Thursday, October 23, 2014
Friday, March 13, 2009 lostbrokengirl, Community Member, asks

Q: is butalb-apap-caff 50/325/40 or fioricet tablets bad for ME?

we'll.. on march 23rd 2009 iim turning 17, and they are putting me on butalb-apap-caff 50/325/40 or fioricet tablets. is it a very serious drug? its the strongest kind i  thing, 325 mg, and i take 4 a day, with or with out a head ache, and since it has caffine should i be taking it? i mean im anemic too and have to take iron, along with anti biotics and anti depressants. should they be putting me on these things? im scared because im only 17.. and they have me on soo much and im afraid its because all we can aford is medical"Practice" to take care of me.

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Answers (7)
Teri Robert, Health Guide
3/14/09 5:22pm



You're taking four Fioricet a day, whether you have a headache or not? Are you sure that's how you're supposed to be taking them?


Fioricet isn't bad IF it's taken only occasionally. Otherwise, it cause big problems...


Taking Migraine abortive meds such as the triptans or ergotamines or any kind of pain med (such as Fioricet) more than two or three days a week can make matters worse by causing medication overuse headache (MOH), aka rebound. See Medication Overuse Headache - When the Remedy Backfires for more information on this.


ANY use of opioids or barbiturates (such as Fioricet) and frequent use of triptans and NSIADs are associated with increased risk of transformed Migraine. See Transformed Migraine - Risk Increased by Some Medications for more information on this.


For these reasons, most doctors are reluctant to prescirbe Fioricet at all, and when they do, they insist that it not be used more than two days a week.


Anyone who has more than three Migraines a month needs to be taking something for prevention. There's growing evidence that Migraine is a progressive brain disease. A recent study showed that Migraines can cause brain damage, and that people with three or more Migraines a month are more susceptible to this damage. For more information, see Is Migraine a Progressive Brain Disease? and Yes, Migraines Can Cause Brain Damage.


It really sounds like you and your doctor need to have a long talk about your treatment. I know paying for prescriptions can be an issue. Most of the pharmaceutical companies have patient assistance programs to provide free medications to patients with no insurance who meet their income guidelines. Those guidelines are pretty generous. Try going to to check on all of your medications. You list all of them on the site, and it will tell you which ones have programs you qualify for. It will then even take you through the process to fill out the application forms and print them. You then take them to your doctor for his or her signature and send them in.


Hope this helps,



JP, Community Member
9/ 8/09 11:42am

Be very careful with this and any of these types of drugs.  They are correct about the rebound headaches - if you take them when you don't have a headache, then you will get one.  Also, make sure you check your medication when you pick it up from the drug store.  I have been taking this medication for many, many, many, many years for migrain headaches, so I know what it does and I know how it makes me feel, after taking it for many, many, many years.  All of this to say, I recently picked up a prescription from CVS and the pills look weird.  They are all chaulky.  I took them back and asked about it, but they just brushed me off as if I didn't know what I was talking about.  They claimed they changed them out for others from the same bottle, but these are also chaulky.  I think they are some of the pills I read about that are fake ones that get into our drug stores.  I say this because I have been taking them for many, many, many years - around 20 years, so I know what I'm talking about.  Needless to say, when I take these, they do help with the headache, but the side affect is I'm awake for 12-20 hours after I take just one of these and I use to take two at a time.  I thought maybe this was all in my mind, but I've taken at least 5 of this new batch of pain pills and everytime I take one, I'm awake for many, many, many hours.  I know they have caffeine in them, but they have always had caffeine in them and I have never had this side affect before I picked these up.  There is definitely something wrong with this batch and I refuse to take them anymore.  I told the pharmacy that if they did not find a new mfg that I was going to a different drug store and I will.  I'm old and can't afford to stay awake all night when I have a headache.  I need my sleep so I can go to work the following day.  Anyways, all of this to say, check your medication when you pick it up from the drug store and if they start using a new manufacturer, be very careful and make sure the pills work the same way and you don't have weird side affects like I am.  Other than that, if you are not in pain, don't take them, or you can become addicted to them.  I've been taking them for over 20 years and I am not addicted.  If I take more than 4 a day and my headache does not go away, I won't take anymore of these, then I'll go to plain old aspirin or Tylenol.

ittsjjustme, Community Member
10/28/09 6:59pm

i have a migrain everyday they put me on butalb but it makes me mean and have a worse headace im so tired of the headaces what can i do help

Robbie, Community Member
9/21/10 10:13pm

Thanks cause I am taking the medication now.I was very scared about the medication cause I have migrains.How would I know if the Med is fake or not.I have good doctors and I really respect them.So,Please let me know about this medicaton.


Teri Robert, Health Guide
9/21/10 10:45pm

Always buy medications from your local pharmacy or the mail order pharmacy recommended by your insurance company (if you have insurance). Never buy medications from foreign pharmacies or ANY pharmacy that wells prescription medications without a prescription from your own doctor.


You also need to know that this medication shouldn't be taken more than two or three days a week because of it's strong potential to cause medication overuse headache. You can read more about that in Medication Overuse Headache: When the Remedy Backfires.



Casie, Community Member
4/19/10 5:19pm

I couldnt help but reply to this completly bogus post. It is COMPLETLY wrong. I am currently in the medical practice and in no way, shape, or form can headaches more then 3 times a month cause brain damage, or disease. People have headaches everday or more then 3 times a week for reasons unknown. Headaches can be cause by many things, for example sinuses. Someone with sinuse issues can trigger a headache, so can stress, no sleep, not eating right and so on. And for the record 99 percent of what you read on the computer for medical answers, is INNCORRECT! people write what they believe is true.  Depending on the severity of the headache you can take 1-2 fioricets every 4-6 hours. Acetaminophen is what you need to be careful of because if if you take more than 4000 mg a day over a long period of time, you can cause liver damage. SO do not worry about the crap your reading above, take the meds if you need it, the doctor wouldnt perscribe you something that would hurt you. Just dont over do it, considering fioricet is addictive.

Teri Robert, Health Guide
4/19/10 5:46pm



Kindly follow the links I posted, then look at the references for those articles. Everything I posted is based on research published in peer-reviewed journals, and all of my articles are reviewed by a Migraine specialist physician. What I posted is correct, not crap. There is indeed evidence that, long-term, Migraines may indeed cause white matter lesions and possible other issues.


As for "simple sinus," sinus headache without infection is actually rare. 90% of what people think to be sinus headaches are actually Migraines. Again, that is based on research, not just something I'm making up.


Please note that nobody gives medical advice here, not even our review physicians. We give people information that they can discuss with their own doctors. We also speak to and about each other with respect here.



Abi A, Community Member
4/19/10 11:48pm



I can't believe you posted this. First, if you believe that 99% of what you read on the computer for medical answers is incorrect, what are you doing here?


Second, this site is well known for accurate, physician reviewed information. Quite a few doctors send their patients to this site for information.


Just what do you do "in the medical practice?" What are your qualifications to dispute information from sources such as the journals of the American and International Headache Societies -- the sources for the articles that Teri posted?


This is a great site with friendly and helpful people. You, on the other hand, have started out being really rude and obnoxious. Makes me wonder if you're a troll.



Mags, Community Member
4/25/10 11:35am

Holy cow! What got your panties in such a bunch, Casie? I always have confidence in the information on this site, especially since it's "physician reviewed," but out of curiosity, I got my doc to take a look at this question and the answers and the links in Teri's answer. He said he's never seen a site with information for patients that's as good as this one.


Now, who am I going to believe, you or my doctor?


I don't know what your problem is, but don't come here being nasty and trying to make it our problem too. You disrespected this site and a woman who knows more about migraines than you ever will. In my eyes, you owe her an apology.


Oh, and by the way, maybe you should learn about drugs and how and when they become addictive before you start throwing that word around. People don't get addicted when they're really taking drugs for pain. There's a good article on that topic around here somewhere, but with that huge chip on your shoulder, I'm not going to bother looking for the link for you. If you want respect, show some.




crystal perona, Community Member
7/30/10 11:58pm

well these pills usally get rid of my headachs but today i took two of them because my head was hurting unbearably but they dident help, i took them about three hours ago and now i just took one more and it;s starting to help but can taking them so close togeather hurt me like really bad? thats all i want to know.

Teri Robert, Health Guide
7/31/10 10:42am



What are the directions on the bottle? The directions should tell you how long to wait between doses.


My original answer to this question has more information about the use of this medication.


Since the medication didn't work today when you took it, you should talk to your doctor about what other options you have.


Hope you feel better soon,


nanshere, Community Member
3/13/12 7:24pm

i have these pills.......... and mine say.....................take 1 tablet every 8 hours to 12 hours as needed.......  if your head has settled down keep them handy, but don't take 4 a day.... get mom to check out a clinic or something were you can get advice,  even if you just go to the emergebcy room. and simply ask to speck to a nurse practicinier, they are informed, or can  ask a doctor for you, 

 i take iron,,,,,also thyroid meds and antibiotics each day..... but i am 62 years old, have a mrsa staph in my sinus's.  so 2 bactrim a day, 

  had frightening head aches for a bit.  found mostly caused by stress.......  i keep the pills in my medicine cabinet but i do not use  unless i can not stand the pain..

 i walk and breathe relaxing me.  also read meditations which really help to feed my mind,  instead of worrying........  all doctors are not God....  and if your guts say something follow it and find out.....GOD BLESS YOU>>>>>........


Pamela63, Community Member
7/27/09 1:35pm

dear lost broken girl


I am 63 and was put on the same med about 1 mo ago. The order is for 1 pill twice a day.  For a few days I took more ( my own decision) until the meds 'caught up' to the migraine.  I now take 1 in the am, 1 early evening.  I like it, no side effects and it helps other pain conditions.  For migraine I also take a beta-blocker, Verapamil SR, again 1 in the am, 1 early evening.This is a drug I take if I have a headache or not. It works most of the time.  These 2 drugs have made a big difference in the quality of my life.

Do your own research. Talk to a pharmacist, any pharmacist, but not a pharmacy tech.  Research the net more. I know I didnt answer your questions but I'm glad I found your post.  How is it working for you?


yatesy, Community Member
3/ 9/10 5:37am

I am also on 325 mg Fioricet tablets and I am seventeen years old; I have very good insurance.  Caffeine is one of the ingredients because it often helps get rid of migraines.  Do not take four a day.  Take one at the onset of the migraine headache, and one after that if your doctor says it's okay if the first did not work.



taylor8271, Community Member
6/23/10 12:22am

Wow. This is my first time on this site and I have to say its been very interesting.  I got on here because my daughters doctor put her on it, and I was reluctent to give it to her.  My daughter is 13yrs and  is taking 1 tablet as needed.  I would just assume letting her take the excedrin instead.  And seen that every one has something  to say, I would just like to say to the pregnant women be careful, cause caffine isnt good for a baby, I am no physcian but I do have 4 children and I was always told to stay away from caffine. And I know the difference between the ones I did drink caffine with and the ones I didnt, But that is between you and your doctor

Andrea, Community Member
8/12/10 10:21pm

First of all you are supposed to take your pill BEFORE your headache gets bad, you need to take it as soon as you feel the headache coming on or else the longer you wait the longer it will take to get rid of the migraine!  Good luck!

Bflygirl13, Community Member
1/12/12 3:45pm

I have CVID, and the doctor gave me this.  It seems to help when I do start hurting.  But my doctor told me I could take two advil each time I take this pill so it works faster.  My problem with that is I start to get cramps and my lower back starts hurting.  My doctor says that the advil will help.  Should I be taking the advil with this?

Laura, Community Member
9/13/12 12:39pm
I have been taking fioricet for about 5 years now. I love it, as long as I have the right kind of migraine/headache. It only works if I have a tension migraine. It tends to make me a little loopy when it first starts working, but then that effect goes away. If it is not the "right kind" of headache, I feel no side effects at all (and no relief). I've tried it for ocular migraines (which in my opinion are the worst) and it does absolutely nothing. However, in response to having to take it as soon as you feel the pain coming on, I don't usually. I hate taking meds and it takes a while for my brain to finally decide its stupid to sit in this much pain when I know I can just take a pill and it will be gone. I just hate popping pills for everything (sometimes I think that's all our society does). Anyway...getting off my soapbox...remember that all medications affect everyone differently. As for taking it with advil, I take mine with Mortin all the time. My doctor says that's fine and Motrin is one of the most versatile drugs (meaning it can be taken alongside most other medications). Make sure to follow your prescription bottle for dosage. Mine says 1-2 every 6 hours as needed. Anyway, good luck. If it does end up working for you, you'll love it like I do! Reply
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By lostbrokengirl, Community Member— Last Modified: 03/31/14, First Published: 03/13/09