Fioricet®

Fioricet is a combination medication composed of acetaminophen (Tylenol’s main ingredient), caffeine, and butalbital. It is used to relieve tension headaches and can also be prescribed to treat mild to moderate migraine.

Butalbital belongs to the barbiturate class of medication, which means it is a sedative, or relaxant.1 This makes Fioricet a barbiturate. Because it contains acetaminophen and caffeine, it is also a pain reliever and a stimulant.

Medications containing this combination of ingredients come in capsule and tablet forms, which can be taken by mouth. This combination of medications is also available in generics. Other brand names and formulations include:

  • Esgic®
  • Fioricet® with Codeine (containing Acetaminophen, Butalbital, Caffeine, Codeine)
  • Phrenilin® with Codeine (containing Acetaminophen, Butalbital, Caffeine, Codeine)2

What are the ingredients in Fioricet?

The active ingredients in Fioricet are acetaminophen, caffeine, and butalbital.

How does Fioricet work?

The acetaminophen in Fioricet is a pain reliever, the caffeine works as a stimulant to increase the acetaminophen’s effectiveness, and the butalbital is a sedative that decreases anxiety while causing relaxation and sleepiness. These actions are believed to ease migraine symptoms, but there is limited evidence that barbituates ease migraine symptoms.1

Learn more about how Fioricet works, officially called the mechanism of action.

What are the possible side effects of Fioricet?

The most common side effects from Fioricet include:

  • Drowsiness
  • Upset stomach
  • Vomiting
  • Stomach pain
  • Depression
  • Lightheadedness
  • Confusion3

The following side effects could be signs of allergy or more serious complications and should be reported to health provider immediately:

  • Skin rash
  • Itching
  • Difficulty breathing2

This is not an exhaustive list of all potential side effects of Fioricet. For more information, consult your doctor or healthcare provider. If you notice any new or worsening side effects, contact your doctor or healthcare provider immediately.

Things to note about Fioricet

Fioricet can be habit-forming, so you should use extreme caution if you decide to take it. Additionally, some people who take barbituates or opioids for extended periods can experience rebound headaches, which can increase in severity. These are also known as MOH, or medication overuse headaches.1

Barbituates can cause drowsiness, and their effect can be increased by alcohol use. It is important not to drive or use heavy machinery until you know how this drug affects you.2

Before taking Fioricet, tell your doctor if you:

  • Are allergic to any ingredients in the medication
  • Are taking blood thinners, antidepressants, antihistamines, or other sedatives like sleeping pills or tranquilizers.
  • Are taking pain medications. Many over-the-counter pain relievers contain acetaminophen, and too much of this drug can be harmful.
  • Have ever had liver disease, porphyria, or depression
  • Are pregnant, plan to become pregnant, or are breastfeedingii

Dosing information

Patients should take 1 or 2 tablets every 4 hours as needed. Your total daily dosage should not exceed 6 tablets. Fioricet can cause upset stomach, so you should take this medication with food or milk.3

Written by: Sara Finkelstein | Last reviewed: June 2018.
View References
  1. Treating Migraine Headaches. ABIM Foundation. Published February 2013. http://www.choosingwisely.org/patient-resources/treating-migraine-headaches/ Accessed May 10, 2018.
  2. Acetaminophen, Butalbital, and Caffeine. MedLine Plus National Library of Medicine. Published 2/15/2018. https://medlineplus.gov/druginfo/meds/a601009.html Accessed May 10, 2018.
  3. Fioricet. DailyMed. US National Library of Medicine. Published April 13, 2016. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d63959d5-b1dc-4422-8f69-7599f8b11f4a&audience=consumer Accessed May 10, 2018.