Efficacy of Fioricet

In a double blind test, researchers discovered that Fioricet worked better than a combination of codeine and acetaminophen for reducing tension and headache pain. The same study found that this medication may react faster to headache pain reduction, and the pain relief may last longer than the acetaminophen and codeine combination.

By the end of four hours during this test, a large number of people being tested in this trial experienced total pain relief using Fioricet, versus those who used the codeine and acetaminophen combination.

Because of limited research on the efficacy of Fioricet when used for migraine and tension headaches, this use has not been approved by the FDA. Research indicates that Fioricet does not have as good of a result against migraines as do triptan medications, such as Zomig or Imitrex.

However, physicians prescribe this drug for helping patients with migraines, under the assumption that the acetaminophen controls the migraine pain, and the butalbital relaxes the body.

Aside from possible addiction, the primary problem physicians see with using Fioricet to control migraines is that it can cause rebound headaches. Patients who suffer from rebound headaches usually experience headaches on a daily basis, they experience headaches within one day of their last dose of Fioricet or their headaches continue for multiple days in a row.

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The headaches occur more frequently or feel stronger, so more medication is taken to control the pain, leading to excessive use of this drug and possible dependency. The "excessive use" which leads to worse headaches can vary with each individual. It can mean as little as using the drug three times a day for two or three days in a week.

The only way to bring the stronger headaches under control is to gradually stop using the Fioricet, although the headaches may get worse for awhile until this medication works its way out of your body.

Because Fioricet is addictive, creates withdrawal symptoms and can cause medication overuse, or rebound, headaches, this prescription drug should only be taken when a physician can monitor use, and only for a limited time. A pain medication containing butalbital, such as Fioricet, is not considered the first drug a physician should reach for when prescribing a pain medication to a patient. Besides addiction, this drug can slow reflexes and impair judgment.

Fioricet is an appropriate medication to prescribe only if no other medication solves the medical problem, or no other medication is available.

Butalbital has a long half-life of 10 to 50 hours, which means that each time a patient takes a Fioricet tablet or capsule, not all of the medication leaves the body right away. Patients can have minor withdrawal symptoms as soon as 36 hours after their last dose. Problems with withdrawal peak at about 40 hours after the last dose, and then the symptoms slowly go away in two to 15 days after the last dose.

If taken several times a day, the butalbital can build up in the body, and the side effects can be stronger and more noticeable, to the point that people taking several Fioricet can experience memory loss, uncoordinated movement of arms and legs, and feelings of being sedated. Also, with a long half-life, side effects can be felt for hours, or even days, if Fioricet is taken in large amounts or over long periods of time.

Children under age 12 should not use Fioricet, because the drug's effectiveness isn't proven in children.

Patients age 65 and older should begin taking Fioricet at the lowest dose recommended by their physician. The effects of Fioricet on older adults has not been part of any studies, so it is unknown whether or not people over 65 respond differently to the drug than younger people.

However, some older adults exposed to butalbital have shown signs of mental depression, excitement or confusion. Potential medical problems, such as kidney, liver or heart disease, are greater in older adults. Plus, older adults tend to be on more prescription medication. Also, the side effects of Fioricet, such as drowsiness, may be stronger in older adults, possibly contributing to falling. All of this has to be taken into consideration before a physician chooses to prescribe Fioricet.

Because butalbital, one of the three ingredients found in Fioricet, is removed from the body mainly by the kidneys, patients with kidney problems stand a greater chance of toxic buildup in the body. The smallest dose of Fioricet should be prescribed to these patients, if the physician chooses to use this particular drug.

Although fairly rare, incidents of addiction, because of the barbiturate butalbital, can occur with Fioricet. This is particularly true for patients with a history of drug or alcohol addiction. The main attraction of butalbital is the fact that it relaxes the body, and it can make people feel happy and in control of their lives.

The first sign of drug dependency occurs when the amount of Fioricet being taken no longer has the same effect as it once did. If patients taking this drug start increasing the dosage themselves to obtain the same results, instead of first discussing the change in the effectiveness of Fioricet with their physicians, the result can be drug addiction.

The other side of the intoxicating high caused by butalbital is the downer that occurs when the drug wears off. People abusing Fioricet may feel depressed or anxious, and can experience classic withdrawal symptoms, such as insomnia, tremors, fever, nausea, weight loss, vision distortion and dizziness.

Sometimes, as they experience withdrawal, people take even more Fioricet in order to feel in control once more. Many people who are addicted to this medication may not even realize they have a problem. Others who do realize there is an issue with this drug, may not seek help because they are embarrassed or they fear they will have to have a hospital stay to break the hold Fioricet has on them. This is not necessarily true.

The greatest indicator that people are addicted is that the level of tolerance to this drug continues to rise, and tolerance can build up the longer the drug is used. Although people may not realize they are addicted to Fioricet, others around them may notice a sudden obsession with taking the medication.

Also, people who are addicted to this medication may think they cannot live or operate without a steady supply of the drug.

Typically, the average barbiturate addict needs about 1,500 milligrams of the drug. Because the body can build up a tolerance for barbiturates, the temptation is to take more of the drug to experience the same level of intoxication, possibly leading to overdose and death.

When barbiturates are taken with alcohol, it takes a lot less of the drug to reach a fatal level. Without the addition of alcohol, a toxic dose of butalbital is one gram, or 20 tablets of Fioricet. The toxic dose for acetaminophen is 10 grams or 30 tablets, and for caffeine, the toxic dose is 1 gram or 25 tablets.

If people who are addicted to barbiturates stop taking the drug all at once, they can experience major withdrawal issues, such as delirium, respiratory depression, confusion, hypertension, mental depression and convulsions as early as 16 hours after stopping the drug. Patients who quit all at once may also experience angry outbursts.

The major withdrawal symptoms can last up to five days, after which the strength of the symptoms gradually decreases for upward of 15 days.

Although people can quit without the help of a healthcare professional, the chances of success are much greater if they experience a program of professional detoxification. This is because Fioricet effects are psychological as well as physical.

The best way to withdraw from butalbital addiction is very gradually and with monitoring by a physician. One way to stop butalbital dependence is to return the patient to the level of Fioricet which the patient should currently be taking, and then gradually decreasing the dose until the patient no longer needs the medication. Along with this slow reduction of the medication comes behavioral and mental therapy, usually with a psychiatrist or psychologist, to teach the patient skills they can use to cope with a life that doesn't include Fioricet. This combination increases the chance of success. This kind of detoxification program can be done in a hospital or rehabilitation center, or as a supervised rehabilitation in the patient's own home.

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