What Are The Ingredients In Fioricet?
A Combination Medication is a drug which includes two or more pharmaceutical ingredients in a fixed dose. There are three ingredients in standard Fioricet: Acetaminophen, Butalbital, and Caffeine. All three ingredients have different effects which combine to soothe headaches.
- Acetaminophen is a medication which alleviates pain and reduces fever. It’s more widely known by the brand name Tylenol. Acetaminophen works by impairing the production of the prostaglandin chemical in the brain. This chemical activates pain signals in the nervous system.
- Butalbital is a Sedative Barbiturate which stimulates the brain’s production of GABA. This neurotransmitter calms the nervous system by blocking signals among neurons. It also relaxes muscle tension in the head, thereby alleviating headaches. Butalbital is a Schedule III controlled substance in the United States.
- Caffeine is a Stimulant which raises a person’s blood pressure. While high blood pressure is not necessarily healthy, low blood pressure worsens headaches by causing blood vessels to expand and push against the brain. By raising blood pressure, Caffeine causes blood vessels to constrict and increases blood flow. This effect helps relieve headaches.
With these three ingredients at work, Fioricet can be an effective source of headache relief. However, the medication also poses risks for side effects, overdose, and addiction.
A total of 586 drugs are known to interact with Fioricet (acetaminophen / butalbital / caffeine) categorized as 45 major, 490 moderate, and 51 minor interactions.
Drug Interactions with Fioricet
Fioricet, which contains acetaminophen, butalbital, and caffeine, has the potential for numerous drug interactions due to the combined pharmacologic effects of these ingredients.
Below is a breakdown of major types of interactions grouped by clinical concern:
1. Central Nervous System (CNS) Depressants
| Interacting Drugs | Effect | Risk |
|---|---|---|
| Benzodiazepines (e.g., diazepam, lorazepam) | Enhanced sedation, respiratory depression | Coma, death (especially in overdose) |
| Opioids (e.g., oxycodone, morphine) | Increased CNS depression | Life-threatening respiratory effects |
| Alcohol | Additive sedative effect | Fatal CNS/respiratory depression |
| Antihistamines (1st gen, e.g., diphenhydramine) | Increased drowsiness and confusion | Impaired cognition, falls |
2. Liver Toxicity Risk (Acetaminophen)
| Interacting Drugs | Effect | Risk |
|---|---|---|
| Isoniazid, Rifampin | Increased liver enzyme induction | Hepatotoxicity |
| Alcohol (chronic use) | Enhances liver metabolism of acetaminophen | Increased toxic metabolite (NAPQI) |
| Warfarin (long-term use) | Enhanced anticoagulant effect | Increased bleeding risk |
3. Stimulant Effect (Caffeine)
| Interacting Drugs | Effect | Risk |
|---|---|---|
| MAO Inhibitors (e.g., phenelzine) | Hypertensive crisis | Elevated blood pressure |
| Other caffeine sources (coffee, tea) | Additive CNS stimulation | Insomnia, tremors, palpitations |
| Theophylline | Similar mechanism, additive effects | Tachycardia, seizures |
4. Enzyme Induction (Butalbital)
Butalbital is a CYP450 enzyme inducer, especially CYP3A4 and CYP1A2. It may reduce the effectiveness of other medications.
| Affected Drugs | Effect | Risk |
|---|---|---|
| Oral contraceptives | Reduced hormonal levels | Contraceptive failure |
| Anticonvulsants (e.g., phenytoin) | Variable levels | Seizure breakthrough |
| Antidepressants (e.g., SSRIs) | Reduced efficacy | Poor mood control |
| Anticoagulants (e.g., warfarin) | Altered INR levels | Risk of bleeding or clotting |
5. Drug-Drug Interaction Examples to Avoid
| Combination | Why It’s Risky |
|---|---|
| Fioricet + Alcohol | Profound CNS depression + liver damage |
| Fioricet + Opioids (e.g., Norco, Vicodin) | Respiratory failure, overdose |
| Fioricet + SSRIs + NSAIDs | Bleeding risk (via serotonergic and hepatic effects) |
| Fioricet + Antiepileptics | Decreased seizure control or increased toxicity |
Monitoring Recommendations
- Liver function tests (if long-term use or other hepatotoxic drugs are involved)
- INR if used with warfarin
- Signs of CNS depression when used with sedatives
- Serum drug levels for narrow-therapeutic-index drugs (e.g., theophylline)
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Most frequently checked interactions
View interaction reports for Fioricet (acetaminophen / butalbital / caffeine) and the medicines listed below.
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- Ambien (zolpidem)
- baclofen
- clonazepam
- Cymbalta (duloxetine)
- Flexeril (cyclobenzaprine)
- gabapentin
- ibuprofen
- Klonopin (clonazepam)
- levothyroxine
- lisinopril
- Lyrica (pregabalin)
- Norco (acetaminophen / hydrocodone)
- omeprazole
- prednisone
- Topamax (topiramate)
- tramadol
- trazodone
- Vitamin D3 (cholecalciferol)
- Xanax (alprazolam)
- Zofran (ondansetron)
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Medications known to interact with Fioricet (acetaminophen / butalbital / caffeine)
Note: Showing generic names only.
A
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- abametapir topical
- abemaciclib
- acalabrutinib
- acebutolol
- acetylcarbromal
- adenosine
- aldesleukin
- alfentanil
- alfuzosin
- alosetron
- alpelisib
- alprazolam
- altretamine
- aminophylline
- amitriptyline
- amlodipine
- amobarbital
- amoxapine
- amprenavir
- anagrelide
- anisindione
- apalutamide
- apixaban
- apomorphine
- apraclonidine ophthalmic
- apremilast
- aprepitant
- aripiprazole
- armodafinil
- asenapine
- asparaginase erwinia chrysanthemi
- asparaginase escherichia coli
- aspirin
- atazanavir
- atorvastatin
- atropine
- avanafil
- avapritinib
- axitinib
- azatadine
- azilsartan medoxomil
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B
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- baclofen
- bedaquiline
- belladonna
- bendamustine
- benoxinate ophthalmic
- benzocaine topical
- benztropine
- bepridil
- betamethasone
- bexarotene
- biperiden
- black cohosh
- boceprevir
- bortezomib
- bosutinib
- brentuximab
- brexanolone
- brexpiprazole
- brigatinib
- brimonidine ophthalmic
- brimonidine topical
- brivaracetam
- bromocriptine
- brompheniramine
- buprenorphine
- bupropion
- buspirone
- busulfan
- butabarbital
- butorphanol
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C
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- cabazitaxel
- cabozantinib
- calaspargase pegol
- calcifediol
- calcitriol
- canagliflozin
- cannabidiol
- cannabis
- capmatinib
- carbamazepine
- carbetapentane
- carbinoxamine
- cariprazine
- carisoprodol
- carvedilol
- caspofungin
- cenobamate
- ceritinib
- cetirizine
- cevimeline
- charcoal
- chlophedianol
- chloral hydrate
- chloramphenicol
- chlordiazepoxide
- chlorotrianisene
- chlorphenesin
- chlorpheniramine
- chlorpromazine
- chlorzoxazone
- cholecalciferol
- cholestyramine
- cimetidine
- ciprofloxacin
- citalopram
- clemastine
- clevidipine
- clidinium
- clobazam
- clofarabine
- clomipramine
- clonazepam
- clonidine
- clorazepate
- clozapine
- cobimetinib
- cocaine nasal
- cocaine topical
- codeine
- conjugated estrogens
- copanlisib
- corticorelin
- corticotropin
- cortisone
- cosyntropin
- crizotinib
- cyclobenzaprine
- cycloserine
- cyclosporine
- cyproheptadine
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D
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- daclizumab
- dantrolene
- dapsone
- dapsone topical
- darifenacin
- darolutamide
- darunavir
- dasatinib
- deferasirox
- delavirdine
- desipramine
- desvenlafaxine
- deutetrabenazine
- dexamethasone
- dexbrompheniramine
- dextromethorphan
- dezocine
- diazepam
- dibucaine topical
- dicumarol
- dicyclomine
- diflunisal
- digitoxin
- dihydroergotamine
- dihydrotachysterol
- diltiazem
- diphenhydramine
- dipyridamole
- disopyramide
- disulfiram
- divalproex sodium
- docetaxel
- dolutegravir
- donepezil
- doravirine
- doxazosin
- doxepin
- doxepin topical
- doxercalciferol
- doxorubicin
- doxorubicin liposomal
- doxycycline
- doxylamine
- dronabinol
- dronedarone
- droperidol
- drospirenone
- duloxetine
- duvelisib
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E
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- echinacea
- efavirenz
- elagolix
- eliglustat
- encorafenib
- enoxacin
- entacapone
- entrectinib
- enzalutamide
- epirubicin
- ergocalciferol
- ergonovine
- ergotamine
- erlotinib
- escitalopram
- esketamine
- eslicarbazepine
- estazolam
- esterified estrogens
- estradiol
- estradiol topical
- estrone
- estropipate
- eszopiclone
- ethanol
- ethinyl estradiol
- ethosuximide
- ethotoin
- etonogestrel
- etravirine
- everolimus
- exemestane
- ezogabine
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F
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- felbamate
- fenofibrate
- fenoldopam
- fenoprofen
- fentanyl
- fesoterodine
- flavoxate
- flibanserin
- fludrocortisone
- fluoxetine
- fluphenazine
- flurazepam
- fluvoxamine
- fosamprenavir
- fosaprepitant
- fosphenytoin
- fostamatinib
- fostemsavir
- furazolidone
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G
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- gabapentin
- gabapentin enacarbil
- gefitinib
- gilteritinib
- givosiran
- glasdegib
- glycerol phenylbutyrate
- glycopyrrolate
- grepafloxacin
- griseofulvin
- guanfacine
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H
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- halazepam
- haloperidol
- hemin
- heroin
- hydrocodone
- hydrocortisone
- hydromorphone
- hydroxyprogesterone
- hyoscyamine
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I
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-
-
- ibrutinib
- idelalisib
- ifosfamide
- iloperidone
- imatinib
- imipramine
- indinavir
- infigratinib
- interferon beta-1a
- interferon beta-1b
- irinotecan
- irinotecan liposomal
- isavuconazonium
- isocarboxazid
- isoniazid
- isradipine
- ivabradine
- ivacaftor
- ixabepilone
- ixazomib
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K
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- kava
- ketamine
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L
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-
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- labetalol
- lamotrigine
- lapatinib
- larotrectinib
- lasmiditan
- lefamulin
- leflunomide
- lemborexant
- lesinurad
- levamlodipine
- levetiracetam
- levobupivacaine
- levocetirizine
- levomethadyl acetate
- levonorgestrel
- levorphanol
- levothyroxine
- lidocaine
- lidocaine ophthalmic
- lidocaine topical
- linagliptin
- linezolid
- liothyronine
- liotrix
- liraglutide
- lithium
- lofexidine
- lomitapide
- lonafarnib
- lorazepam
- lorlatinib
- losartan
- loxapine
- lumateperone
- lurasidone
- lurbinectedin
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M
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- macimorelin
- macitentan
- maprotiline
- maraviroc
- medroxyprogesterone
- mefloquine
- megestrol
- melatonin
- mepenzolate
- meperidine
- mephenytoin
- mephobarbital
- mesoridazine
- metaxalone
- methadone
- methdilazine
- methocarbamol
- methohexital
- methotrexate
- methotrimeprazine
- methoxyflurane
- methscopolamine
- methsuximide
- methyldopa
- methylene blue
- methylergonovine
- methylprednisolone
- methysergide maleate
- metoclopramide
- metoprolol
- metronidazole
- metyrosine
- mibefradil
- midazolam
- midostaurin
- mifepristone
- mipomersen
- mirabegron
- mirtazapine
- mitotane
- modafinil
- molindone
- montelukast
- morphine
- morphine liposomal
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N
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- nabilone
- nalbuphine
- nalidixic acid
- naloxegol
- naltrexone
- nebivolol
- nefazodone
- nelfinavir
- nicardipine
- nicotine
- nifedipine
- nilotinib
- nimodipine
- nisoldipine
- nitisinone
- norethindrone
- norfloxacin
- norgestrel
- nortriptyline
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O
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- obeticholic acid
- olanzapine
- olaparib
- oliceridine
- olopatadine nasal
- opicapone
- opium
- orphenadrine
- osilodrostat
- osimertinib
- ospemifene
- oxazepam
- oxcarbazepine
- oxtriphylline
- oxybutynin
- oxycodone
- oxymorphone
- ozanimod
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P
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- paclitaxel
- paclitaxel protein-bound
- palbociclib
- paliperidone
- panobinostat
- paraldehyde
- paramethadione
- paricalcitol
- paroxetine
- pazopanib
- pegaspargase
- peginterferon beta-1a
- pemigatinib
- penbutolol
- pentazocine
- pentobarbital
- perampanel
- pergolide
- perphenazine
- pexidartinib
- phenacemide
- phenelzine
- phenobarbital
- phensuximide
- phenytoin
- pimavanserin
- pimozide
- pitolisant
- pneumococcal 13-valent vaccine
- pneumococcal 7-valent vaccine
- ponatinib
- pramipexole
- praziquantel
- prazosin
- prednisolone
- prednisone
- pregabalin
- prilocaine
- primidone
- probenecid
- procarbazine
- prochlorperazine
- procyclidine
- progesterone
- progesterone topical
- promazine
- promethazine
- propafenone
- propantheline
- proparacaine ophthalmic
- propiomazine
- propoxyphene
- propranolol
- protriptyline
- pyridoxine
- pyrilamine
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Q
-
-
-
- quazepam
- quetiapine
- quinestrol
- quinidine
- quinine
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R
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-
-
- ramelteon
- ranitidine
- ranitidine bismuth citrate
- ranolazine
- rasagiline
- regadenoson
- relugolix
- remdesivir
- remifentanil
- remimazolam
- repaglinide
- ribociclib
- rifampin
- rilpivirine
- riluzole
- riociguat
- ripretinib
- risperidone
- ritonavir
- rivaroxaban
- rolapitant
- ropinirole
- ropivacaine
- rotigotine
- rucaparib
- rufinamide
- ruxolitinib
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-
S
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-
-
- saquinavir
- saxagliptin
- scopolamine
- secobarbital
- selpercatinib
- selumetinib
- sertraline
- sibutramine
- sildenafil
- silodosin
- sirolimus
- sodium nitrite
- sodium oxybate
- sodium salicylate
- solifenacin
- sonidegib
- sorafenib
- sotorasib
- st. john’s wort
- stiripentol
- sufentanil
- sulfinpyrazone
- sunitinib
- suvorexant
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T
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-
-
- tacrolimus
- tadalafil
- tafamidis
- tamoxifen
- tamsulosin
- tapentadol
- tasimelteon
- tazemetostat
- telaprevir
- telithromycin
- telmisartan
- temazepam
- temsirolimus
- tepotinib
- terazosin
- terbinafine
- teriflunomide
- tetrabenazine
- tetracaine ophthalmic
- tetracaine topical
- thalidomide
- theophylline
- thiabendazole
- thiethylperazine
- thioguanine
- thiopental
- thioridazine
- thiothixene
- thyroid desiccated
- tiagabine
- ticagrelor
- timolol
- tinidazole
- tipranavir
- tizanidine
- tofacitinib
- tolcapone
- tolterodine
- tolvaptan
- topiramate
- topotecan
- toremifene
- trabectedin
- tramadol
- tranylcypromine
- trazodone
- triamcinolone
- triazolam
- trifluoperazine
- triflupromazine
- trihexyphenidyl
- trimeprazine
- trimethadione
- trimethobenzamide
- trimipramine
- tripelennamine
- triprolidine
- trospium
- trovafloxacin
- tucatinib
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-
U
-
-
-
- ubrogepant
- ulipristal
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-
V
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-
-
- valbenazine
- valerian
- valproic acid
- vemurafenib
- venetoclax
- venlafaxine
- verapamil
- vigabatrin
- vilazodone
- viloxazine
- voriconazole
- vortioxetine
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W
-
-
-
- warfarin
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Z
-
-
-
- zaleplon
- zanubrutinib
- ziconotide
- zidovudine
- ziprasidone
- zolpidem
- zonisamide
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Fioricet (acetaminophen / butalbital / caffeine) alcohol/food interactions
There are 6 alcohol/food interactions with Fioricet (acetaminophen / butalbital / caffeine)