Butalbital, Acetaminophen, Caffeine

Brand names: Esgic, Esgic-Plus, Anolor 300, Fioricet

Why is Butalbital, Acetaminophen, Caffeine prescribed?

Fioricet, a strong, non-narcotic pain reliever and relaxant, is prescribed for the relief of tension headache symptoms caused by muscle contractions in the head, neck, and shoulder area. It combines a sedative barbiturate (butalbital), a non-aspirin pain reliever (acetaminophen), and caffeine.

Most important fact about Butalbital, Acetaminophen, Caffeine

Mental and physical dependence can occur with the use of barbiturates such as butalbital when these drugs are taken in higher than recommended doses over long periods of time.

How should you take Butalbital, Acetaminophen, Caffeine?

Take Fioricet exactly as prescribed. Do not increase the amount you take without your doctor's approval.

  • If you miss a dose...Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.
  • Storage instructions...Store at room temperature in a tight, light-resistant container.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Fioricet.

  • Side effects may include:Abdominal pain, dizziness, drowsiness, intoxicated feeling, light-headedness, nausea, sedation, shortness of breath, vomiting

Why should Butalbital, Acetaminophen, Caffeine not be prescribed?

If you are sensitive to or have ever had an allergic reaction to barbiturates, acetaminophen, or caffeine, you should not take Butalbital, Acetaminophen, Caffeine. Make sure that your doctor is aware of any drug reactions that you have experienced.

Unless you are directed to do so by your doctor, do not take Butalbital, Acetaminophen, Caffeine if you have porphyria (an inherited metabolic disorder affecting the liver or bone marrow).

Special warnings about Butalbital, Acetaminophen, Caffeine

Fioricet may cause you to become drowsy or less alert; therefore, driving or operating dangerous machinery or participating in any hazardous activity that requires full mental alertness is not recommended until you know your response to Butalbital, Acetaminophen, Caffeine.

If you are being treated for severe depression or have a history of severe depression or drug abuse, consult with your doctor before taking Fioricet.

Use Butalbital, Acetaminophen, Caffeine with caution if you are elderly or in a weakened condition, if you have liver or kidney problems, or if you have severe abdominal trouble.

Possible food and drug interactions when taking Butalbital, Acetaminophen, Caffeine

Butalbital slows the central nervous system (CNS) and intensifies the effects of alcohol and other CNS depressants. Use of alcohol with Butalbital, Acetaminophen, Caffeine may also cause overdose symptoms. Avoid alcoholic beverages while taking Fioricet.

If Fioricet is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Fioricet with the following:

Antihistamines such as diphenhydramineDrugs known as monoamine oxidase inhibitors, including the antidepressants phenelzine and tranylcypromineDrugs to treat depression such as amitriptylineMajor tranquilizers such as chlorpromazine and haloperidolMuscle relaxants such as cyclobenzaprineNarcotic pain relievers such as propoxypheneSleep aids such as triazolamTranquilizers such as alprazolam and diazepam

Special information if you are pregnant or breastfeeding

If you are pregnant or plan to become pregnant, inform your doctor immediately. Fioricet can affect a developing baby. It also appears in breast milk. If Butalbital, Acetaminophen, Caffeine is essential to your health, your doctor may advise you to discontinue breastfeeding your baby until your treatment is finished.

Recommended dosage for Butalbital, Acetaminophen, Caffeine


The usual dose of Fioricet is 1 or 2 tablets taken every 4 hours as needed. Do not exceed a total dose of 6 tablets per day.

The usual dose of Esgic-Plus is 1 tablet every 4 hours as needed. Do not take more than 6 tablets a day.


The safety and effectiveness of Fioricet have not been established in children under 12 years of age.


Fioricet may cause excitement, depression, and confusion in older people. Therefore, your doctor will prescribe a dose individualized to suit your needs.


Symptoms of Fioricet overdose can be due to its barbiturate or its acetaminophen component.

  • Symptoms of barbiturate poisoning may include:Coma, confusion, drowsiness, low blood pressure, shock, slow or troubled breathing

Overdose due to the acetaminophen component of Fioricet may cause kidney and liver damage, blood disorders, or coma due to low blood sugar. Massive doses may cause liver failure.

  • Symptoms of liver damage include:Excess perspiration, feeling of bodily discomfort, nausea, vomiting

If you suspect an overdose, seek emergency medical treatment immediately.