How Long Can You Take Other Medications after Taking Fioricet ?

After taking Fioricet, wait at least 4 hours before taking anything else that contains caffeine or acetaminophen so you don’t overdose on these ingredients.

This includes Excedrin Migraine, Excedrin Extra Strength, Excedrin Tension Headache, and Excedrin PM Headache.

BAC 50mg-325mg-40mg Tablet Mikart Inc Pill Identification: MIA 110
BAC 50mg-325mg-40mg Tablet
Mikart Inc
Pill Identification: MIA 110

Butalbital stays in your body for about 35 hours after a single dose of Fioricet.

It causes sleepiness, and taking more doses of Fioricet in this time will make the sleepiness worse.

Avoid alcohol or other relaxant medications while there is still butalbital in your body.

How does Fioricet Work ?

How Does Butalbital Work ?
How Does Butalbital Work ?

Fioricet is a combination pain-reliever (analgesic) containing acetaminophen, butalbital, and caffeine.

How Does Acetaminophen Work?

Researchers have been guessing at acetaminophen’s mechanism of action for decades. Some explanations involve chemical messengers of inflammation and pain. Others invoke aspects of neurotransmission in the brain and spinal cord. None of the proposals have accumulated enough supporting evidence to satisfy everyone.

This mystery might seem like minutiae in the grand scheme of things. Acetaminophen has been used clinically for many decades, with more than 27 billion doses sold in 2009 alone. But the drug’s well-known danger to the liver makes understanding its mechanism more than a minor detail.

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The drug’s safety margin—the difference between a safe dose and a toxic dose—is narrow. So it is deceptively easy to take too much and cause a trip to the emergency room, permanent liver damage, or even death. Deaths from accidental acetaminophen poisoning are rare—approximately 150 in the U.S. each year, according to a 2013 investigation by the nonprofit newsroom ProPublica. Even that number is too many to the researchers puzzling over acetaminophen’s mechanism of action and seeking safer alternatives.

ACETAMINOPHEN AT A GLANCE

AKA: N-(4-hydroxyphenyl)acetamide, paracetamol, APAP

U.S. brand name: Tylenol

First synthesized: 1878

Over-the-counter debut: 1960

Sales: 27 billion doses in 2009

SOURCES: Tylenol.com, ProPublica, Merck Index

One mechanism researchers have kicked around is that acetaminophen blocks cyclooxygenase (COX) enzymes. These help to form prostaglandins, which are pain- and inflammation-mediating signaling molecules. This would make acetaminophen similar to aspirin, or to ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs).

How Does Butalbital Work ?

Butalbital belongs to the class of medicines called barbiturates. When used for pain due to tension headaches experts believe it works by relaxing muscle contractions and causing sedation via an enhancement of the inhibitory effects of GABA (a neurotransmitter that regulates communication between brain cells).

Barbiturates increase the activity of a chemical in the brain that helps transmit signals. This chemical is known as gamma amino butyric acid (GABA). As a medication, they reduce muscle spasms, relieve anxiety, prevent seizures, and induce sleep.

How Does Caffeine Work ?

Caffeine is thought to enhance the pain-relieving effects of acetaminophen by up to 40%. In addition, it has vasoconstrictive properties, narrowing blood vessels in the brain thereby decreasing blood flow and oxygen tension (before a headache or a migraine, blood vessels tend to enlarge). This also helps to relieve pain.

Fioricet belongs to the class of medicines known as barbiturates because it contains butalbital. It may also be called a combination analgesic.

What other Drugs Will Affect acetaminophen, butalbital, caffeine (Fioricet )?

Fioricet Side Effects

Do not take acetaminophen, butalbital, caffeine, and codeine with any other narcotic pain medications, sedatives, tranquilizers, sleeping pills, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result.

Tell your doctor about all other medicines you use, especially:

  • glycopyrrolate (Robinul);
  • mepenzolate (Cantil);
  • ciprofloxacin (Cipro);
  • atropine (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);
  • bladder or urinary medications such as darifenacin (Enablex), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);
  • a bronchodilator such as ipratropium (Atrovent) or tiotropium (Spiriva);
  • irritable bowel medications such as dicyclomine (Bentyl) or hyoscyamine (Anaspaz, Cystospaz, and others); or
  • an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate).

This list is not complete and other drugs may interact with acetaminophen, butalbital, caffeine, and codeine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Geriatric Use of Fioricet

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.

Butal/APAP/Caf 50-325-40mg Tab Able Laboratories Inc Pill Identification: A 236
Butal/APAP/Caf 50-325-40mg Tab
Able Laboratories Inc
Pill Identification: A 236

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.

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of butalbital, acetaminophen, and caffeine combination in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving butalbital, acetaminophen, and caffeine combination.

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.