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Drug Guideprovided by: Healthwise
=================================

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Acetaminophen/butalbital/caffeine/codeine
=========================================

Pronunciation: a seet a MIN o fen/byoo TAL bi tall/CAF een/KOE deenBrand
Names: Fioricet with Codeine

* Drug Details

* What is the most important information I should know about
acetaminophen/butalbital/caffeine/codeine?

* What is acetaminophen/butalbital/caffeine/codeine?

* Who should not take acetaminophen/butalbital/caffeine/codeine?

* How should I take acetaminophen/butalbital/caffeine/codeine?

* What happens if I miss a dose?

* What happens if I overdose?

* What should I avoid while taking
acetaminophen/butalbital/caffeine/codeine?

* What are the possible side effects of
acetaminophen/butalbital/caffeine/codeine?

* What other drugs will affect
acetaminophen/butalbital/caffeine/codeine?

* Where can I get more information?

* What does my medication look like?

Email this article Print this article

What is the most important information I should know about
acetaminophen/butalbital/caffeine/codeine?



Do not stop taking acetaminophen/butalbital/caffeine/codeine suddenly
if you have been taking it continuously for more than 5 to 7 days.
Stopping suddenly could cause withdrawal symptoms and make you very
uncomfortable. Your doctor may want to gradually reduce your dose.

Codeine and butalbital will cause drowsiness and fatigue. Avoid
alcohol, sleeping pills, antihistamines, sedatives, and tranquilizers
except under the supervision of your doctor. These may also make you
drowsy.



Codeine will also cause constipation. Drink plenty of water (six to
eight full glasses a day) to lessen this side effect. Increasing the
amount of fiber in your diet can also help to alleviate constipation.

Never take more acetaminophen/butalbital/caffeine/codeine than is
prescribed for you. If your pain is not being adequately treated, talk
to your doctor.

Watch the acetaminophen content of other over-the-counter and
prescription products while taking this medication. You should not
exceed 4 grams (4000 mg) of acetaminophen per day.



It is dangerous to drink alcohol while taking this medication.

(back to top)

What is acetaminophen/butalbital/caffeine/codeine?

Codeine is in a class of drugs called narcotic analgesics. It relieves
pain.

Acetaminophen is a less potent pain reliever that increases the
effects of codeine.

Butalbital is in a class of drugs called barbiturates that slow down
your central nervous system (brain and nerve impulses).

Caffeine is believed to constrict dilated blood vessels that may
contribute to tension headaches.

Together, acetaminophen, butalbital, caffeine, and codeine are used to
relieve complex tension headaches although precisely how it works is
unknown.

Acetaminophen/butalbital/caffeine/codeine may also be used for
purposes other than those listed in this medication guide.

(back to top)

Who should not take acetaminophen/butalbital/caffeine/codeine?

This medication is habit forming and should only be used under close
supervision if you have an alcohol or drug addiction.

Before taking this medication, tell your doctor if you have

* kidney disease;

* liver disease;

* asthma;

* urinary retention;

* an enlarged prostate;

* hypothyroidism;

* seizures or epilepsy;

* gallbladder disease;

* a head injury; or

* Addison's disease.

You may not be able to take acetaminophen/butalbital/caffeine/codeine,
or you may require a lower dose or special monitoring during treatment
if you have any of the conditions listed above.



This drug combination is in the FDA pregnancy category C. This means
that its effects on an unborn baby are not known. Do not take this
medication without first talking to your doctor if you are pregnant.



This drug combination passes into breast milk and may harm a nursing
infant. Do not take this medication without first talking to your
doctor if you are breast-feeding a baby.

If you are younger than 18 years of age or older than 60 years of age,
you may be more likely to experience side effects from this therapy.
Use extra caution.

Acetaminophen/butalbital/caffeine/codeine has not been approved for
use in children younger than 12 years of age.

(back to top)

How should I take acetaminophen/butalbital/caffeine/codeine?

Take acetaminophen/butalbital/caffeine/codeine exactly as directed by
your doctor. If you do not understand these directions, ask your
pharmacist, nurse, or doctor to explain them to you.



Take each dose with a full glass of water.



Take acetaminophen/butalbital/caffeine/codeine with food or milk if it
upsets your stomach.

Never take more of this medication than is prescribed for you. Too
much acetaminophen/butalbital/caffeine/codeine could be very harmful.
The maximum dose is six capsules per day.

Do not stop taking acetaminophen/butalbital/caffeine/codeine suddenly
if you have been taking it continuously for more than 5 to 7 days.
Stopping suddenly could cause withdrawal symptoms and make you feel
uncomfortable. Your doctor may want to gradually reduce your dose.



Increase the amount of fiber and water (six to eight glasses daily) in
your diet to prevent constipation.

Do not share this medication with anyone else.



Store acetaminophen/butalbital/caffeine/codeine at room temperature
away from moisture and heat.

(back to top)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Do not take a double
dose of this medication. Wait the prescribed amount of time before
taking your next dose.

(back to top)

What happens if I overdose?



Seek emergency medical attention.

Symptoms of an acetaminophen/butalbital/caffeine/codeine overdose
include slow breathing, seizures, dizziness, weakness, loss of
consciousness, coma, confusion, tiredness, cold and clammy skin, small
pupils, nausea, vomiting, and sweating.

(back to top)

What should I avoid while taking
acetaminophen/butalbital/caffeine/codeine?



Avoid alcohol while taking acetaminophen/butalbital/caffeine/codeine.
Alcohol will greatly increase the drowsiness and dizziness caused by
acetaminophen/butalbital/caffeine/codeine and could be dangerous.
Also, acetaminophen can damage your liver if you drink three or more
alcoholic beverages a day.

Also avoid sleeping pills, tranquilizers, sedatives, and
antihistamines except under the supervision of your doctor. These
medications also may cause dangerous sedation.



Use caution when driving, operating machinery, or performing other
hazardous activities. Codeine and butalbital may cause drowsiness. If
you experience drowsiness, avoid these activities.

(back to top)

What are the possible side effects of
acetaminophen/butalbital/caffeine/codeine?



If you experience any of the following serious side effects, stop
taking acetaminophen/butalbital/caffeine/codeine and seek emergency
medical attention:

* an allergic reaction (difficulty breathing; closing of your
throat; swelling of your lips, tongue, or face; or hives);

* slow, weak breathing;

* seizures;

* cold, clammy skin;

* severe weakness or dizziness;

* unconsciousness;

* yellowing of the skin or eyes; or

* unusual fatigue, bleeding, or bruising.

Other, less serious side effects may be more likely to occur. Continue
to take acetaminophen/butalbital/caffeine/codeine and talk to your
doctor if you experience

* constipation;

* dry mouth, nausea, vomiting, or decreased appetite;

* dizziness, tiredness, or lightheadedness;

* muscle twitches;

* sweating;

* itching;

* decreased urination; or

* decreased sex drive.



Acetaminophen/butalbital/caffeine/codeine is habit forming. Do not
stop taking it suddenly.

Side effects other than those listed here may also occur. Talk to your
doctor about any side effect that seems unusual or that is especially
bothersome.

(back to top)

What other drugs will affect
acetaminophen/butalbital/caffeine/codeine?

Do not take acetaminophen/butalbital/caffeine/codeine if you have
taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid
(Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the
last 14 days. Dangerous side effects could result.

The most serious interactions affecting
acetaminophen/butalbital/caffeine/codeine are with those drugs that
also cause sedation. The following drugs may lead to dangerous
sedation if taken with acetaminophen/butalbital/caffeine/codeine:

* antihistamines such as brompheniramine (Dimetane, Bromfed,
others), diphenhydramine (Benadryl, Nytol, Compoz, others),
chlorpheniramine (Chlor-Trimeton, Teldrin, others), and others;

* tricyclic antidepressants, such as amitriptyline (Elavil) and
doxepin (Sinequan), and serotonin reuptake inhibitors such as
fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil);

* other commonly used antidepressants, including amoxapine
(Asendin), clomipramine (Anafranil), desipramine (Norpramin),
imipramine (Tofranil), nortriptyline (Pamelor), and protriptyline
(Vivactil);

* anticholinergics such as belladonna (Donnatal), clidinium
(Quarzan), dicyclomine (Bentyl, Antispas), hyoscyamine (Levsin,
Anaspaz), ipratropium (Atrovent), propantheline (Pro-Banthine),
and scopolamine (Transderm-Scop);

* phenothiazines such as chlorpromazine (Thorazine), fluphenazine
(Prolixin), thioridazine (Mellaril), and prochlorperazine
(Compazine); and

* tranquilizers and sedatives such as phenobarbital (Solfoton,
Luminal), amobarbital (Amytal), secobarbital (Seconal), alprazolam
(Xanax), diazepam (Valium), lorazepam (Ativan), flurazepam
(Prosom), and temazepam (Restoril).

Do not take any of the drugs listed above without the approval of your
doctor.

Many other drugs contain acetaminophen, especially over-the-counter
pain, fever, cold, and allergy medications.

Drugs other than those listed here may also interact with
acetaminophen/butalbital/caffeine/codeine. Talk to your doctor and
pharmacist before taking any prescription or over-the-counter
medicines.

(back to top)

Where can I get more information?

Your pharmacist has additional information about
acetaminophen/butalbital/caffeine/codeine written for health
professionals that you may read.

(back to top)

What does my medication look like?

Acetaminophen/butalbital/caffeine/codeine is available with a
prescription under the brand name Fioricet with Codeine. Other brand
or generic formulations may also be available. Ask your pharmacist any
questions you have about this medication, especially if it is new to
you.

Acetaminophen/butalbital/caffeine/codeine strengths are as follows:

* Fioricet with Codeine 325 mg/50 mg/40 mg/ 30 mg--dark-blue/gray
capsules

(back to top)

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.

Every effort has been made to ensure that the information provided
by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and
complete, but no guarantee is made to that effect. Drug
information contained herein may be time sensitive. Multum
information has been compiled for use by healthcare practitioners
and consumers in the United States and therefore Multum does not
warrant that uses outside of the United States are appropriate,
unless specifically indicated otherwise. Multum's drug information
does not endorse drugs, diagnose patients or recommend therapy.
Multum's drug information is an informational resource designed to
assist licensed healthcare practitioners in caring for their
patients and/or to serve consumers viewing this service as a
supplement to, and not a substitute for, the expertise, skill,
knowledge and judgment of healthcare practitioners. The absence of
a warning for a given drug or drug combination in no way should be
construed to indicate that the drug or drug combination is safe,
effective or appropriate for any given patient. Multum does not
assume any responsibility for any aspect of healthcare
administered with the aid of information Multum provides. The
information contained herein is not intended to cover all possible
uses, directions, precautions, warnings, drug interactions,
allergic reactions, or adverse effects. If you have questions
about the drugs you are taking, check with your doctor, nurse or
pharmacist.

Copyright 1996-2003 Cerner Multum, Inc. Version: 5.04. Revision
date: 2/13/04.

(back to top)

Your use of the content provided in this service indicates that you
have read, understood and agree to the End-User License Agreement,
which can be accessed by clicking on this link.


Medication Safety Resources

National Poison Control Hotline

A national toll-free number that reaches a poison control center from
anywhere in the United States, anytime.

* If you suspect poisoning, call:
800-222-1222

* If the victim has collapsed or is having trouble breathing, call:
911

* Learn more at the National Poison Control web site.

U.S. Food and Drug Administration

A regulatory agency that protects consumers by ensuring the safety and
effectiveness of foods, drugs, and other products.

* U.S. Food and Drug Administration

* Recalls, market withdrawals, and safety alerts

* Center for Drug Evaluation and Research

* Buying medicines online tips and warnings

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