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Drug interactions between Fioricet with Codeine and oxycodone

Results for the following 2 drugs:
Fioricet with Codeine (acetaminophen/butalbital/caffeine/codeine)

Interactions between your selected drugs


oxycodone ↔ butalbital

Applies to:oxycodone and Fioricet with Codeine (acetaminophen/butalbital/caffeine/codeine)

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Barbiturates may potentiate the central nervous system (CNS) depressant effects of opioids. Concomitant use may result in profound sedation, respiratory depression, coma, and death. On the other hand, some barbiturates can also induce the hepatic metabolism of opioids that are metabolized by CYP450 3A4 such as butorphanol, fentanyl, hydrocodone, methadone and oxycodone, resulting in enhanced clearance. Reduced efficacy or withdrawal symptoms may occur in patients maintained on their opioid regimen following the addition of a barbiturate. Conversely, discontinuation of the barbiturate may increase plasma concentrations of the opioid and potentiate the risk of overdose and fatal respiratory depression.

MANAGEMENT: The use of opioids in conjunction with other CNS depressants such as barbiturates should generally be avoided unless alternative treatment options are inadequate. If coadministration is necessary, the dosage and duration of each drug should be limited to the minimum required to achieve desired clinical effect, and patients should be closely monitored for signs and symptoms of CNS and respiratory depression. Particular caution is advisable when a barbiturate is added to or withdrawn from therapy in patients receiving opioids that are CYP450 3A4 substrates, as there may be an increased risk of withdrawal symptoms (e.g., restlessness, insomnia, sweating, lacrimation, or rhinorrhea) following initiation of the barbiturate and overdose following discontinuation. A dosage adjustment for one or both drugs may be required.


  1. Bell J, Seres V, Bowron P, Lewis J, Batey R "The use of serum methadone levels in patients receiving methadone maintenance." Clin Pharmacol Ther 43 (1988): 623-9
  2. Liu S-J, Wang RI "Case report of barbiturate-induced enhancement of methadone metabolism and withdrawal syndrome." Am J Psychiatry 141 (1984): 1287-8
  3. "Product Information. OxyContin (oxycodone)." Purdue Frederick Company, Norwalk, CT.
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codeine ↔ oxycodone

Applies to:Fioricet with Codeine (acetaminophen/butalbital/caffeine/codeine) and oxycodone

Using codeine together with oxyCODONE may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug Interaction Classification

The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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