Fioricet is a prescription medication composed of three main ingredients: the barbiturate butalbital, the pain reliever acetaminophen, and caffeine. It is often found under other brand names such as Capacet, Vanatol, and Zebutal. Although Fioricet is approved by the U.S. Food and Drug Administration (FDA) to address tension headaches, it is sometimes prescribed “off-label” for migraines as well.
Like all barbiturates, Fioricet carries a significant risk of dependence and addiction. Even taking a relatively small quantity may be enough to trigger overdose symptoms. Because a Fioricet overdose can be life-threatening, emergency medical attention is crucial. If you think someone may have overdosed, call 911 immediately.
How Do Overdoses Occur?
Barbiturates, including butalbital in Fioricet, are well-known for their potential for misuse. Individuals who have misused Fioricet have reported experiencing a sense of feeling “goofy” or “loopy.” These drugs act as sedative-hypnotics, meaning they depress the central nervous system and foster rapid tolerance, causing people to require escalating doses to achieve the same effects. This swift increase in tolerance can easily progress into dependence and addiction.
Combining Fioricet with other substances, such as alcohol or other drugs, intensifies its sedative qualities and may lead to dangerous outcomes, including respiratory depression, coma, or even death. The most concerning component of Fioricet is butalbital. Each Fioricet tablet has 50 mg of butalbital, and around 1,000 mg (equal to about 20 pills) is considered toxic for adults. Additionally, each pill contains 325 mg of acetaminophen and 40 mg of caffeine; their toxic thresholds are 10 g (approximately 30 pills) and 1 g (about 25 pills), respectively.
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With a half-life of approximately 35 hours, Fioricet can accumulate in the body over time. Taking multiple doses over the span of a few days can cause these substances to build up to dangerous levels.
Although many Fioricet overdoses involve combining it with other drugs or alcohol, overdosing on Fioricet alone is possible. A standard prescription might direct someone to take six tablets per day, which is already more than a quarter of the toxic level. Individuals suffering from intense tension headaches may overuse the medication out of desperation for relief. Furthermore, Fioricet can cause rebound headaches — painful headaches that persist despite additional medication.
It’s critical to use Fioricet infrequently, precisely as prescribed, and with great care. Avoid using this prescription if it was not prescribed to you, and never share it with others.
Fioricet Overdose Signs and Symptoms
Signs and symptoms of Fioricet overdose may include:
- Dizziness
- Drowsiness
- Lethargy
- Confusion
- Low body temperature (hypothermia)
- Low blood pressure (hypotension)
- Slowed or stopped breathing, which can lead to coma or death
- Possible hypovolemic shock (a drastic drop in blood volume) in severe cases
Since Fioricet also contains acetaminophen and caffeine, overdosing on either of those is a concern as well. Excessive acetaminophen use can damage the liver and may manifest as nausea, vomiting, unusual tiredness, or extreme sweating. Too much caffeine can cause insomnia, tremors, confusion, and heart palpitations.
What Happens if You Overdose on Fioricet?
If Fioricet is the only substance involved and the individual is still conscious and responsive, inducing vomiting might be appropriate. However, because polysubstance use is often a factor — especially with alcohol or other drugs — a Fioricet overdose can quickly become more critical. Treatment varies depending on the substances that were used alongside Fioricet.
A Fioricet overdose is a serious, potentially fatal medical emergency that requires immediate professional treatment. If you suspect an overdose, do not delay — call 911 right away.
Fioricet Overdose Deaths
Barbiturates saw widespread use in the 1960s and 1970s but have largely been replaced by benzodiazepines due to the latter’s safer profile. Consequently, barbiturate overdoses are much less common today.
Though exact figures on barbiturate-related deaths can be difficult to obtain, the American Association of Poison Control Centers reported that sedative, hypnotic, and antipsychotic medications (a group that includes barbiturates) were the fourth most common cause of poisoning in 2017, accounting for nearly 150,000 exposures and 5.7% of poisonings overall. In some circumstances, barbiturates are also connected to intentional deaths, including suicide and lethal injection.
Fioricet Overdose Treatment
Because Fioricet overdose frequently results in slowed breathing, the first step in treatment usually involves supporting or restoring respiration. Medical professionals may administer oxygen or, in more critical cases, provide assisted ventilation. Intravenous fluids often help stave off hypovolemic shock, and activated charcoal can sometimes prevent damage to the liver from acetaminophen.
If an overdose includes other substances, such as opioids, additional measures become necessary to address those components. Proper and prompt medical attention is crucial for anyone who experiences a Fioricet overdose.
Fioricet Overdose Prevention
The most effective way to avoid a Fioricet overdose is simply not to take it unless it is medically necessary. If you are prescribed Fioricet, follow your doctor’s directions, use it sparingly, and be aware that daily or long-term use can significantly raise the risk of dependency.
Fioricet’s common side effects include mild dizziness and sleepiness. If you or someone else has taken Fioricet as prescribed yet still feels alarmingly unwell, it’s essential to call 911.
Getting Help for Fioricet Addiction
Barbiturate addiction can be especially difficult to break free from. If you or someone you know is struggling with Fioricet dependence or addiction, The Recovery Village Palm Beach at Baptist Health can provide comprehensive support. Our medical and therapeutic teams understand the physical and psychological difficulties linked to barbiturate withdrawal and recovery. With both residential and outpatient treatment options, we are committed to helping individuals move beyond substance use and regain control of their lives.
Contact us today to learn more about how our programs and personalized care can help you or your loved one overcome Fioricet addiction.
