Generic name: BUTALBITAL 50mg, ACETAMINOPHEN 325mg, CAFFEINE 40mg
Dosage form: tablet
One or 2 tablets every 4 hours as needed. Total daily dosage should not exceed 6 tablets.
Extended and repeated use of Fioricet is not recommended because of the potential for physical dependence.
Fioricet Dosage Instructions
First and foremost before looking at the specific Fioricet dosage guidelines, it’s important for people to realize that following these guidelines and also their doctor’s instructions with this medicine are incredibly important. Fioricet contains acetaminophen, which while it is available over-the-counter in medicines like Tylenol, can cause liver toxicity when high amounts are taken.
Fioricet contains a black box warning because of the relationships between acetaminophen and acute liver failure. There have been users of not only Fioricet but other medicines containing acetaminophen that have required a liver transplant or have died as a result of the ingredient.
Usually, acetaminophen becomes problematic or fatal at doses of 4,000 mg or more a day. Some of the people most at risk for liver problems related to Fioricet and acetaminophen include people who have existing liver disease, take more than one medicine with acetaminophen in it at a time, or who drink alcohol while using it.
Also relevant to Fioricet dosage instructions is the butalbital ingredient this medicine contains. This ingredient is a barbiturate, and it may be habit-forming. It’s also a central nervous system depressant, so taking too much can result in respiratory depression and overdose.
With that being said, the recommended Fioricet dosage for most adults is to take one to two tablets every four hours as needed for pain, and no more than six tablets should be taken a day. Also part of the Fioricet dosage instructions is the fact that this drug shouldn’t be used long term because of the potential for dependence and abuse.
If someone doesn’t follow the Fioricet dosage instructions, they’re more likely to become ill or overdose from the toxicity of the acetaminophen and the butalbital, rather than the caffeine. Signs you may have overdosed on Fioricet include confusion or extreme drowsiness.
If you miss a dosage of Fioricet, the medicine’s instructions advise to take it when you remember, unless it’s close to the time for your next dosage. Doubling up on dosages is dangerous and can be deadly.
Since a Fioricet dosage contains acetaminophen, you should be cautious as mentioned above, and make sure that you’re not combining multiple medicines with acetaminophen. Some of the signs of liver damage include nausea or vomiting, yellowing of the skin or eyes and dark-colored urine. Extreme stomach or abdominal pain can also be a sign of liver damage, as can extreme fatigue.
Older adults may have different Fioricet dosage instructions, and doctors will usually start older patients out at the lowest possible Fioricet dosage. This is because they are at a higher risk of heart, kidney and liver conditions, and their kidney functionality may be reduced so it could be easier for the drug to build up in their system and cause damage or contribute to an overdose.
People should never try to achieve a Fioricet high or take this drug in any way other than how their doctor prescribes it to them because of the risks this can bring.
Also important when looking at the Fioricet dosage information are the potential interactions. Fioricet may interact with MAOIs, antidepressants, some tranquilizers and sedative-hypnotics, so speak with your doctor if you take any of these. You should also tell your doctor about any over-the-counter drugs you take, or herbal remedies and nutritional supplements.
Butalbital is well absorbed from the gastrointestinal tract and is expected to distribute to most tissues in the body. Barbiturates in general may appear in breast milk and readily cross the placental barrier. They are bound to plasma and tissue proteins to a varying degree and binding increases directly as a function of lipid solubility.
Elimination of butalbital is primarily via the kidney (59% to 88% of the dose) as unchanged drug or metabolites. The plasma half-life is about 35 hours. Urinary excretion products include parent drug (about 3.6% of the dose), 5-isobutyl-5-(2, 3-dihydroxypropyl) barbituric acid (about 24% of the dose), 5-allyl-5(3-hydroxy-2-methyl-1-propyl) barbituric acid (about 4.8% of the dose), products with the barbituric acid ring hydrolyzed with excretion of urea (about 14% of the dose), as well as unidentified materials. Of the material excreted in the urine, 32% is conjugated.
The in vitro plasma protein binding of butalbital is 45% over the concentration range of 0.5-20 mcg/mL. This falls within the range of plasma protein binding (20%-45%) reported with other barbiturates such as phenobarbital, pentobarbital, and secobarbital sodium. The plasma-to-blood concentration ratio was almost unity, indicating that there is no preferential distribution of butalbital into either plasma or blood cells.