Fioricet and Esgic are brand name drugs made from a combination of butalbital (a barbiturate, 50 mg), acetaminophen (325 mg), and caffeine (40 mg). They are indicated for the treatment of tension headaches and muscle contraction headaches. Although not indicated, they are commonly used to treat migraines and other pain related ailments. Note that Fioricet (and some other pain medications) are implicated as causing repeat headaches with over-use (see NYT citation below)
Usage and dosage
Fioricet is indicated for the treatment of complex and muscle contraction headaches. It is also commonly prescribed for migraines although it is not FDA indicated for this use. The usual adult dose is 1-2 tablets every four hours as needed, not exceeding six tablets in a 24 hour period.
Mechanism of action
Butalbital has generalized depressant effect on central nervous system 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.
Butalbital has a half-life of about 35 hours. Acetaminophen has a half-life of about 1.25 to 3 hours, but may be increased by liver damage and after an overdose. Caffeine has a half-life of about 3 hours.
Side effects
Side effects for any drug are difficult to predict, but commonly reported side effects for Fioricet include:
Dizziness
Drowsiness
Intoxicated feeling
Light-headedness
Nausea
Vomiting
Sedation
Addiction
Shortness of breath
Abdominal pain
[edit] Variations
Phrenilin is an equivalent combination of butalbital and acetaminophen, without the caffeine (325/50).
Esgic Plus and Phrenilin Forte contains 500 and 650 miligrams of acetaminophen respectively, instead of 325 milligrams. Additionally, Esgic Plus contains 40 milligrams of caffeine.
Fiorinal contains aspirin instead of acetaminophen.
Fiorinal and Fioricet also come as combination drugs with codeine called Fiorinal with Codeine and Fioricet with Codeine, respectively, which add 30 milligrams of codeine phosphate to each mixture.
External links
Fioricet - drugs.com
Fiorinal & Fioricet - National Headache Foundation
A Hidden Cause of Headache Pain - New York Times
