How Does Fioricet Work with other Drugs ?

Medicines that interact with Fioricet may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Fioricet.

An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

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.

Common medications that may interact with Fioricet include:

  • antidepressants, such as tricyclic antidepressants (eg, amitriptyline), monoamine oxidase inhibitors (eg, isocarboxazid, phenelzine, and tranylcypromine), or SSRIs (eg, fluoxetine, sertraline)
  • anticonvulsants, such as carbamazepine, divalproex, lamotrigine, phenytoin, phenobarbital, or primidone
  • antipsychotics (such as butyrophenones, phenothiazines, or thioxanthenes) and atypical antipsychotics (eg, olanzapine, quetiapine, ziprasidone)
  • any medication that may cause drowsiness, such as amphetamines, benzodiazepines (eg, diazepam, lorazepam), first-generation antihistamines (such as doxylamine or promethazine), metoclopramide, or opioids (such as codeine, fentanyl or morphine)
  • buprenorphine
  • cannabis
  • cyclosporine
  • dextromethorphan
  • duloxetine
  • heart medications such as diltiazem or verapamil
  • HIV medications such as ritonavir
  • migraine medications, such as ergotamine or dihydroergotamine
  • muscle relaxants, such as cyclobenzaprine
  • naltrexone
  • other medications that contain acetaminophen or an opioid either in combination or as the sole ingredient
  • pentazocine
  • prilocaine
  • rifampin
  • sodium oxybate
  • tamsulosin
  • tramadol
  • warfarin.

Avoid drinking alcohol or taking illegal or recreational drugs while taking Fioricet.

Note that this list is not all-inclusive and includes only common medications that may interact with Fioricet. You should refer to the prescribing information for Fioricet for a complete list of interactions.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

  • Riociguat
  • Viloxazine

Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alfentanil
  • Alprazolam
  • Amobarbital
  • Anisindione
  • Aprobarbital
  • Butabarbital
  • Calcium Oxybate
  • Capmatinib
  • Carisoprodol
  • Chloral Hydrate
  • Chlordiazepoxide
  • Chlorzoxazone
  • Clarithromycin
  • Clonazepam
  • Clorazepate
  • Dantrolene
  • Darunavir
  • Diazepam
  • Dicumarol
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Esketamine
  • Estazolam
  • Ethchlorvynol
  • Etonogestrel
  • Flunitrazepam
  • Flurazepam
  • Givosiran
  • Halazepam
  • Imatinib
  • Iobenguane I 131
  • Isoniazid
  • Ketazolam
  • Lorazepam
  • Lormetazepam
  • Magnesium Oxybate
  • Medazepam
  • Mephenesin
  • Mephobarbital
  • Meprobamate
  • Metaxalone
  • Methocarbamol
  • Methohexital
  • Midazolam
  • Nifedipine
  • Nitrazepam
  • Oxazepam
  • Peginterferon Alfa-2b
  • Pentobarbital
  • Phenindione
  • Phenobarbital
  • Phenprocoumon
  • Piperaquine
  • Pixantrone
  • Pneumococcal 13-Valent Vaccine, Diphtheria Conjugate
  • Potassium Oxybate
  • Prazepam
  • Primidone
  • Quazepam
  • Secobarbital
  • Sodium Oxybate
  • Temazepam
  • Thiopental
  • Trazodone
  • Triazolam
  • Ulipristal

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Using medicines in this class with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use your medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Ethanol
  • Tobacco

Other Medical Problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

  • Alcohol abuse (or history of) or
  • Drug abuse or dependence (or history of)—Dependence on butalbital may develop. Also, acetaminophen may cause liver damage in people who abuse alcohol.
  • Asthma (or history of), emphysema, or other chronic lung disease or
  • Hepatitis or other liver disease or
  • Hyperactivity (in children) or
  • Kidney disease—The chance of serious side effects may be increased.
  • Type 2 diabetes mellitus or
  • Mental depression or
  • Overactive thyroid or
  • Porphyria (or history of)—Butalbital can make these conditions worse.
  • Heart disease (severe)—The caffeine in some butalbital and acetaminophen combinations can make some kinds of heart disease worse.

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