet. It is also not known whether butalbital, acetaminophen, and caffeine can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. This product should be given to a pregnant woman only when clearly needed.

Nonteratogenic Effects

Withdrawal seizures were reported in a two-day-old male infant whose mother had taken a butalbital-containing drug during the last two months of pregnancy. Butalbital was found in the infant’s serum. The infant was given phenobarbital 5 mg/kg, which was tapered without further seizure or other withdrawal symptoms.

Nursing Mothers

Caffeine, barbiturates, and acetaminophen are excreted in breast milk in small amounts, but the significance of their effects on nursing infants is not known. Because of potential for serious adverse reactions in nursing infants from butalbital, acetaminophen, and caffeine, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Pediatric Use

Safety and effectiveness in pediatric patients below the age of 12 have not been established.

Geriatric Use

Clinical studies of Fioricet (Butalbital, Acetaminophen, and Caffeine Tablets, USP) did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

Butalbital is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. Fioricet Overdose sympton and treatment

Following an acute overdosage of butalbital, acetaminophen, and caffeine, toxicity may result from the barbiturate or the acetaminophen. Toxicity due to caffeine is less likely, due to the relatively small amounts in this formulation.

Overdose Signs and Symptoms

Toxicity from barbiturate poisoning include drowsiness, confusion, and coma; respiratory depression; hypotension; and hypovolemic shock.

In acetaminophen overdosage: dose-dependent, potentially fatal hepatic necrosis is the most serious adverse effect. Renal tubular necroses, hypoglycemic coma, and thrombocytopenia may also occur. Early symptoms following a potentially hepatotoxic overdose may include: nausea, vomiting, diaphoresis, and general malaise. Clinical and laboratory evidence of hepatic toxicity may not be apparent until 48 to 72 hours post-ingestion. In adults hepatic toxicity has rarely been reported with acute overdoses of less than 10 grams, or fatalities with less than 15 grams. Acute caffeine poisoning may cause insomnia, restlessness, tremor, and delirium, tachycardia and extrasystoles.

Fioricet Overdose Treatment

Fioricet Overdose Treatment
Fioricet Overdose Treatment

A single or multiple overdose with Fioricet is a potentially lethal polydrug overdose, and consultation with a regional poison control center is recommended.

Immediate treatment includes support of cardiorespiratory function and measures to reduce drug absorption. Vomiting should be induced mechanically, or with syrup of ipecac, if the patient is alert (adequate pharyngeal and laryngeal reflexes). Oral activated charcoal (1 g/kg) should follow gastric emptying. The first dose should be accompanied by an appropriate cathartic. If repeated doses are used, the cathartic might be included with alternate doses as required.

Hypotension is usually hypovolemic and should respond to fluids. Pressors should be avoided. A cuffed endotracheal tube should be inserted before gastric lavage of the unconscious patient and when necessary, to provide assisted respiration. If renal function is normal, forced diuresis may aid in the elimination of the barbiturate.
Alkalinization of the urine increases renal excretion of some barbiturates, especially phenobarbital. Meticulous attention should be given to maintaining adequate pulmonary ventilation. In severe cases of intoxication, peritoneal dialysis, or preferably hemodialysis may be considered.
If hypoprothrombinemia occurs due to acetaminophen overdose, vitamin K should be administered intravenously. If the dose of acetaminophen may have exceeded 140 mg/kg, acetylcysteine should be administered as early as possible. Serum acetaminophen levels should be obtained, since levels four or more hours following ingestion help predict acetaminophen toxicity.
Do not await acetaminophen assay results before initiating treatment. Hepatic enzymes should be obtained initially, and repeated at 24-hour intervals. Methemoglobinemia over 30% should be treated with methylene blue by slow intravenous administration.

Toxic Doses (for adults)

 Butalbital:

    toxic dose

   1 g

   (20 tablets)

 Acetaminophen:

    toxic dose

   10 g

   (30 tablets)

 Caffeine:

    toxic dose

   1 g

   (25 tablets)

In all cases of suspected overdosage, call your Regional Poison Control Center to obtain the most up-to-date information about the treatment of overdosage. Telephone numbers of certified Regional Poison Control Centers are listed in the Physicians’ Desk Reference®.

Fioricet Drug Active Ingrdients and Inactive Ingrdients

Fioricet Customer Reviews

Fioricet Reviews for Headache
Fioricet Reviews for Headache

Patients Review Fioricet is perfect for Tension Headahce and Migraine.

The formulation of this medication is accentuated with a dose of caffeine. Although caffeine doesn’t necessarily stop All kinds of Headache, 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 All kinds of Headache. 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 online, though, make sure that you’re getting it from a reputable online 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 online find that they enjoy the privacy of it. No one needs to know that you’re suffering from All kinds of Headache, 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 All kinds of Headache of all sorts, and you’ll be able to get rid of your All kinds of Headache more efficiently than ever before.

Leave a Reply