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All about: Fiorinal

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Generic name: Butalbital, Aspirin, Caffeine
Brand names: Fiorinal

Why is Fiorinal prescribed?

Fiorinal, a strong, non-narcotic pain reliever and muscle relaxant, is prescribed for the relief of tension headache symptoms caused by stress or muscle contraction in the head, neck, and shoulder area. It combines a non-narcotic, sedative barbiturate (butalbital) with a pain reliever (aspirin) and a stimulant (caffeine).

Most important fact about Fiorinal

Barbiturates such as butalbital can be habit-forming if you take them over long periods of time.

How should you take Fiorinal?

For best relief, take Fiorinal as soon as a headache begins.

Take the medication with a full glass of water or food to reduce stomach irritation. Do not take Fiorinal if it has a strong odor of vinegar.

Take Fiorinal exactly as prescribed. Do not increase the amount you take without your doctor's approval, or take the drug for longer than prescribed.

--If you miss a dose...

If you take Fiorinal on a regular schedule, take the forgotten dose as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

--Storage instructions...

Store at room temperature. Keep the container tightly closed.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Fiorinal.

  • More common side effects may include:
    Dizziness, drowsiness

Why should Fiorinal not be prescribed?

If you are sensitive to or have ever had an allergic reaction to barbiturates, aspirin, caffeine, or other sedatives and pain relievers, you should not take Fiorinal. The aspirin in Fiorinal, in particular, can cause a severe reaction in someone allergic to it. Make sure your doctor is aware of any drug reactions you have experienced.

Unless you are directed to do so by your doctor, do not take Fiorinal if you have porphyria (an inherited metabolic disorder affecting the liver or bone marrow).

Because aspirin, when given to children and teenagers suffering from flu or chickenpox, can cause a dangerous neurological disease called Reye's syndrome, do not use Fiorinal under these circumstances.

Fiorinal contains aspirin. If you have a stomach (peptic) ulcer or a disorder affecting the blood clotting process, you should not take Fiorinal. Aspirin may irritate the stomach lining and may cause bleeding.

Special warnings about Fiorinal

Fiorinal may make you drowsy or less alert; therefore, you should not drive or operate dangerous machinery or participate in any hazardous activity that requires full mental alertness until you know your response to Fiorinal.

Taking more of Fiorinal than your doctor has prescribed may cause dependence and symptoms of overdose.

Be especially careful with Fiorinal if you are an older person or in a weakened condition, if you have any kidney, liver, or intestinal problems or an enlarged prostate gland, or if you have had a head injury. Also be cautious if you have a thyroid problem, blood clotting difficulties, or a urinary disorder.

Possible food and drug interactions when taking Fiorinal

Butalbital decreases the activity of the central nervous system and intensifies the effects of alcohol. Avoid drinking alcohol while you are taking Fiorinal.

If Fiorinal is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Fiorinal with the following:

Acetazolamide (Diamox)
Beta-blocking blood pressure drugs such as Inderal and Tenormin
Blood-thinning drugs such as Coumadin
Drugs known as MAO inhibitors, such as the antidepressants Nardil and Parnate
Mercaptopurine (Purinethol)
Methotrexate (Rheumatrex)
Narcotic pain relievers such as Darvon and Percocet
Nonsteroidal anti-inflammatory drugs such as Naprosyn, Motrin
Oral contraceptives
Oral diabetes drugs such as Micronase
Probenecid (Benemid)
Sleep aids such as Halcion and Nembutal
Steroid medications such as prednisone
Sulfinpyrazone (Anturane)
Theophylline (Theo-Dur, others)
Tranquilizers such as Librium, Valium, and Xanax
Valproic acid (Depakene, Depakote)

Special information if you are pregnant or breastfeeding

The effects of Fiorinal during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. If you take aspirin late in your pregnancy it could cause bleeding in you or your baby, or could delay the baby's birth. Aspirin, butalbital, and caffeine appear in breast milk. If Fiorinal is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with Fiorinal is finished.

Recommended dosage


The usual dose of Fiorinal is 1 or 2 tablets or capsules taken every 4 hours. You should not take more than 6 tablets or capsules in a day.


The safety and effectiveness of Fiorinal have not been established in children.


Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

  • Symptoms of an overdose of Fiorinal are mainly attributed to its barbiturate component. These symptoms may include:
    Coma, confusion, drowsiness, low blood pressure, shock, slow or troubled breathing
  • Symptoms attributed to the aspirin and caffeine components of Fiorinal may include:
    Abdominal pain, deep, rapid breathing, delirium, high fever, inability to fall or stay asleep, rapid or irregular heartbeat, restlessness, ringing in the ears, seizures, tremor, vomiting

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