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Fioricet Addiction: Symptoms, Signs and Side Effects

Written by Renee Deveney

& Medically Reviewed by Stephanie Hairston, MSW

Medically Reviewed

Up to Date

This article was reviewed by a medical professional to guarantee the delivery of accurate and up-to- date information. View our research policy.

Last Updated - 6/17/2022

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Fioricet is the brand name for a medication that combines caffeine, acetaminophen and butalbital. It is approved by the Food and Drug Administration (FDA) for the treatment of tension headaches. While doctors sometimes prescribe Fioricet for migraine headaches, research shows that it does not effectively treat them. Using Fioricet for migraines is not approved by the FDA and is not covered by many insurance plans.

In addition to these restrictions, many doctors hesitate to prescribe Fioricet because of the risk of Fioricet abuse. One of the main ingredients of Fioricet is butalbital, a barbiturate that can cause tolerance, withdrawal and medical complications including overdose. Mixing butalbital with alcohol is especially dangerous. Some formulations of Fioricet include codeine, an opioid that further increases risks of addiction and overdose.

To avoid the potentially negative effects of Fioricet, it’s important to understand the drug’s symptoms, side effects and signs of misuse.

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Symptoms of Fioricet Abuse

Fioricet addiction symptoms include tolerance, which occurs when people need to take Fioricet more frequently or in greater amounts to achieve the same effects, and withdrawal. Symptoms of Fioricet withdrawal include:

  • Fever
  • Anxiety
  • Tremors
  • Insomnia
  • Irritability
  • Delirium
  • Nausea

These symptoms occur as the sedative effects of butalbital wear off. They are caused by temporary overactivity of the central nervous system (CNS).

People can exhibit signs of Fioricet abuse before they become physically addicted. The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders defines substance abuse as persistent substance use despite negative social, physical, psychological and behavioral effects. Fioricet abuse symptoms can include:

  • Being preoccupied with obtaining and using Fioricet
  • Going to multiple doctors (“doctor shopping”) to get more Fioricet
  • Taking Fioricet for off-label purposes (reasons other than headache)
  • Using Fioricet despite increased conflict in personal relationships
  • Continuing to use Fioricet when it causes problems at work, school or home
  • Being under the influence of Fioricet in situations in which it is physically dangerous to be so

Other warning signs of addiction to Fioricet include financial or legal problems caused by actions a person took to obtain more Fioricet.

Side Effects of Fioricet

Prescription labels on bottles of Fioricet warn of potential side effects such as:

  • Itching
  • Vomiting
  • Confusion
  • Drowsiness
  • Lightheadedness
  • Breathing problems
  • Stomach discomfort

These effects can occur even when people take Fioricet as prescribed and do not misuse it. People who misuse Fioricet are at increased risk of these moderate and severe side effects, which include:

  • Seizures
  • Hot flashes
  • Constipation
  • Kidney problems
  • Difficulty swallowing
  • Increased heart rate
  • Heart palpitations
  • Water retention

Additional side effects of Fioricet abuse include negative mental health effects like symptoms of anxiety and depression. Fioricet use depresses the CNS and can prolong or intensify depressive symptoms in people who are prone to depression. Similarly, the CNS hyperactivity that occurs during the Fioricet withdrawal period can cause or worsen symptoms of anxiety.

Side Effects of Long-Term Fioricet Abuse

Long-term side effects of Fioricet use can be serious. Over time, episodic or acute effects can progress into recurrent, chronic effects. For example, as people experience stomach problems more frequently, they can develop chronic digestive and gastrointestinal disorders. Fioricet abuse can also cause chronic insomnia as people develop tolerance to its sedative effects.

Short-term psychological effects like depressed mood and anxiety can develop into chronic mental health conditions over time as neurotransmitter levels become imbalanced. Chronic excitation of the central nervous system can cause generalized anxiety symptoms, while frequent episodes of depressed mood can progress to the point a person is diagnosed with major depressive disorder.

Because Fioricet includes acetaminophen, another serious risk of long-term Fioricet abuse is liver damage and liver failure. Acetaminophen is toxic to the liver in higher doses, which is why the FDA now requires drugs with acetaminophen to contain no more than 325 milligrams per dose. Liver toxicity is especially likely if people exceed 4000 milligrams of acetaminophen a day, but it can occur at lower doses. Mixing alcohol and Fioricet increases the risk of liver damage.

One of the most frustrating side effects of long-term Fioricet use is rebound or withdrawal headaches. Medication-overuse headaches (MOH) affect 1-2 percent of the global population. People only develop MOH if they have a pre-existing headache disorder and overuse headache medicines in an attempt to alleviate headache pain. Unfortunately, this means medications like Fioricet can actually make headaches more intense and frequent over time. People can develop MOH when they use Fioricet or butalbital for as few as five days a month.

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Signs of Fioricet Overdose

Fioricet overdose can be caused by butalbital, acetaminophen or codeine. Both butalbital and codeine cause respiratory depression. People may stop breathing when they take either drug in large amounts. Acetaminophen overdose occurs when people take enough acetaminophen to damage the liver. Symptoms of Fioricet overdose can include:

  • Nausea
  • Seizures
  • Confusion
  • Drowsiness
  • Stomach pain
  • Shallow breathing
  • Labored breathing
  • Low blood pressure
  • Blue lips or fingernails

A Fioricet overdose requires emergency medical treatment. In addition to lack of oxygen, which can cause coma and brain damage, other severe withdrawal symptoms like seizures can be fatal if they are not addressed right away. After a person receives treatment for an overdose in a hospital, clinicians usually recommend that they go to a hospital for detoxification or to a substance abuse treatment facility with medically-supervised detoxification services.

The Recovery Village Ridgefield offers integrated treatment for substance use disorders including Fioricet use disorders. In addition to medically-supervised detoxification, Ridgefield provides intensive outpatient, partial hospitalization and residential treatment programs. At these programs, people receive group and individual therapy for substance use disorders and co-occurring mental health conditions. If you need treatment for Fioricet addiction, contact The Recovery Village Ridgefield to learn more about which treatment options and which level of care are right for you.