Will Fioricet Help with Opiate Withdrawal?

The terms opiate, opioid and narcotic are often used in what would seem the same way. With prescription pain medications reaching their highest point in years, it’s wise to know the difference between each of these terms and how they work.

Opioids are a powerful and very addictive class of drugs that are impacting millions of people in the U.S. right now. Opioids work by attaching to certain receptors in the central nervous system, and when this happens, they can create a euphoric high for the user, but they also trigger a flood of dopamine. When your brain is unnaturally flooded with dopamine, and a reward response is triggered, it can lead you to an addiction.

Opiate

Classically, the term opiate refers to natural substances that come from opium. Opium itself can be extracted from the opium poppy and contains chemical compounds, including morphine and codeine. Thus, examples of opiates are morphine and codeine.

Opioids

There are also products that work by binding to the same receptors as opiates, but do not occur naturally, known as semi-synthetic or synthetic opioids. While synthetic opioids are manufactured chemically, semi-synthetic opioids are a hybrid resulting from chemical modifications to natural opiates.

Examples of synthetic opioids include fentanyl and methadone, while oxycodone and hydrocodone are examples of semi-synthetic opioids.

Opioid vs Opiate

Most people have now moved away from differentiating between opiate and opioid and use the term opioid for both natural or synthetic (or semi-synthetic) substances that act at one of the three main opioid receptor systems (mu, kappa, delta). If the term opiate is used it is thought of as the naturally occurring substances within the opioid class.

Though opioids are prescribed mainly to relieve pain symptoms, they can have negative effects including drowsiness and physical dependence. Because opioids have the potential for abuse and addiction, prescription opioid use is regulated by the Controlled Substances Act in the United States. However, not all opioids are available to be prescribed for pain treatment. Non-prescription opioids include heroin, which is a derivative of morphine, and is an illegal opioid commonly abused by injection.

There are a couple of different reasons people might wonder will Fioricet help with opiate withdrawal.

The first is because this drug as mentioned can help treat headaches, which is commonly a side effect of opiate withdrawal.

Another reason people might wonder whether or not Fioricet will help with opiate withdrawal is because the butalbital is a barbiturate, which can help relieve muscle tension and calm anxiety. Muscle aches, tension, and anxiety, are all symptoms of withdrawal from opioids.

Despite the reasons people might think Fioricet would be helpful for the treatment of opiate withdrawal, it’s probably not something a doctor would recommend.

First, Fioricet itself has the potential to become habit forming. The butalbital in this drug can create a type of high when people use it, and it is also addictive.

It may be that someone turns to Fioricet for opiate withdrawal and then ultimately finds themselves trading out one addiction for another. Also, it’s unlikely that Fioricet would really do much to help with the symptoms of opiate withdrawal.

There are other drugs that would do a better job. Fioricet may be part of someone trying to treat themselves at home for opioid addiction, and it’s not a wise move. The best thing to do if you’re wondering will Foriciet help with opiate withdrawal or what you can do to make withdrawal more bearable is to speak with your physician and find a medically supervised program that can give you the interventions you need without putting your life at risk.

 

Can Fioricet Get You High?

NO. I do not think Fioricet can get you high.

One of the key active ingredients responsible for the so-called Fioricet high is butalbital.

butalbital
Butalbital is a barbiturate that’s considered short-to-intermediate acting, and it can relieve symptoms of anxiety, reduce pain, relax muscles and act as a sedative. There are many neuropsychological effects of butalbital, some of which aren’t clearly understood to this day.
The belief is that the Fioricet high is caused by the fact that butalbital can increase the inhibition neurotransmitters in the brain called GABA.
But by rxlist,  the barbiturate butalbital addict per day is usually about 1,500 mg. One pill of fioricet contains 40mg butalbital. if you are taking 1,500mg per day, you will take more than 30 tablet of fioricet which contain 9000mg acetaminophen. If you have taken more than 9000mg acetaminophen, you will die. The max dosage of acetaminophen per day is 3000mg.
Besides,  As tolerance to barbiturates develops, the amount needed to maintain the same level of intoxication increases; tolerance to a fatal dosage, however, does not increase more than twofold. As this occurs, the margin between an intoxication dosage and fatal dosage becomes smaller.
The lethal dose of a barbiturate is far less if alcohol is also ingested. Major withdrawal symptoms (convulsions and delirium) may occur within 16 hours and last up to 5 days after abrupt cessation of these drugs. Intensity of withdrawal symptoms gradually declines over a period of approximately 15 days. Treatment of barbiturate dependence consists of cautious and gradual withdrawal of the drug.
Barbiturate-dependent patients can be withdrawn by using a number of different withdrawal regimens. One method involves initiating treatment at the patient’s regular dosage level and gradually decreasing the daily dosage as tolerated by the patient.
Fioricet can reduce anxiety and some people with anxiety disorders may take it for this reason, although this is not what it’s approved for. There is the potential for Fioricet to decrease feelings of anxiety even when it’s taken at a normal dose, and this is because of the impact of butalbital on GABA. For some people, a Fioricet high is actually just equated with a reduction in anxiety.
Not everyone will associate the use of this drug with the Fioricet high. Some of the factors that determine whether or not a person will experience a Fioricet high can include the dosage they take and their tolerance. Newer users may be more likely to experience what they would describe as the Fioricet high. Other factors that could influence this include the specific formulation of the drug and whether or not other substances are taken with it. Some people may try to extract the butalbital from Fioricet and remove it from the caffeine and acetaminophen for a greater high.
This is not only drug abuse, but might not even achieve the effects the person is looking for. It’s important to realize that there can be serious and deadly consequences associated with trying to achieve a Fioricet high.
This can include addiction, adverse reactions, brain damage, emotional crashes, and overdose. Since Fioricet has acetaminophen, if people abuse it to get high they may also sustain liver damage or failure.

Is It Safe to Take Fioricet While Pregnant?

If you’re pregnant, it may be difficult to keep track of the different drugs you should avoid. Trying to understand the complexities of these substances and what they can do to your body or unborn child can induce stress.Luckily, the Food and Drug Administration made this process easier by categorizing drugs based on their risk to pregnancies. These categories are labeled A, B, C, D, and X. Category A includes drugs that are safe to take during pregnancy, while Category X contains substances that should never be taken while pregnant.

  • Category A
    • Research indicates that these drugs show no evidence of risk to the fetus throughout a pregnancy. Many multivitamins taken during pregnancy fit into this category.
  • Category B
    • If a clinical need must be met, substances in this category are considered safe to take during pregnancy. These drugs include acetaminophen, found in Tylenol, and amoxicillin.
  • Category C
    • These substances can be risky to take during pregnancy. If these drugs are given to pregnant women, the potential benefits should outweigh the potential risks. Category C drugs include aspirin, saccharine and gentamicin.
  • Category D
    • Studies show that these substances could harm the fetus. Despite these health risks, some pregnant women still take these drugs, which include tetracyclines and ACE inhibitors, for the potential benefits.
  • Category X
    • Because these drugs demonstrate clear risks to the fetus, they are contraindicated in women who are or could become pregnant. Category X substances include Lipitor and oral contraceptives.

Fioricet US FDA pregnancy category: C

Comment: Monitor for barbiturate withdrawal in neonates

Animal reproduction studies have not been conducted on this combination product. Epidemiologic data for acetaminophen, including a population based case-control study from the National Birth Defects Prevention Study (n= 11,610) and data from 26,424 live singleton births have shown no increased risk of major birth defects in children with first trimester prenatal exposure.

In 2015, the US Food and Drug Administration released results of their evaluation on published research studies looking at mothers who took acetaminophen (either over the counter or as a prescription product) at any time during their pregnancy and the risk of attention deficit hyperactivity (ADHD) in their babies.

They found all studies reviewed had potential limitations in their designs that prevented drawing reliable conclusions. Barbiturates have been reported to readily cross the placental barrier. A 2-day old infant whose mother had taken a butalbital-containing product during the last two months of pregnancy experienced withdrawal seizures; butalbital was found in the infant’s serum. There are no controlled data in human pregnancy.

US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

What should I avoid while taking Fioricet to relieve your pain and headache?

Fioricet can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen.

Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as APAP) is contained in many combination medicines.

Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Check the label to see if a medicine contains acetaminophen or APAP.

While you are taking this medication, avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor’s advice.

IMPORTANT WARNING:

Taking too much acetaminophen can cause liver damage, sometimes serious enough to require liver transplantation or cause death. You might accidentally take too much acetaminophen if you do not follow the directions on the prescription or package label carefully, or if you take more than one product that contains acetaminophen.

To be sure that you take acetaminophen safely, you should

  • not take more than one product that contains acetaminophen at a time. Read the labels of all the prescription and nonprescription medications you are taking to see if they contain acetaminophen. Be aware that abbreviations such as APAP, AC, Acetaminophen, Acetaminoph, Acetaminop, Acetamin, or Acetam. may be written on the label in place of the word acetaminophen. Ask your doctor or pharmacist if you don’t know if a medication that you are taking contains acetaminophen.
  • take acetaminophen exactly as directed on the prescription or package label. Do not take more acetaminophen or take it more often than directed, even if you still have fever or pain. Ask your doctor or pharmacist if you do not know how much medication to take or how often to take your medication. Call your doctor if you still have pain or fever after taking your medication as directed.
  • be aware that you should not take more than 4000 mg of acetaminophen per day. If you need to take more than one product that contains acetaminophen, it may be difficult for you to calculate the total amount of acetaminophen you are taking. Ask your doctor or pharmacist to help you.
  • tell your doctor if you have or have ever had liver disease.
  • not take acetaminophen if you drink three or more alcoholic drinks every day. Talk to your doctor about the safe use of alcohol while you are taking acetaminophen.
  • stop taking your medication and call your doctor right away if you think you have taken too much acetaminophen, even if you feel well.

Talk to your pharmacist or doctor if you have questions about the safe use of acetaminophen or acetaminophen-containing products.

Fioricet dosing information

Usual Adult Dose of Fioricet for Headache:

Acetaminophen 300 mg, butalbital 50 mg, and caffeine 40 mg:
1 or 2 capsule(s) orally every 4 hours as needed. Maximum daily dose: 6 doses.

Acetaminophen 325 mg, butalbital 50 mg, and caffeine 40 mg:
1 or 2 tablet(s), capsule(s), or tablespoonful(s) orally every 4 hours.
Maximum daily dose: 6 doses

Acetaminophen 500 mg, butalbital 50 mg, and caffeine 40 mg:
1 tablet or capsule orally every 4 hours.
Maximum daily dose: 6 doses

Acetaminophen 750 mg, butalbital 50 mg, and caffeine 40 mg:
1 tablet orally every 4 hours.
Maximum daily dose: 5 tablets

Usual Pediatric Dose of Fioricet for Headache:

12 years and older:
Acetaminophen 300 mg, butalbital 50 mg, and caffeine 40 mg:
1 or 2 capsule(s) orally every 4 hours as needed. Maximum daily dose: 6 doses.

What should I know before I take Fioricet ?

Do not use Fioricet if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

You should not use Fioricet if you are allergic to acetaminophen, butalbital, or caffeine, if you have porphyria, or if you have recently used alcohol, sedatives, tranquilizers, or other narcotic medications.

To make sure Fioricet is safe for you, tell your doctor if you have:

  • liver disease, cirrhosis, a history of alcoholism or drug addiction, or if you drink more than 3 alcoholic beverages per day;
  • kidney disease;
  • asthma, sleep apnea, or other breathing disorder;
  • stomach ulcer or bleeding;
  • a history of skin rash caused by any medication;
  • a history of mental illness or suicidal thoughts; or
  • if you use medicine to prevent blood clots.

It is not known whether Fioricet 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. Tell your doctor if you are pregnant or plan to become pregnant.

This medicine can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Pharmacology

Mechanism of Action

Butalbital: Barbiturate; elicits generalized CNS depressant effects; depresses sensory cortex; decreases motor activity

Acetaminophen: Nonopioid, nonsalicylate analgesic; acts on hypothalamus to produce analgesia and antipyresis

Caffeine: Vasoconstrictive properties of cerebral blood vessels may be helpful when treating headaches; improves skeletal muscle contraction and medullary respiratory center sensitivity; stimulates central inspiratory drive

Absorption

Butalbital and caffeine: Well absorbed

Bioavailability: 100% acetaminophen

Distribution

Protein bound: Butalbital (45%); acetaminophen (20-50%)

Metabolism

Butalbital

  • Metabolized in liver by CYP450 enzyme system
  • Induces hepatic enzymes, but to lesser degree than phenobarbital

Acetaminophen

  • Metabolized in liver by microsomal enzyme systems
  • 80-85% conjugated principally with glucuronic acid and to a lesser extent with sulfuric acid and cysteine
  • 4% metabolized by CYP450 to toxic metabolite (N acetyl-p-benzoquinoneimine, N-acetylimidoquinone [NAPQI]), which is detoxified by conjugation with glutathione; high doses may deplete fixed amount of glutathione in body, causing NAPQI accumulation

Caffeine

  • Metabolized in liver via CYP1A2 to paraxanthine, theobromine, and theophylline

Elimination