Medically reviewed: November 28, 2016
What is aspirin, butalbital, and caffeine?
Aspirin is a pain reliever, as well as an anti-inflammatory and a fever reducer.
Butalbital is a barbiturate. It relaxes muscle contractions involved in a tension headache.
Caffeine is a central nervous system stimulant. It relaxes muscle contractions in blood vessels to improve blood flow.
Aspirin, butalbital, and caffeine is a combination medicine used to treat tension headaches. This medicine is not for treating headaches that come and go.
Aspirin, butalbital, and caffeine may also be used for purposes not those listed in this medication guide.
Aspirin may cause stomach or intestinal bleeding, which can be fatal.
Stop using aspirin, butalbital, and caffeine and call your doctor at once if you have: black, bloody, or tarry stools, and coughing up blood or vomit that looks like coffee grounds.
Aspirin should not be given to a child or teenager who has a fever.
Butalbital may be habit-forming. Misuse of habit-forming medicine can cause addiction, overdose, or death.
Before taking this medicine
Aspirin may cause stomach or intestinal bleeding, which can be fatal. This can occur without warning while you are taking this medicine.
You should not use this medicine if you are allergic to aspirin, butalbital, or caffeine, or if you have:
severe liver disease;
porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system);
a bleeding or blood clotting disorder (such as hemophilia); or
asthma, or a history of severe allergic reaction (sneezing, runny or stuffy nose, wheezing, shortness of breath) after taking aspirin or another NSAID (nonsteroidal anti-inflammatory drug) such as Advil, Motrin, Aleve, Celebrex, Orudis, Indocin, Lodine, Voltaren, Toradol, Mobic, Relafen, Feldene, and others.
To make sure aspirin, butalbital, and caffeine is safe for you, tell your doctor if you have:
liver or kidney disease;
asthma or another respiratory disease;
a stomach or intestinal disorder;
a thyroid disorder;
enlarged prostate or urination problems; or
Addison's disease (an adrenal gland disorder).
It is not known whether this medicine will harm an unborn baby. If you use butalbital while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Taking aspirin during late pregnancy may cause bleeding in the mother or the baby during delivery. Tell your doctor if you are pregnant or plan to become pregnant.
Aspirin, butalbital, and caffeine can pass into breast milk and may harm a nursing baby. Aspirin use while breast-feeding could cause bleeding in the infant. You should not breast-feed while using this medicine.
Do not give this medicine to a child or teenager with a fever, flu symptoms, or chicken pox. Aspirin can cause Reye's syndrome, a serious and sometimes fatal condition in children.
How should I take aspirin, butalbital, and caffeine?
Follow all directions on your prescription label. Never use aspirin, butalbital, and caffeine in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your headache.
Butalbital may be habit-forming. Never share aspirin, butalbital, and caffeine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.
Misuse of habit-forming medicine can cause addiction, overdose, or death. Selling or giving away this medicine is against the law.
If you need surgery, tell the surgeon ahead of time that you are using aspirin, butalbital, and caffeine. You may need to stop using the medicine for a short time.
Do not stop using this medicine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using aspirin, butalbital, and caffeine.
Store at room temperature away from moisture and heat.
Keep track of the amount of medicine used from each new bottle. Aspirin, butalbital, and caffeine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.
What happens if I miss a dose?
Since this medicine is used when needed, you may not be on a dosing schedule. If you are on a schedule, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of butalbital can be fatal.
Overdose symptoms may include extreme drowsiness, confusion, restless feeling, insomnia, tremors, fast heart rate, vomiting, stomach pain, rapid breathing, feeling hot, ringing in your ears, weak or shallow breathing, seizure (convulsions), or fainting.
What should I avoid while taking aspirin, butalbital, and caffeine?
This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how the medicine will affect you.
Ask a doctor or pharmacist before using any cough, cold, allergy, or pain medication. Aspirin and caffeine are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains aspirin or caffeine.
Do not drink alcohol. Dangerous side effects, overdose, or death can occur when alcohol is combined with butalbital. Alcohol may increase your risk of stomach bleeding while you are taking aspirin.
Aspirin, butalbital, and caffeine side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
shallow breathing, slow heart rate;
fast or pounding heart rate, muscle twitching;
confusion, unusual thoughts or behavior;
symptoms of stomach bleeding--bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
problems with urination; or
easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin.
Serious side effects may be more likely in older adults and those who are ill or debilitated.
Common side effects include:
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
What other drugs will affect aspirin, butalbital, and caffeine?
Taking this medicine with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures.
You should not use aspirin, butalbital, and caffeine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
Tell your doctor about all your current medicines and any you start or stop using, especially:
insulin or oral diabetes medicine;
This list is not complete. Other drugs may interact with aspirin, butalbital, and caffeine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Copyright 1996-2018 Cerner Multum, Inc. Version: 2.03.
More about Fiorinal (aspirin / butalbital / caffeine)
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- Drug class: analgesic combinations
Other brands: Butalbital Compound