Fioricet | Effects, Warnings, & Abuse Potential

Fioricet is a combination medication that is most often prescribed for headaches and other forms of moderate pain. While the abuse potential for Fioricet is lower than other medications in its class, people who use Fioricet should always follow the prescription provided by their healthcare provider.

While narcotic painkillers and illicit stimulants are widely recognized as being highly addictive, dangerous, and deadly substances, there are many lesser-known prescription drugs that can also be habit-forming and harmful if misused or abused.

Fioricet, a combination medication used to treat headaches, is one such substance of abuse.

What Is Fioricet?

Fioricet is a brand name prescription medication containing a combination of three separate active ingredients, namely:

  • butalbital
  • acetaminophen (also known as paracetamol)
  • caffeine

Another formulation, Fioricet with Codeine, also includes the mild opioid analgesic codeine.


Fioricet is used to treat chronic tension headaches, which are caused by stress and tight neck and scalp muscles. 

The medication is also prescribed to treat migraines, a poorly understood condition that causes severe pain on one side of the head, nausea, and hypersensitivity to motion, light, and sound.

Fioricet Vs. Fiorinal

Fioricet is very similar to the medication Fiorinal, which omits acetaminophen in favor of aspirin. A number of other generic and brand name products that contain these active ingredients are also available, including Esgic and Orbivan.

Effects Of Fioricet Use

The ingredients in Fioricet each have a different set of effects which act in combination.


Butalbital is a barbiturate, a class of sedative drugs that work by increasing the production of the GABA neurotransmitter in the central nervous system. This relaxes both physical and mental stress, which helps to address both the cause and symptoms of different types of headaches.


Acetaminophen (Tylenol) is a common over the counter pain reliever that reduces pain and fever by impairing the function of prostaglandin in the central nervous system, interfering with the body’s pain processes.


Caffeine is a mild stimulant found in cola and coffee. Along with increasing wakefulness and attention, caffeine can also increase blood pressure and contract blood vessels, including blood vessels in the brain, which can take pressure off aggravated brain tissue.


Codeine is a naturally occurring opiate substance that acts as a prodrug for morphine. It is used to treat mild to moderate pain (including headache pain), cough, and diarrhea.

Fioricet Warnings & Precautions

In high doses, Fioricet can damage the liver. Contact your prescribing healthcare provider right away if you have abdominal pain, yellowing eyes or skin, or other signs of liver damage or liver disease.

Fioricet may cause serious skin reactions including blistering, peeling, lesions, skin rash, sores, and more. 

Serious allergic reactions have also occurred, causing symptoms including itching, difficulty breathing or swallowing, and swelling hands, face, or mouth. Seek medical attention if you experience these effects.

Fioricet may also cause impairment that can make it unsafe to use machinery or drive.

Fioricet should be used with caution by those who are breastfeeding, as butalbital does pass into the breast milk. And those with a history of porphyria should not use Fioricet.

General Side Effects

Common side effects associated with Fioricet may include:

  • drowsiness
  • upset stomach
  • stomach pain
  • vomiting
  • feelings of depression
  • lightheadedness
  • confusion
  • sleepiness
  • shortness of breath
  • trouble sleeping
  • increased urination

Other serious side-effects and adverse reactions have also been reported.

Fioricet Drug Interactions

Known drug interactions related to Fioricet include other CNS depressants (benzodiazepines, alcohol, sedatives, antihistamines, opioids, muscle relaxants, anesthetics, etc.), which may cause life threatening respiratory depression (trouble breathing). 

In addition, one should avoid using alcohol, other sources of acetaminophen, and other substances known to cause liver damage in combination with Fioricet.

Frequently Asked Questions About Fioricet

Fioricet is not discussed as often as other habit-forming drugs. The following frequently asked questions can help address concerns you may have if you have been prescribed Fioricet, or if you know someone who is abusing the drug.

If Fioricet is used as prescribed, the risks of addiction or dependence are low. However, abusing Fioricet increases the risks of:

    • tolerance (becoming accustomed to the drug and requiring higher doses for the same effects)

    • physical dependence (adapting to the drug’s effects to the point that not taking the drug causes uncomfortable rebound headaches or withdrawal symptoms)

    • substance use disorder/addiction (a chronic and compulsive pattern of harmful drug abuse)

Acetaminophen is an over-the-counter drug and caffeine is an uncontrolled substance that is freely available in many commercial products.

Butalbital and codeine, however, are classified by the FDA and DEA as Schedule III and II/V controlled substances, respectively, with considerable potentials for abuse and the development of physical and psychological dependence.

As a result, Fioricet and similar medications are classified as Schedule III drugs and are only legally available from pharmacies with a valid medical prescription from a licensed healthcare provider.

While Fioricet is considered to have a lower potential for diversion, abuse, and addiction than opioid analgesics like oxycodone or morphine, butalbital is a habit-forming substance.

This barbiturate can be abused in high doses to generate a pleasurable, relaxed drug high similar to alcohol or benzodiazepine intoxication.

Find Addiction Recovery Care In Ohio

If you or a loved one live with drug addiction and need help, please contact us for information on our inpatient treatment options.

  1. Case Reports in Psychology
  2. Food and Drug Administration (FDA)
  3. National Library of Medicine: MedlinePlus

Written by Ohio Recovery Center Editorial Team

Published on: August 16, 2023

© 2024 Ohio Recovery Center | All Rights Reserved

* This page does not provide medical advice.

Prefer Texting?
We've got you covered.

Receive 24/7 text support right away.
There is no obligation and you can opt out at any time.

Sign up for text support

Receive 24/7 text support right away.
There is no obligation and you can opt out at any time.
Let us walk you through the treatment process. We're here to help.
For 24/7 Treatment Help:
100% Free & Confidential. Call (419) 904-4158