Acetaminophen/butalbital , sold under the brand name Fioricet among others, is a combination medication of the barbiturate butalbital, the analgesic acetaminophen, and the vasoconstrictive xanthine caffeine. Approved for the treatment of tension headaches, muscle contraction headaches, and post-dural puncture headaches, it is also commonly prescribed off label for migraine headaches, although chronic use has been known to cause rebound migraines.
In 2016 it was the 202nd most prescribed medication in the United States with more than 2 million prescriptions.
Fioricet is indicated for the treatment of tension headaches. It is also commonly prescribed for migraines, although it is not approved by the FDA for this use in the United States. The usual adult dose is one to two tablets every four hours as needed, not to exceed six tablets in a twenty-four-hour period.
Commonly reported side effects include euphoria, dizziness or lightheadedness, drowsiness or sedation, intoxication, nausea, vomiting, dependence, shortness of breath, and abdominal pain.
Prolonged use can cause rebound headaches.
Rarely, use of barbiturates can lead to Stevens–Johnson syndrome.
Butalbital exerts its toxicity through excessive sedation, resulting in respiratory depression and ultimately death via hypoxia. Nonlethal overdoses may also result in coma and death. There is no specific antidote to barbiturate overdose; treatment is supportive, generally including the administration of intravenous saline, naloxone, thiamine, glucose, sodium bicarbonate to alkalize the urine and increase rate of excretion, and activated charcoal via nasogastric tube.
Buy Acetaminophen/butalbital Online exerts its toxicity through the production of a toxic metabolite that can cause liver damage at doses as low as four grams. Larger doses can precipitate acute liver failure, acute kidney injury, or gastrointestinal bleeding; death has been known to occur with ingestion of ten to fifteen grams. The specific antidote to acetaminophen overdose is N-acetylcysteine.
Mechanism of action
Butalbital exerts a generalized depressant effect on the central nervous system and, in very high doses, has peripheral effects. Buy Acetaminophen/butalbital Online has analgesic and antipyretic effects mediated by a metabolite that acts at cannabinoid receptors. Caffeine is thought to produce constriction of cerebral blood vessels and serves to counteract the sedative effect of butalbital.
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 2.5 to 4.5 hours.