Fiorinal

Pronunciation

Generic Name: aspirin/butalbital/caffeine (AS-pir-in/byoo-TAL-bi-tal/kaf-EEN)
Brand Name: Examples include Farbital and Fiorinal

Children and teenagers should not use aspirin, aspirin-containing, or aspiring-related medicines for flu symptoms or chickenpox without first consulting a doctor. A rare but serious illness known as Reye syndrome may occur.


Fiorinal is used for:

Treating tension headaches. It may also be used for other conditions as determined by your doctor.

How these medicines work is not completely understood. Aspirin reduces pain and inflammation. Caffeine may work by constricting blood vessels that may cause headaches. Butalbital has a depressant effect that reduces anxiety and causes relaxation.

Do NOT use Fiorinal if:

  • you are allergic to nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) or any ingredient in Fiorinal
  • you have Von Willebrand disease, porphyria, or bleeding or blood clotting problems
  • you are taking sodium oxybate (GHB), heparin, probenecid, or sulfinpyrazone
  • your child has the flu, chickenpox, or joint problems

Contact your doctor or health care provider right away if any of these apply to you.

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Before using Fiorinal:

Some medical conditions may interact with Fiorinal. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have asthma, stomach or intestinal problems (eg, peptic ulcer, bleeding), liver problems, the flu, Kawasaki syndrome, nasal polyps, kidney problems, lung or respiratory tract disease, severe heart disease, skin irritation or inflammation, chickenpox, vitamin K deficiency, or difficulty sleeping
  • if you have a history of stroke, anxiety, substance abuse or dependence, depression, or suicidal thoughts or behaviors

Some MEDICINES MAY INTERACT with Fiorinal. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Benzodiazepines (eg, chlordiazepoxide), monoamine oxidase (MAO) inhibitors (eg, phenelzine), narcotic analgesics (eg, morphine), sleeping medicines (eg, temazepam), or sodium oxybate (GHB) because they may increase the risk of Fiorinal's side effects
  • Anticoagulants (eg warfarin), celecoxib, clopidogrel, heparin, or NSAIDs (eg, ibuprofen) because the risk of serious side effects, such as stomach ulcers and bleeding, may be increased
  • Carbonic anhydrase inhibitors (eg, acetazolamide), insulin, meglitinides (eg, repaglinide), methotrexate, quinolone antibiotics (eg, ciprofloxacin), or valproic acid because the risk of their side effects may be increased by Fiorinal
  • Angiotensin-converting enzyme (ACE) inhibitors (eg, lisinopril), antipsychotics (eg, clozapine), beta-blockers (eg, atenolol), corticosteroids (eg, prednisone), doxycycline, estrogens (eg, estradiol), metronidazole, oral contraceptives (eg, norethindrone/ethinyl estradiol), quinidine, probenecid, sulfinpyrazone, theophylline, or tricyclic antidepressants (eg, amitriptyline) because their effectiveness may be decreased by Fiorinal

This may not be a complete list of all interactions that may occur. Ask your health care provider if Fiorinal may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Fiorinal:

Use Fiorinal as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take Fiorinal by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation. Taking it with food may not decrease the risk of stomach or bowel problems (such as bleeding or ulcers) that may occur while taking Fiorinal. Talk with your doctor or pharmacist if you experience persistent stomach upset.
  • Do not take Fiorinal if it has a strong vinegar-like smell, or if any vinegar smell remains after leaving the bottle open for 10 minutes.
  • If you miss a dose of Fiorinal and you are taking it regularly, take it as soon as possible. If several hours have passed or if it is almost time for your next dose, do not double the dose to catch up, unless advised to do so by your doctor. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Fiorinal.

Important safety information:

  • Fiorinal may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Fiorinal with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Fiorinal; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Serious stomach ulcers or bleeding can occur with the use of Fiorinal. Taking it in high doses or for a long time, smoking, or drinking alcohol increases the risk of these side effects. Taking Fiorinal with food will NOT reduce the risk of these effects. Contact your doctor or emergency room at once if you develop severe stomach or back pain; black, tarry stools; vomit that looks like blood or coffee grounds; or unusual weight gain or swelling.
  • Tell your doctor or dentist that you take Fiorinal before you receive any medical or dental care, emergency care, or surgery.
  • Fiorinal has aspirin in it. Before you start any new medicine, check the label to see if it has aspirin in it too. If it does or if you are not sure, check with your doctor or pharmacist.
  • Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor. Taking more than the recommended dose or taking Fiorinal for longer than prescribed may be habit-forming.
  • Aspirin has been linked to a serious illness called Reye syndrome. Do not give Fiorinal to a child or teenager who has the flu, chickenpox, or a viral infection. Contact your doctor with any questions or concerns.
  • Hormonal birth control (eg, birth control pills) may not work as well while you are using Fiorinal. To prevent pregnancy, use an extra form of birth control (eg, condoms).
  • Use Fiorinal with caution in the ELDERLY; they may be more sensitive to its effects.
  • Fiorinal should not be used in CHILDREN younger than 12 years old; safety and effectiveness in these children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Fiorinal while you are pregnant. Fiorinal is not recommended during the last 3 months (third trimester) of pregnancy because it may cause harm to the fetus. Fiorinal is found in breast milk. If you are or will be breast-feeding while you use Fiorinal, check with your doctor. Discuss any possible risks to your baby.

When used for long periods of time or at high doses, Fiorinal may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Fiorinal stops working well. Do not take more than prescribed.

Some people who use Fiorinal for a long time may develop a need to continue taking it. People who take high doses are also at risk. This is known as DEPENDENCE or addiction. If you suddenly stop taking Fiorinal, you may experience WITHDRAWAL symptoms, including anxiety, muscle twitching, trembling hands and fingers, weakness, dizziness, hallucinations, nausea, vomiting, sleeplessness, lightheadedness, or seizures.

Possible side effects of Fiorinal:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Dizziness; drowsiness; gas; lightheadedness; nausea; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black or bloody stools; confusion; fast heartbeat; red, swollen, or blistered skin; stomach pain; unusual bruising or bleeding.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include confusion; fast or irregular heartbeat; loss of consciousness; nausea; ringing in the ears; sleeplessness; slow or shallow breathing; stomach pain; tremor; unusual drowsiness or dizziness; vomiting.

Proper storage of Fiorinal:

Store Fiorinal at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Fiorinal out of the reach of children and away from pets.

General information:

  • If you have any questions about Fiorinal, please talk with your doctor, pharmacist, or other health care provider.
  • Fiorinal is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take Fiorinal or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Fiorinal. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Fiorinal. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Fiorinal.

Issue Date: December 3, 2014
Database Edition 14.4.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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