Category: Fioricet

What’s in Fioricet?

Fioricet is a tablet which contains three active ingredients, including 325 mg acetaminophen, 50 mg butalbital, and 40 mg caffeine. The drug was approved by the Food and Drug Administration in 1984.

But the FDA in 2011 advised drug manufacturers to limit acetaminophen to not more than 325 mg to prevent consumers from developing severe liver damage that was associated with too much acetaminophen.

What Are The Ingredients In Fioricet?
What Are The Ingredients In Fioricet?

Acetaminophen acts as a pain reliever and helps in reducing the patient’s fever. Butalbital, on the other hand, relaxes muscle contractions that develop in a tension headache. Similar to butalbital, caffeine, a widely used psychoactive drug, also helps patients to relax muscle contractions and improve blood flow.

The patients who used Fioricet reported varying effects. Some patients reportedly find it effective in managing migraine. A 50-year-old patient said she didn’t find any side effects whenever she used the drug at the onset of her migraine. She said the medicine works after about 20 minutes of taking Fioricet.

However, a 34-year-old patient found it “considerably effective” and noted some moderate side effects after taking the drug.

Butalbital, acetaminophen, caffeine, and codeine combination is used to relieve symptoms of tension (or muscle contraction) headaches. Extended and repeated use of this product is not recommended.

Butalbital belongs to the group of medicines called barbiturates. They act in the central nervous system (CNS) to produce their effects.

Acetaminophen is used to relieve pain and reduce fever in patients. It does not become habit-forming when taken for a long time. But acetaminophen may cause other unwanted effects when taken in large doses, including serious liver damage. Although rare, use of acetaminophen has been reported to lead to liver transplantation and death, usually at high doses and when multiple acetaminophen-containing products have been used.

Caffeine is a CNS stimulant that is used with pain relievers to increase their effect. It has also been used for migraine headaches. Codeine belongs to the group of medicine called narcotic analgesics (pain medicines). It acts on the central nervous system (CNS) to relieve pain.

When butalbital or codeine is used for a long time or in large doses, it may become habit-forming, causing mental or physical dependence. However, people who have continuing pain should not let the fear of dependence keep them from using narcotics to relieve their pain. Mental dependence (addiction) is not likely to occur when narcotics or barbiturates are used for this purpose. Physical dependence may lead to withdrawal side effects when you suddenly stop taking the medicine. In patients who get headaches, the first symptom of withdrawal may be new (rebound) headaches.

This medicine is available only under a restricted distribution program called the Opioid Analgesic REMS (Risk Evaluation and Mitigation Strategy) program.

The patient took one to two tablets of Fioricet every four hours for the six months. She said each time she takes more than one pill since she finds the first dose ineffective in improving migraine, she will feel very dizzy and will be incapacitated until the effect has worn off. Some patients also reported having the feeling of agitation, insomnia, withdrawal syndrome and hallucination after taking Fioricet.

You should not use Fioricet if you have porphyria, or if you have recently used alcohol, sedatives, tranquilizers, or other narcotic medications.

Do not use Fioricet if you have taken a MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

Do not take more Fioricet than is recommended. An overdose of acetaminophen can damage your liver or cause death. Call your doctor at once if you have nausea, pain in your upper stomach, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of your skin or eyes).

In rare cases, acetaminophen may cause a severe skin reaction. Stop taking Fioricet and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.

Before taking this medicine

Do not use Fioricet if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

You should not use Fioricet if you are allergic to acetaminophen, butalbital, or caffeine, if you have porphyria, or if you have recently used alcohol, sedatives, tranquilizers, or other narcotic medications.

To make sure Fioricet is safe for you, tell your doctor if you have:

  • liver disease, cirrhosis, a history of alcoholism or drug addiction, or if you drink more than 3 alcoholic beverages per day;
  • kidney disease;
  • asthma, sleep apnea, or other breathing disorder;
  • stomach ulcer or bleeding;
  • a history of skin rash caused by any medication;
  • a history of mental illness or suicidal thoughts; or
  • if you use medicine to prevent blood clots.
 This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.

This medicine can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

 

The most important Fioricet Patient Information

You should not use Fioricet if you have porphyria, or if you have recently used alcohol, sedatives, tranquilizers, or other narcotic medications.

Do not use Fioricet if you have taken a MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid,  linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

Do not take more Fioricet than is recommended. An overdose of acetaminophen can damage your liver or cause death. Call your doctor at once if you have nausea, pain in your upper stomach, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of your skin or eyes).

In rare cases, acetaminophen may cause a severe skin reaction. Stop taking Fioricet and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.

Before taking this medicine

Do not use Fioricet if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

You should not use Fioricet if you are allergic to acetaminophen, butalbital, or caffeine, if you have porphyria, or if you have recently used alcohol, sedatives, tranquilizers, or other narcotic medications.

To make sure Fioricet is safe for you, tell your doctor if you have:

  • liver disease, cirrhosis, a history of alcoholism or drug addiction, or if you drink more than 3 alcoholic beverages per day;
  • kidney disease;
  • asthma, sleep apnea, or other breathing disorder;
  • stomach ulcer or bleeding;
  • a history of skin rash caused by any medication;
  • a history of mental illness or suicidal thoughts; or
  • if you use medicine to prevent blood clots.
This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.

This medicine can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Information For Patients /Caregivers

  • Do not take Fioricet® Capsules if you are allergic to any of its ingredients.
  • If you develop signs of allergy such as a rash or difficulty breathing, stop taking Fioricet® Capsules and contact your healthcare provider immediately.
  • Do not take more than 4000 milligrams of acetaminophen per day. Call your doctor if you took more than the recommended dose.

This product may impair mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery. Such tasks should be avoided while taking this product.

Alcohol and other CNS depressants may produce an additive CNS depression, when taken with this combination product, and should be avoided.

Butalbital may be habit-forming. Patients should take the drug only for as long as it is prescribed, in the amounts prescribed, and no more frequently than prescribed.

Fioricet overdose and overdose treatment

Following an acute overdosage of butalbital, acetaminophen and caffeine, toxicity may result from the barbiturate or the acetaminophen. Toxicity due to caffeine is less likely, due to the relatively small amounts in this formulation.

Fioricet overdose Signs And Symptoms

Toxicity from barbiturate poisoning includes drowsiness, confusion, and coma; respiratory depression; hypotension; and hypovolemic shock.

In acetaminophen overdosage: dose-dependent, potentially fatal hepatic necrosis is the most serious adverse effect. Renal tubular necroses, hypoglycemic coma and coagulation defects may also occur. Early symptoms following a potentially hepatotoxic overdose may include: nausea, vomiting, diaphoresis and general malaise. Clinical and laboratory evidence of hepatic toxicity may not be apparent until 48 to 72 hours post-ingestion.

Acute caffeine poisoning may cause insomnia, restlessness, tremor, and delirium, tachycardia and extra systoles.

Fioricet overdose Treatment

A single or multiple drug overdose with this combination product is a potentially lethal polydrug overdose, and consultation with a regional poison control center is recommended. Immediate treatment includes support of cardiorespiratory function and measures to reduce drug absorption.

Oxygen, intravenous fluids, vasopressors, and other supportive measures should be employed as indicated. Assisted or controlled ventilation should also be considered.

Gastric decontamination with activated charcoal should be administered just prior to N-acetylcysteine (NAC) to decrease systemic absorption if acetaminophen ingestion is known or suspected to have occurred within a few hours of presentation. Serum acetaminophen levels should be obtained immediately if the patient presents 4 hours or more after ingestion to assess potential risk of hepatotoxicity; acetaminophen levels drawn less than 4 hours post-ingestion may be misleading. To obtain the best possible outcome, NAC should be administered as soon as possible where impending or evolving liver injury is suspected. Intravenous NAC may be administered when circumstances preclude oral administration.

Vigorous supportive therapy is required in severe intoxication. Procedures to limit the continuing absorption of the drug must be readily performed since the hepatic injury is dose dependent and occurs early in the course of intoxication.

Addiction is a disease that impacts your behavior because your brain is pushing you toward continuing to use the drug that triggered the reward response again and again. Addiction to opioids is difficult to escape from, and it can lead to overdose and death. Another element of the use of opioids is tolerance and dependence. While these aren’t the same as addiction, these scenarios often go hand in hand with one another.

An opioid tolerance means that your body has become somewhat immune to the effects of these drugs so that you require higher doses to feel anything. A physical dependence means that in many ways the presence of opioids has become your new normal.

If you suddenly stop using opioids when you’re physically dependent on them, whether or not you’re addicted, you may experience very uncomfortable symptoms which are categorized as withdrawal.

Some of the symptoms of opiate withdrawal can include nausea, vomiting, goose bumps, cramping, diarrhea, agitation, anxiety, insomnia, and yawning. Withdrawal from opioids can range from annoying to very painful. During a medically-supervised opioid detox, doctors can prescribe certain medicines that can help keep the person more comfortable and help them be more successful at stopping their use of the drugs.

Some of the medicines that may be given to patients during opiate withdrawal include methadone, buprenorphine, clonidine, and naltrexone. These drugs do everything from providing a maintenance system for opioid addicts, to helping with the actual symptoms such as muscle aches and anxiety.

Some people may attempt to manage their own withdrawal from opioids, and not only can this be dangerous, but it is also often ineffective.

 

What is Fioricet Pharmacokinetics and Fioricet Side Effects ?

This combination drug product is intended as a treatment for tension headache.

What Are The Ingredients In Fioricet?
What Are The Ingredients In Fioricet?

It consists of a fixed combination of butalbital, acetaminophen and caffeine. The role each component plays in the relief of the complex of symptoms known as tension headache is incompletely understood.

Pharmacokinetics

The behavior of the individual components is described below.

Butalbital

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 to 20 mcg/mL. This falls within the range of plasma protein binding (20% to 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 (See OVERDOSAGE for toxicity information).

Acetaminophen

Acetaminophen is rapidly absorbed from the gastrointestinal tract and is distributed throughout most body tissues. The plasma half-life is 1.25 to 3 hours, but may be increased by liver damage and following overdosage. Elimination of acetaminophen is principally by liver metabolism (conjugation) and subsequent renal excretion of metabolites. Approximately 85% of an oral dose appears in the urine within 24 hours of administration, most as the glucuronide conjugate, with small amounts of other conjugates and unchanged drug.

Caffeine

Like most xanthines, caffeine is rapidly absorbed and distributed in all body tissues and fluids, including the CNS, fetal tissues, and breast milk.

Caffeine is cleared through metabolism and excretion in the urine. The plasma half-life is about 3 hours. Hepatic biotransformation prior to excretion, results in about equal amounts of 1-methylxanthine and 1-methyluric acid. Of the 70% of the dose that is recovered in the urine, only 3% is unchanged drug.

What is the side effects of Fioricet ?

Frequently Observed

The most frequently reported adverse reactions are drowsiness, lightheadedness, dizziness, sedation, shortness of breath, nausea, vomiting, abdominal pain, and intoxicated feeling.

Infrequently Observed

All adverse events tabulated below are classified as infrequent.

Central Nervous System: headache, shaky feeling, tingling, agitation, fainting, fatigue, heavy eyelids, high energy, hot spells, numbness, sluggishness, seizure. Mental confusion, excitement or depression can also occur due to intolerance, particularly in elderly or debilitated patients, or due to overdosage of butalbital.

Autonomic Nervous System: dry mouth, hyperhidrosis.

Gastrointestinal: difficulty swallowing, heartburn, flatulence, constipation.

Cardiovascular: tachycardia.

Musculoskeletal: leg pain, muscle fatigue.

Genitourinary: diuresis.

Miscellaneous: pruritus, fever, earache, nasal congestion, tinnitus, euphoria, allergic reactions.

Several cases of dermatological reactions, including toxic epidermal necrolysis and erythema multiforme, have been reported.

The following adverse drug events may be borne in mind as potential effects of the components of this product. Potential effects of high dos age are listed in the OVERDOSAGE section.

Acetaminophen: allergic reactions, rash, thrombocytopenia, agranulocytosis.

Caffeine: cardiac stimulation, irritability, tremor, dependence, nephrotoxicity, hyperglycemia.

 

Drug Abuse And Dependence

Abuse And Dependee

Butalbital

Barbiturates may be habit-forming: Tolerance, psychological dependence, and physical dependence may occur especially following prolonged use of high doses of barbiturates. The average daily dose for the barbiturate addict is usually about 1500 mg. As tolerance to barbiturates develops, the amount needed to maintain the same level of intoxication increases; tolerance to a fatal dosage, however, does not increase more than two-fold. As this occurs, the margin between an intoxication dosage and fatal dosage becomes smaller. The lethal dose of a barbiturate is far less if alcohol is also ingested. Major withdrawal symptoms (convulsions and delirium) may occur within 16 hours and last up to 5 days after abrupt cessation of these drugs. Intensity of withdrawal symptoms gradually declines over a period of approximately 15 days. Treatment of barbiturate dependence consists of cautious and gradual withdrawal of the drug. Barbiturate-dependent patients can be withdrawn by using a number of different withdrawal regimens. One method involves initiating treatment at the patient’s regular dosage level and gradually decreasing the daily dosage as tolerated by the patient.

What other drugs will affect Fioricet?

Taking this medicine with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking  Fioricet with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Other drugs may interact with Fioricet, including prescription and over-the-counter medicines, vitamins, and herbal products.

Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Most frequently checked interactions

View interaction reports for Fioricet (acetaminophen / butalbital / caffeine) and the medicines listed below.

  • Adderall (amphetamine / dextroamphetamine)
  • Advil (ibuprofen)
  • Ambien (zolpidem)
  • aspirin
  • Ativan (lorazepam)
  • baclofen
  • caffeine
  • clonazepam
  • codeine
  • Cymbalta (duloxetine)
  • Excedrin (acetaminophen / aspirin / caffeine)
  • Flexeril (cyclobenzaprine)
  • gabapentin
  • hydrocodone
  • ibuprofen
  • ibuprofen
  • Imitrex (sumatriptan)
  • Klonopin (clonazepam)
  • levothyroxine
  • Lexapro (escitalopram)
  • lisinopril
  • Lyrica (pregabalin)
  • meloxicam
  • naproxen
  • Norco (acetaminophen / hydrocodone)
  • omeprazole
  • oxycodone
  • Percocet (acetaminophen / oxycodone)
  • prednisone
  • Suboxone (buprenorphine / naloxone)
  • Topamax (topiramate)
  • tramadol
  • trazodone
  • Tylenol (acetaminophen)
  • Vitamin D3 (cholecalciferol)
  • Xanax (alprazolam)
  • Zofran (ondansetron)

What other drugs could interact with this medication?

There may be an interaction between ASA – caffeine – butalbital and any of the following:

  • abiraterone
  • acetazolamide
  • alcohol
  • alendronate
  • amphetamines (e.g., dextroamphetamine, lisdexamfetamine)
  • angiotensin receptor blockers (ARBs; e.g., candasartan, irbesartan, losartan)
  • angiotensin converting enzyme inhibitors (ACEIs; e.g., captopril, ramipril)
  • antihistamines (e.g., chlorpheniramine, diphenhydramine, doxylamine)
  • antipsychotic medications (e.g., chlorpromazine, haloperidol, quetiapine, risperidone)
  • apixaban
  • atomoxetine
  • azelastine
  • other barbiturates (e.g., butalbital, pentobarbital phenobarbital)
  • benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
  • beta-blockers (e.g., atenolol, propranolol)
  • birth control pills
  • brimonidine
  • fast acting bronchodilators (e.g., salbutamol, terbutaline)
  • long acting bronchodilators (e.g., formoterol, indacaterol, salmeterol)
  • buprenorphine
  • buspirone
  • calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
  • cannabis
  • celecoxib
  • chloral hydrate
  • clopidogrel
  • corticosteroids (e.g., prednisone)
  • cyclosporine
  • dabigatran
  • dasatinib
  • decongestant cold medications (e.g., phenylephrine, pseudoephedrine)
  • decongestant eye drops and nose sprays (e.g., naphazoline, oxymetazoline, xylometazoline)
  • deferasirox
  • diabetes medications (e.g., chlorpropamide, glipizide, glyburide, insulin, metformin, rosiglitazone)
  • dipivefrin
  • disopyramide
  • diuretics (water pills; e.g., furosemide, hydrochlorothiazide, spironolactone)
  • edoxaban
  • efavirenz
  • epinephrine
  • estrogens
  • ginkgo biloba
  • glucosamine
  • heparin
  • imatinib
  • kava kava
  • levonorgestrel
  • linezolid
  • lithium
  • low molecular weight heparins (e.g., dalteparin, enoxaparin, tinzaparin)
  • mercaptopurine
  • methadone
  • methotrexate
  • methoxsalen
  • methylphenidate
  • mexiletine
  • mirtazapine
  • modafinil
  • monoamine oxidase inhibitors (MAOIs e.g., moclobemide, phenelzine, tranylcypromine)
  • muscle relaxants (e.g., baclofen, cyclobenzaprine, methocarbamol, orphenadrine, tizanadine)
  • nabilone
  • narcotic pain relievers (e.g., codeine, fentanyl, morphine)
  • nitrates (e.g., nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
  • nonsteroidal anti-inflammatory drugs (e.g., ibuprofen, ketorolac, naproxen)
  • olopatadine
  • omega-3 fatty acids
  • pentoxifylline
  • pramipexole
  • prasugrel
  • pyridoxine
  • quinine
  • quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, moxifloxacin)
  • rifampin
  • rifabutin
  • rivaroxaban
  • ropinirole
  • rotigotine
  • selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, sertraline)
  • seizure medications (e.g., clobazam, levetiracetam, phenobarbital, phenytoin, primidone, topiramate, valproic acid, zonisamide)
  • serotonin/norepinephrine reuptake inhibitors (e.g., desvenlafaxine, duloxetine, venlafaxine)
  • somatostatin
  • sulfinpyrazone
  • tapentadol
  • teniposide
  • teriflunomide
  • tetracaine
  • tetracyclines (e.g., doxycycline, minocycline, tetracycline)
  • thalidomide
  • theophyllines (e.g., aminophylline, oxtriphylline, theophylline)
  • ticagrelor
  • ticlopidine
  • tramadol
  • tricyclic antidepressants (e.g., amitriptyline, desipramine, nortriptyline)
  • ulipristal
  • vaccines
  • vemurafenib
  • voriconazole
  • warfarin
  • zolpidem
  • zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

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What Are The Ingredients In Fioricet?

A combination medication is a drug which includes two or more pharmaceutical ingredients in a fixed dose.

What Are The Ingredients In Fioricet?
What Are The Ingredients In Fioricet?

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 its 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 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. For this reason, doctors usually refrain from prescribing Fioricet until safer over-the-counter medications fail to help their patients.

Important information before you take Fioricet

You should not use Fioricet if you have porphyria, or if you have recently used alcohol, sedatives, tranquilizers, or other narcotic medications.

Do not use Fioricet if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

Do not take more Fioricet than is recommended. An overdose of acetaminophen can damage your liver or cause death. Call your doctor at once if you have nausea, pain in your upper stomach, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of your skin or eyes).

In rare cases, acetaminophen may cause a severe skin reaction. Stop taking this medicine and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.

Before taking Fioricet

Do not use Fioricet if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

You should not use Fioricet if you are allergic to acetaminophen, butalbital, or caffeine, if you have porphyria, or if you have recently used alcohol, sedatives, tranquilizers, or other narcotic medications.

To make sure Fioricet is safe for you, tell your doctor if you have:

1. liver disease, cirrhosis, a history of alcoholism or drug addiction, or if you drink more than 3 alcoholic beverages per day;
2. kidney disease;
3.  asthma, sleep apnea, or other breathing disorder;
4. stomach ulcer or bleeding;
5.  a history of skin rash caused by any medication;
6.  a history of mental illness or suicidal thoughts; or
7. if you use medicine to prevent blood clots.
8. Butalbital may be habit forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

FDA pregnancy category C. It is not known whether Fioricet will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

How should I take Fioricet?

Take Fioricet exactly as prescribed. Follow all directions on your prescription label. Do not take more of this medication than recommended. An overdose can damage your liver or cause death. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Take the medicine with food or milk if it upsets your stomach.

Store Fioricet at room temperature away from moisture and heat.

Keep track of the amount of medicine used from each new bottle. Butalbital is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Since this medicine is used when needed, you may not be on a dosing schedule. If you are on a schedule, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of Fioricet can be fatal.

The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.

Overdose symptoms may also include insomnia, restlessness, tremor, diarrhea, increased shallow breathing, uneven heartbeats, seizure (convulsions), or fainting.

What Are the Possible Side-Effects of Fioricet?

Like any medication, Fioricet can cause side-effects. People who misuse Fioricet or use it compulsively are at greater risk for experiencing the worst side-effects of the medication.

fioricet Side Effects
fioricet Side Effects

The possible side-effects of Fioricet are:

      • Anxiety
      • Dizziness
      • Drowsiness
      • Feelings of being intoxicated
      • Lightheadedness
      • Nausea and vomiting
      • Shaking and tremors
      • Shortness of breath
      • Stomach pain
      • Trouble sleeping

In some cases, a person who takes Fioricet may develop an allergic reaction to the drug. The symptoms of an allergic reaction are trouble breathing, itching, rashes, intense dizziness, and swelling in the face, throat, and tongue.

What should I avoid?

Fioricet can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen.

Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Check the label to see if a medicine contains acetaminophen or APAP.

While you are taking Fioricet, avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor’s advice.

Is it safe to take Cymbalta if I take Fioricet(Butalbital APAP Caffeine)?

Is it safe to take Cymbalta if I take Fioricet(Butalbital APAP Caffeine)?

I take Fioricet(Butalbital APAP Caffeine) sometimes 3 to 4 tablets a day for migraines. I was prescribed Cymbalta for fibromyalgia. Is it safe to take these on the same day? I took one dose of Cymbalta at night and the next day was very dizzy while driving. I had taken the Fioricet(Butalbital APAP Caffeine) in the morning.

Best answer:

Answer by David
But, just phone a 24 hour pharmacy, like shoppers drug mart, and they will tell you definitively right away. It is very important your prescribing physician knows about all medications you take, even if they are herbal remedies.

Don’t forget you just started this med. So it will probably take 2-3 weeks for side effects to subside. Dizziness is a noted side effect.

I just looked up fioricet and it is a combination of a barbiturate, caffeine and acetaminophen.

You can note that Cymbalta puts a certain strain on the Liver, so the addition of other things that add a certain strain on the liver (i.e. fioricet) will make your liver work a bit. So, whether or not your liver is healthy or not and can handle this load, would have to be determined by your doctor. Hepatoxicity is the concern.

Here is an excerpt pertinent to you (specifically the barbiturate, which is a CNS depressant):
“CNS Acting medications — Given the primary CNS effects of Cymbalta, it should be used with caution when it is taken in combination with or substituted for other centrally acting drugs, including those with a similar mechanism of action [see Warnings and Precautions (5.11) and medication Interactions (7.17)].”

Excerpt pertinent to Caffeine:
“In vitro drug interaction studies demonstrate that duloxetine does not induce CYP1A2 activity. Therefore, an increase in the metabolism of CYP1A2 substrates (e.g., theophylline, caffeine) resulting from induction is not anticipated, although clinical studies of induction have not been performed. Duloxetine is an inhibitor of the CYP1A2 isoform in in vitro studies, and in two clinical studies the average (90% confidence interval) increase in theophylline AUC was 7% (1%-15%) and 20% (13%-27%) when co-administered with duloxetine (60 mg twice daily).”

In general:
5.11 Clinically Important medication Interactions
Both CYP1A2 and CYP2D6 are responsible for duloxetine metabolism.
Potential for Other medications to Affect Cymbalta
CYP1A2 Inhibitors — Co-administration of Cymbalta with potent CYP1A2 inhibitors should be avoided [see medication
Interactions (7.1)].
CYP2D6 Inhibitors — Since CYP2D6 is involved in duloxetine metabolism, concomitant use of duloxetine with
potent inhibitors of CYP2D6 would be expected to, and does, result in higher concentrations (on average of 60%) of duloxetine [see medication Interactions (7.2)].”

Another Excerpt:
“7.18 medications Highly Bound to Plasma Protein
Because duloxetine is highly bound to plasma protein, administration of Cymbalta to a patient taking another drug that is highly protein bound may cause increased free concentrations of the other drug, potentially resulting in adverse reactions. However, co-administration of duloxetine (60 or 120 mg) with warfarin (2-9 mg), a highly protein-bound drug, did not result in significant changes in INR and in the pharmacokinetics of either total S-or total R-warfarin (protein bound plus free drug) [see medication Interactions (7.4)].”

What do you think? Answer below!

Is it safe to take fioricet while on oxycodone?

Is it safe to take fioricet while on oxycodone?
I just got my wisdom teeth out yesterday and they were bothering me so I took 3 of the 5mg oxycodones that I was prescribed. I have a migraine though and I cannot sleep. Would it be safe for me to take fioricet to help with the migraine?

Best answer:

Answer by John Doe
I do sometimes myself, but I wouldnt take more then one of each due to the amount of Acetaminophen.
Fioricet has 325mg of acetaminophen, and it depends on what type of oxycodone drug your on, some contain 325mg, and some have 650mg’s, or if it’s oxycontin it wont have any acetaminophen at all, just try not to ecceed more then 650 mg of acetaminophen in a 3 hour period.

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What kind of pain drug can i take with fioricet?

What kind of pain drug can i take with fioricet?
My doctor prescibe fioricet for migrains and my dentist prescibed lortabs for my toothache ,i cannot take them together .MY problem is the lortab helps with the toothache but not the headache and thefioricet helps with the head ache but not the toothache.I have a doctors appointment on friday i am hoping she canhelp with this problem…any advise.?

Best answer:

Answer by Mary Soilex
TAKE THE LORTAB…IT WILL HELP BOTH

I ALSO DUNT KNOW WHY YUS CANT TAKE BOTH

FIOROCET IS SOMETIMES IN A CAPSULE MIT CODEINE

LORTAB HAS VICODIN…A CODEINE DERIVITAIVE.

SO PERHAPS IT CAN BE TAKEN TOGETHER ,,,BUT ASK THE DOKTA FURST

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What other drugs will affect Fioricet?

The CNS effects of butalbital may be enhanced by monoamine oxidase (MAO) inhibitors.

Butalbital, acetaminophen and caffeine may enhance the effects of: other narcotic analgesics, alcohol, general anesthetics, tranquilizers such as chlordiazepoxide, sedative-hypnotics, or other CNS depressants, causing increased CNS depression.

Drug/Laboratory Test Interactions

Acetaminophen may produce false-positive test results for urinary 5-hydroxy-indoleacetic acid.

Common medications checked in combination with Fioricet (acetaminophen / butalbital / caffeine)

  • Adderall (amphetamine / dextroamphetamine)
  • Advil (ibuprofen)
  • Ambien (zolpidem)
  • aspirin
  • Ativan (lorazepam)
  • caffeine
  • clonazepam
  • codeine
  • Cymbalta (duloxetine)
  • Excedrin (acetaminophen / aspirin / caffeine)
  • Flexeril (cyclobenzaprine)
  • gabapentin
  • hydrocodone
  • ibuprofen
  • Imitrex (sumatriptan)
  • Klonopin (clonazepam)
  • levothyroxine
  • Lexapro (escitalopram)
  • lisinopril
  • Lyrica (pregabalin)
  • meloxicam
  • naproxen
  • Norco (acetaminophen / hydrocodone)
  • omeprazole
  • oxycodone
  • Percocet (acetaminophen / oxycodone)
  • prednisone
  • Singulair (montelukast)
  • Suboxone (buprenorphine / naloxone)
  • Topamax (topiramate)
  • tramadol
  • trazodone
  • Tylenol (acetaminophen)
  • Vitamin D3 (cholecalciferol)
  • Xanax (alprazolam)
  • Zofran (ondansetron)

Fioricet (acetaminophen / butalbital / caffeine) alcohol/food Interactions

There are 6 alcohol/food interactions with Fioricet (acetaminophen / butalbital / caffeine)

Fioricet (acetaminophen / butalbital / caffeine) disease Interactions

There are 23 disease interactions with Fioricet (acetaminophen / butalbital / caffeine) which include:

  • Alcoholism
  • Liver Disease
  • Acute Alcohol Intoxication
  • Drug Dependence
  • Liver Disease
  • Porphyria
  • Rash
  • Respiratory Depression
  • Cardiac Disease
  • Hypertension
  • Liver Disease
  • Seizure Disorders
  • Pud
  • Pku
  • Adrenal Insufficiency
  • Depression
  • Hematologic Toxicity
  • Osteomalacia
  • Paradoxical Reactions
  • Cardiotoxicity
  • Psychiatric Disorders
  • Renal Dysfunction
  • Gerd

Are there any negative side effects of the pain killer Fioricet?

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

In rare cases, acetaminophen may cause a severe skin reaction that can be fatal. This could occur even if you have taken acetaminophen in the past and had no reaction. Stop taking this medicine and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling. If you have this type of reaction, you should never again take any medicine that contains acetaminophen.

Stop using this medicine and call your doctor at once if you have:

  • confusion, seizure (convulsions);
  • shortness of breath;
  • a light-headed feeling, like you might pass out; or
  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects may include:

  • drowsiness, dizziness;
  • feeling anxious or restless;
  • drunk feeling; or
  • sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

I take Wellbutrin, Alprazolam and Fioricet at the same time?

I can Wellbutrin, Alprazolam and Fioricet at the same time?
Or if not all the same time I usually take Wellbutrin every morning if needed alprazolam for anxiety and Fioricet if necessary. Is it safe Best Answer:

reaction S
Yes, that’s fine. In the future, call a pharmacist and ask. They are a wonderful resource for free information like this.

Enter below your answer to this question!

Can anyone recognize this headache and suggest some natural remedies?

someone can identify and suggest some natural remedies these All kinds of Headache?

My uncle had a persistent headache over his head. Massaging makes things worse.

After he had heard of a trauma , “Can someone please tell me what a headache and perhaps the natural ways in which we cure a headache Thanks Best answer:.

Once the doctor has something that needs to be treated to eliminate excluded, drink plenty of fluids, avoiding alcohol and caffeine, lots of sleep, gentle exercise – they all can help to reduce the impact of such a headache. even though he feels stressed, Rescue Remedy is a natural product, just needs a few drops calmant.Mais have effect to the doctor.

your own answer in the comments!

Is Butalbital fioricet A Narcodic?

Is Butalbital fioricet the Narcodic?

There are lots of answers, the best answer will be:


it depends somewhat of your definition of a narcotic. to be exact, narcotics are derivatives associated with opium. that is, morphine, Demerol, codeine & the like. butalbitol is a barbituate, not an opium derivative. however , since almost all barbituates are addicting in case taken for long periods and in large doses, many people lump them in with the particular “narcotics. ”

What is a Narcotic?

Before exploring if Fioricet is a narcotic, what is a narcotic? The term narcotic was at one point in history used to refer to any psychoactive substance that tended to induce sleep, but currently, in the U.S., it’s primarily associated with opioids including heroin, as well as prescription painkillers.
When you’re looking at the term narcotic in the legal sense, people often associate it with illegal drugs like heroin, but a narcotic can also be used to describe controlled substances such as painkillers that are regulated but available by prescription. In the U.S. there are classifications for various narcotics that define the penalties for possessing the illegally, including without a prescription. So, is Fioricet a narcotic?
As with other narcotics and prescription pain medicines, Fioricet has many warnings that accompany its use. First and foremost, this medicine can cause liver toxicity because of the acetaminophen.
It’s important that people realize that they should never take an excessive amount of acetaminophen in one day because it can lead to liver damage or failure. Also, while it may be somewhat lower than with other narcotics, there is the potential for abuse, addiction, and dependence with the use of barbiturates including butalbital.

Fioricet Overdosage

The treatment of Fioricet overdose is complicated by the presence of two substances which are highly toxic when taken in excessive amounts. Fioricet overdoses generally result in toxic amounts of both acetaminophen and butalbital being consumed at once, requiring both overdoses to be treated at once.

fioricet2

Fioricet overdose by anyone and/or any consumption by persons to whom it is not prescribed (particularly children) is always a medical emergency and medical attention must be sought immediately if an overdose or consumption by other persons is suspected. Fioricet overdose is often fatal and symptoms may not present for hours following consumption, once initial overdose symptoms present they can progress rapidly and there may not be time to reach appropriate medical care after this point.

acetaminophenAcetaminophen over-exerts its toxicity through the production of a toxic metabolite which can sometimes produce liver damage with doses as low as 4,000 mg, although normally requiring doses that are much higher. acute liver failure may result in doses greatly exceeding this, and death has been known to occur with ingestion of 10,000-15,000 mg (10-15 grams of pure acetaminophen). The specific antidote to acetaminophen overdose is N-acetyl-cysteine. Kidney failure andstomach bleeding may also occur.

Butalbital overdoses 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 butalbital overdose and treatment is supportive, common treatment regimens generally include the administration of intravenous administration of saline, naloxone, thiamine, glucose, NaHCO3 to alkalize the urine to increase rate of excretion, and activated charcoal via nasogastric tube.

It is not uncommon for doctor to recommend observation of the patient in the Emergency Department for a number of hours or admission to the hospital for several days of observation if symptoms are severe and to counsel the patient on drug abuse and/or refer them for psychiatric evaluation.

Fioricet Warnings and The Fioricet ‘High’ and Abuse

Fioricet is a prescription medication used to relieve tension headaches. It works by relaxing muscle contractions that can result in mild to moderate head pain.

The Food and Drug Administration (FDA) approved Fioricet in 1984. Novartis Pharmaceuticals was the original manufacturer. In 2003, Watson Pharmaceuticals bought the rights to Fioricet (Watson is now known as Actavis).

Fioricet is currently available from many manufacturers as a generic.

The original formulation of Fioricet included 50 milligrams (mg) of butalbital, 40 mg of caffeine, and 325 mg of acetaminophen.

However, in 2011 the FDA asked makers of prescription combination drugs with acetaminophen to limit the amount of that drug to no more than 325 mg in each tablet by 2014. This action was taken to protect consumers from severe liver damage, a risk linked with taking too much acetaminophen.

Today Fioricet includes 320 mg of acetaminophen, though some versions of the product sold online still have 325 mg.

The Fioricet ‘High’ and Abuse

The butalbital in Fioricet belongs to a class of drugs called barbiturates, a central nervous system depressant. Like other barbiturates, it has the potential to cause physical and psychological dependence, which can lead to abuse.

Those who use too much Fioricet may report feeling so relaxed and stress-free that they seek out the drug as a way to get high. Some describe it as feeling intoxicated. However, users can feel depressed and “crash” once the effects wear off.

Fioricet with Codeine

Another formula, Fioricet with codeine, is also made by Actavis to treat tension headaches. It contains 30 mg of codeine in addition to the other three drugs, and has an increased acetaminophen dose of 325 mg.

Fioricet with codeine carries a black-box warning about liver toxicity, and about the risk of respiratory problems and death in children caused by codeine.

Fioricet Warnings

Fioricet carries a black-box warning cautioning users about the link of acetaminophen to acute liver failure. In some cases, users of Fioricet have needed a liver transplant; in other cases, use of Fioricet has proven fatal.

Most problems have occurred with an acetaminophen dose of more than 4,000 mg a day. Those affected are often taking more than one product containing acetaminophen at the same time or have underlying liver disease.

Another caution concerns butalbital, which may be habit-forming and therefore has the potential to be abused.

Those with a condition known as porphyria, a rare hereditary blood disorder, should not use Fioricet.

What can I do to prevent another migraine/tension headache?

What can I do to prevent an additional migraine/tension headache?
I got a migraine/tension headache the other day and I rarely ever get them but it was really bad.

Fioricet contains a combination of acetaminophen, butalbital, and caffeine Acetaminophen is a pain reliever and fever reducer. Butalbital is in a group of drugs called barbiturates.

It relaxes muscle contractions involved in a tension headache. Caffeine is a central nervous system stimulant. It relaxes muscle contractions in blood vessels to improve blood flow.

Fioricet is used to treat tension headaches that are caused by muscle contractions.

I was at school and I held seeing this blurry blob that really bothered me and I couldn’t focus. Also 1 side of my vision was really sore and I had to lay down the whole day. What can I do to prevent another one? Thanks!: )

There are lots of answers, the best answer is:

Answer by Polkadot
I had comparable symptoms, went to the optometrist and found my remaining eye had astigmatism. further lenses solved my head ache issue! I mostly wear them when on the computer or reading through. You could give that an attempt! =)

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What is Fioricet and was my dr right for prescribing it to me?

What is Fioricet and was my dr right for prescribing it to me?


my dr prescribed me this yesterday for my headaches and back pain .. in pregnant and having a “threatened miscarriage” and says it has caffeine in it. I do not think caffeine would b good for me? In addition, a friend told me that all fioricet is just tylenol is that true Best answer:?
Answer

with * M *
It’s certainly not “just tylenol” although the active ingredient in Tylenol is acetaminophen, fioricet also present in the pills. You’re right about caffeine (headache helps to some degree, but not back pain). The tylenol helps both headaches and back pain to a certain degree as well. but it also has a third ingredient, butabital. Butabital is a barbiturate. Basically, your body slows down a little, away pain, relaxes, helps to fear you may feel to take off. This may wonderful, and it will probably pay a pretty good feeling, but careful not to take more than prescribed because you may be addicted to it. Advantage jokes, but get used to it, because you have not, if you feel better. It would not hurt to ask your doctor if you might have something a little less caffeine and butabital not good for the baby, but should not be too terrible. even though you can handle the pain, while taking tylenol here and there, when he at his worst would préférable.Bonne luck!

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Fioricet Withdrawal and Pain Pills?

Fioricet Withdrawal and discomfort Pills?
I have been getting Fioricet with codeine for the past year or so for my every day Migraines/Headaches.

My doctor reduce me off from the medication all of a sudden. I went through the particular withdrawal symptoms that I have been reading about. I did not want to call my Dr . about it, because I did not want him to get me personally back on it to try and taper off of it. I thought that I got that much without tapering off and I wanted to be off of all of them and never take them again. we wasn’t taking a lot of the particular medicine. Maybe 2-3 per day, if needed (I has been reading about people who get about 30 per day.. ) I was vomiting and using the bathroom a lot, I guess so the medication can get out of my program.

I got so dehydrated, we went to Urgent Care and they gave me an IV and some Tylenol 3 and Percocets for the Migraine pain I was having during the withdrawals. we took a percocet when I got home and I has been finally able to fall asleep.. I am wondering if I was getting withdrawals from the Butalbital or the Codeine in the Firoicet?? we stopped taking the Fioricet over a week ago.

I am sensation better. I took two Tylenol 3s a few days back for a bad headache. we haven’t had any given that.

I feel okay, no withdrawals at all. I am thinking it was the Butalbital I was depending on, and not the codeine….? furthermore, I just went through all of this…. I just found out that I need nose Surgery in about a 30 days and a half. Now, I know that they will be giving me discomfort pills for the recovery (probably Percocets or Vicodin), we don’t want to fall back into what I just went through.

we doubt I will, because these discomfort Pills are different ingredients compared to what I taking for over a year (Fioricet). Is the Butalbital more difficult to withdrawal from than the Codeine that is in Fioricet?

Addiction is a disease that impacts your behavior because your brain is pushing you toward continuing to use the drug that triggered the reward response again and again.

Addiction to opioids is difficult to escape from, and it can lead to overdose and death. Another element of the use of opioids is tolerance and dependence. While these aren’t the same as addiction, these scenarios often go hand in hand with one another.

An opioid tolerance means that your body has become somewhat immune to the effects of these drugs so that you require higher doses to feel anything. A physical dependence means that in many ways the presence of opioids has become your new normal.

If you suddenly stop using opioids when you’re physically dependent on them, whether or not you’re addicted, you may experience very uncomfortable symptoms which are categorized as withdrawal. Some of the symptoms of opiate withdrawal can include nausea, vomiting, goose bumps, cramping, diarrhea, agitation, anxiety, insomnia, and yawning. Withdrawal from opioids can range from annoying to very painful. During a medically-supervised opioid detox, doctors can prescribe certain medicines that can help keep the person more comfortable and help them be more successful at stopping their use of the drugs.

Some of the medicines that may be given to patients during opiate withdrawal include methadone, buprenorphine, clonidine, and naltrexone. These drugs do everything from providing a maintenance system for opioid addicts, to helping with the actual symptoms such as muscle aches and anxiety.

Some people may attempt to manage their own withdrawal from opioids, and not only can this be dangerous, but it is also often ineffective.

There are lots of answers, the best answer is:

Answer by Wulfgar
Codeine will be worse. I take Vicodin 2 & 4 a day depending on how i feel. Percocet and Vicodin are both drugs. I started on seven. /500 then went to 10/500 mg. Oh yea them great ole withdraws. Take Care.

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Fioricet Mechanism of action

Fioricet® (Butalbital, Acetaminophen, and Caffeine Tablets USP) is supplied in tablet form for oral administration.

Each tablet contains the following active ingredients:
butalbital USP . . . . . . . . . . . .50 mg
acetaminophen USP . . . . . . 325 mg
caffeine USP . . . . . . . . . . . . .40 mg

Inactive Ingredients: crospovidone, FD&C Blue #1, magnesium stearate, microcrystalline cellulose, povidone, pregelatinized starch, and stearic acid.

Butalbital has generalized depressant effect on central nervous system and, in very high doses, has peripheral effects. Acetaminophen has analgesic andantipyretic effects mediated by a metabolite which acts at cannabinoid receptors, contrary to popular belief it is not an antiinflammatory at safe levels (it becomes toxic at doses above 1,000mg per dose and/or 3,000mg per day).

fioricet

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 5 to 7

hours.

You can not take Prescription for a long time, you need find a way to treat your pain without prescription. Exercising is the best way to relieve your pain. because exercising can enhance your immune system and increase your muscle strength and make your nerve strong. You can also try to become a usana distributor or associate and eat health organic food to get rid of your headache or nerve pain.