Fioricet 50/325/40

• Generic name: Butalbital/Acetaminophen/Caffeine
• Brand/Trade names: Alagesic, Geone, Fioricet, Margesic, Repan
• Dosages: 50-325-40 mg tablets
• Pharmacologic category: Combined Analgesic
• Habit forming? Yes
• Pregnancy risk factor: C

Fioricet, introduced in the US in the 1960s, is a pain reliever and sedative used to relieve tension headaches, and sometimes other types of pain. According to the customer reviews, Fioricet is a very popular prescription for migraine. However, butalbital-containing compounds are prescribed for migraines without FDA approval.

This analgesic consists of a fixed combination of butalbital 50 mg, acetaminophen 325 mg and caffeine 40 mg. Acetaminophen is a pain reliever and fever reducer (antipyretic). Butalbital is in a class of drugs called barbiturates that slow down central nervous system causing relaxation. Caffeine is believed to constrict dilated blood vessels that may contribute to tension headaches.

• Elimination half-life:
  Butalbital: 35 hours
  Acetaminophen: 1.25-3 hours, may be increased by liver damage and following overdosage
  Caffeine: 3 hours

• proven efficacy in the treatment of tension headache (2)
• may be effective as reserve medication or when other medicines are ineffective or cannot be used (2)
• superior to acetaminophen with codeine in alleviating emotional or psychic tension (3)
• Fioricet was also significantly better than acetaminophen with codeine in relieving this symptom. Certain analyses suggested the possibility that Fioricet had a faster and more sustained analgesic effect than acetaminophen with codeine.

• barbiturates may be habit-forming and potentially abusable
• not for extended use
• risk drug-induced headache
• risk of toxicity
• withdrawal syndrome (1)

• migraine headache
• back pain

Butalbital has generalized depressant effect on CNS and, in very high doses, has peripheral effects. Acetaminophen has analgesic and antipyretic effects; its analgesic effects may be mediated through inhibition of prostaglandin synthetase enzyme complex. Caffeine is thought to produce constriction of cerebral blood vessels.

• User reviews for Fioricet to treat headache (users' rating 8.8 points) on Drugs.com
• User reviews for migraine headaches, back pain on DailyStrength
• User ratings and reviews of Fioricet for migraine, cluster and tension headaches, fibromyalgia on RevolutionHealth

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How to buy Fioricet?

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• 1. Romero CE, Baron JD, Knox AP, Hinchey JA, Ropper AH. Barbiturate withdrawal. Arch Neurol. 2004 Jul;61(7):1111-2.
• 2. Solomon S. Butalbital-containing agents: should they be banned? No. Curr Pain Headache Rep. 2002 Apr;6(2):147-50. PubMed
• 3. Friedman AP, DiSerio FJ. Symptomatic treatment of chronically recurring tension headache: a placebo-controlled, multicenter investigation of Fioricet and acetaminophen with codeine. Clin Ther. 1987;10(1):69-81. PubMed

Last modified: August, 2010