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.

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. Patients should talk to their doctor about what to expect with treatment with Fioricet. 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.

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 breastfeeding²

You should begin no medication or supplement without first checking with your health care provider and should let them know of any other prescriptions, OTCs, and herbals you are taking to ensure there are no interactions.

Fioricet is a prescription medication commonly used to treat tension headaches. It is a combination of three active ingredients: acetaminophen, butalbital, and caffeine. When considering whether you can drink coffee while taking Fioricet, there are a few important points to keep in mind:

Key Considerations

1. Caffeine Content:
   • Fioricet already contains caffeine (40 mg per tablet), which is included to enhance the pain-relieving effects of acetaminophen and to help counteract the sedative effects of butalbital.
   • Drinking coffee, which also contains caffeine, will increase your overall caffeine intake. Excessive caffeine can lead to side effects such as jitteriness, increased heart rate, and anxiety.
2. Caffeine Sensitivity:
   • If you are sensitive to caffeine, adding coffee to the caffeine already present in Fioricet might exacerbate symptoms like nervousness, restlessness, and insomnia.
   • Individuals with certain medical conditions (e.g., anxiety disorders, heart conditions) might need to limit their caffeine intake.
3. Butalbital (a Barbiturate):
   • Butalbital is a sedative that can cause drowsiness and dizziness. Caffeine in both Fioricet and coffee can help counteract these effects, but combining them may lead to overstimulation or affect sleep patterns.
4. Potential Interactions:
   • While there are no direct contraindications against consuming caffeine with Fioricet, it’s important to consider how your body responds to the combined effects.
   • Consult your healthcare provider if you have concerns about interactions, especially if you have other medical conditions or are taking additional medications.

Practical Advice

• Monitor Caffeine Intake: Be mindful of the total amount of caffeine you consume from all sources, including Fioricet, coffee, tea, soft drinks, and other medications.
• Moderation: If you choose to drink coffee, consider limiting the amount to avoid excessive caffeine intake and monitor how you feel. A single cup of coffee in the morning may be reasonable for many people.
• Consult Your Doctor: If you have specific health concerns or are unsure about how much caffeine is safe for you, it’s best to consult with your healthcare provider. They can provide personalized advice based on your health status and medication regimen.