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Butalbital, acetaminophen, and caffeine

Brand names: Fioricet, Esgic

Butalbital-acetaminophen-caffeine (Fioricet) treats tension headaches. It's meant for occasional use.

Brand namesFioricet, Esgic
Type of medicineTension headache medicine (barbiturate combination)
Prescription?Prescription
ImportantThis page is general information, not a prescription. Don't start, stop, or change a medicine without talking to your provider or pharmacist.

Overview

Butalbital is a barbiturate that can be habit-forming and cause rebound headaches.

What it's used for

  • Tension headaches

How to take it

  • Take it only when needed, and limit it to a few days a month.
  • Count it toward your daily acetaminophen limit.

Your dose depends on your health and other medicines. Always follow your prescription label, and ask your pharmacist if anything is unclear.

Side effects

Common side effects

  • Sleepiness
  • Dizziness
  • Nausea
Call 911Slow, shallow, or stopped breathing, blue lips, or can't be woken up
Call 911A seizure after stopping regular use
Call your provider todayYellow skin or eyes or dark urine (liver)

Warnings

  • Frequent use causes medication-overuse headache and dependence.
  • Don't stop suddenly after regular use.

Other medicines, foods, and alcohol

  • Alcohol, opioids, and sedating medicines can dangerously slow breathing.
  • Other acetaminophen products add to the daily limit.
  • It can make birth control less effective.

Tell your provider and pharmacist about every medicine, vitamin, and supplement you take.

Pregnancy and breastfeeding

Talk with your provider.

Missed doses, overdose, and storage

If you miss a dose

This medicine is often taken only when needed. If you take it on a schedule, take a missed dose when you remember, unless it's almost time for the next one. Don't double up.

If someone takes too much

Call Poison Control at 1-800-222-1222 or get help online at poison.org. Call 911 if the person collapses, has a seizure, has trouble breathing, or can't be woken.

Storing it

Store at room temperature, away from heat and moisture (not in the bathroom), and out of reach of children and pets.

Conditions it's used for

Sources

Last updated 2026-11-13.