Fiorinal and Fioricet for Headaches

Risks of Taking Fioricet and Fiorinal and When They May be Indicated

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Fioricet (butalbital/acetaminophen/caffeine) and Fiorinal (butalbital/aspirin/caffeine) are medications sometimes used to treat tension-type headaches. A tension headache is the most common type of headache. It is pain or discomfort in the head, scalp, or neck, and is often associated with muscle tightness in these areas.

Tension headaches occur when neck and scalp muscles become tense, or contract.

The muscle contractions can be a response to stress, depression, head injury, or anxiety. They may occur at any age, but are most common in adults and older teens.

While effective in the short-term, there are a number of downsides to taking these Fiorinal and Fioricet, mostly because they contain butalbital. 

Let's understand butalbital in a bit more detail, and why its use should be limited for your headache health. 

What is Butalbital in Fioricet and Fiorinal?

Butalbital is a barbiturate, which means that is slows down the central nervous system. It's one of the active ingredients in Fioricet and Fiorinal and helps relax the muscle tension believed to be associated with tension headaches. 

What is the Downside of Taking Fioricet and Fiorinal for Headache Relief?

One downside is that medications containing butalbital, such as Fioricet and Fiorinal, can lead to medication overuse headaches. These are headaches that develop when a person overuses butalbital, typically taking Fioricet or Fiorinal to to three times a week or 10 or more days a month.

When a person is experiencing medication overuse headaches, they are often not responsive to preventive headache medications, which can be a clue to the diagnosis.

The other downside is that withdrawal symptoms may occur with butalbital and may occur 8 to 36 hours after the last dose. Withdrawal symptoms can include anxiety, muscle twitching, tremor, weakness, dizziness, nausea and vomiting, insomnia, weight loss and even seizures when the medication is discontinued.

Due to the risk of seizures with withdrawal of butalbital, medical treatment in a monitored setting under the care of a physician is indicated.

Tolerance and addiction may also occur with butalbital. Tolerance means that a person needs more of the medication to achieve headache relief. Addiction to butalbital is characterized by persistent behaviors, like compulsions, to take a butalbital-containing medication — these behaviors impair their life in some way, negatively impacting relationships and/or everyday functioning. 

With butalbital, there is also a concern for intoxication. Symptoms of butalbital intoxication are similar to alcohol intoxication and include lack of coordination, problems with thinking and memory, slowness of speech, disinhibition and emotional disturbances.

When Is It Okay to Take Fiorinal or Fioricet for Headache Relief?

Fiorinal and Fioricet may be reasonable medications once in awhile, such as when other headache medications are not working or cannot be used. Regardless, though, their use should be limited and when used, should be monitored carefully under the guidance of a physician. 

If you have any questions or worries about taking butalbital-containing medications, please speak with your physician.

Also, remember to not stop or change the dosage of a medication without first consulting your doctor. 


Medline. Tension headaches,

National Headache Foundation. Fiorinal and Fioricet.

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