Fioricet is a combination medication composed of acetaminophen (Tylenol’s main ingredient), caffeine, and butalbital. It is used to relieve tension headaches and can also be prescribed to treat mild to moderate migraine.
Butalbital belongs to the barbiturate class of medication, which means it is a sedative, or relaxant. This makes Fioricet a barbiturate. Because it contains acetaminophen and caffeine, it is also a pain reliever and a stimulant.
Medications containing this combination of ingredients come in capsule and tablet forms, which can be taken by mouth. This combination of medications is also available in generics. Other brand names and formulations include:
- Fioricet® with Codeine (containing Acetaminophen, Butalbital, Caffeine, Codeine)
- Phrenilin® with Codeine (containing Acetaminophen, Butalbital, Caffeine, Codeine)
What is Migraine ?
Migraine is a common neurological condition that affects millions of people from all ages, nationalities and gender. Like any other disease, its presence is manifested by symptoms felt by the sufferer and whose existence allows physicians to make a diagnosis.
The most common migraine symptom and the most recognizable as well, is the headache. Although it is not present in the rarer forms of the disease, it is one evident sign of migraine. The headache that accompanies a migraine is not the kind that gives a dull ache. The pain felt by migraines is the intense, throbbing kind which sometimes necessitates complete rest and disrupts normal daily functions. However, a headache is not the only indicator that signals a migraine.
Depending on the migraine attack, a host of other symptoms arise as well. Analyzing them helps the medical practitioner in determining what type of migraine the patient is suffering from and in prescribing the appropriate medications.
An inventory of migraine symptoms could be quite lengthy due to the various types of the disease. A generalized list of these include: severe headache on one or both sides of the head, nausea, vomiting, weakness, vision disturbance, sensitivity to light and sound, pain over one eye, aura, blurred vision and temporary blind spots. When the migraine comes with aura, this gives rise to a whole new set of symptoms that consists of: seeing flashing lights or zigzag lines, temporary blindness, speech difficulty, tingling and weakness in the limbs and face, confusion, giddiness and noise sensitivity.
This does not mean the sufferer undergoes all the symptoms during the attack. Most likely, he will experience only a few. Symptoms also vary from person to person. Further, a migraine symptom could be felt days before the attack, during the prodrome stage. In these times, the migraineur has unexplained feelings of elation or intense energy, cravings for sweets, thirst, drowsiness or irritability and depression.
Diagnosing migraine is not an easy task for the physician. In order to make an accurate evaluation, he will need to have as much information as possible, obtained from the patient and from medical tests conducted. Observation and analysis of symptoms is very helpful in arriving at a diagnosis. By knowing what symptoms are experienced by the patient, the specialist will be able to tell what type of migraine it is and what treatments are to be administered.
During consultation, the patient will be required to describe the duration and frequency of his All kinds of Headache and how intense they are, where pain is located, presence of associated symptoms and behavior during a headache.
Since other illnesses also exhibit similar sings to migraine, these have to be ruled out. A case in point is the fact that people with sever sinusitis also experience double vision and vision loss.
Experiencing migraine, however mild, is not a pleasant event. But the sufferer can put this to good use by being observant and recording what he is going through. The complexity of migraine and the difficulty in diagnosing it means that no detail is insignificant. Thus, if the patient is to take an active role in the management of his disease, he needs to be vigilant of every single migraine symptom.
Migraines, which often begin in childhood, adolescence or early adulthood, can progress through four stages: prodrome, aura, attack and post-drome. Not everyone who has migraines goes through all stages.
One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including:
- Mood changes, from depression to euphoria
- Food cravings
- Neck stiffness
- Increased thirst and urination
- Frequent yawning
For some people, aura might occur before or during migraines. Auras are reversible symptoms of the nervous system. They’re usually visual, but can also include other disturbances. Each symptom usually begins gradually, builds up over several minutes and lasts for 20 to 60 minutes.
Examples of migraine aura include:
- Visual phenomena, such as seeing various shapes, bright spots or flashes of light
- Vision loss
- Pins and needles sensations in an arm or leg
- Weakness or numbness in the face or one side of the body
- Difficulty speaking
- Hearing noises or music
- Uncontrollable jerking or other movements
A migraine usually lasts from four to 72 hours if untreated. How often migraines occur varies from person to person. Migraines might occur rarely or strike several times a month.
During a migraine, you might have:
- Pain usually on one side of your head, but often on both sides
- Pain that throbs or pulses
- Sensitivity to light, sound, and sometimes smell and touch
- Nausea and vomiting
After a migraine attack, you might feel drained, confused and washed out for up to a day. Some people report feeling elated. Sudden head movement might bring on the pain again briefly.
When to see a doctor
Migraines are often undiagnosed and untreated. If you regularly have signs and symptoms of migraine, keep a record of your attacks and how you treated them. Then make an appointment with your doctor to discuss your headaches.
Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different.
See your doctor immediately or go to the emergency room if you have any of the following signs and symptoms, which could indicate a more serious medical problem:
- An abrupt, severe headache like a thunderclap
- Headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or trouble speaking
- Headache after a head injury, especially if the headache worsens
- A chronic headache that is worse after coughing, exertion, straining or a sudden movement
- New headache pain after age 50
Though migraine causes aren’t fully understood, genetics and environmental factors appear to play a role.
Changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway, might be involved. So might imbalances in brain chemicals — including serotonin, which helps regulate pain in your nervous system.
Researchers are studying the role of serotonin in migraines. Other neurotransmitters play a role in the pain of migraine, including calcitonin gene-related peptide (CGRP).
There are a number of migraine triggers, including:
- Hormonal changes in women. Fluctuations in estrogen, such as before or during menstrual periods, pregnancy and menopause, seem to trigger headaches in many women.Hormonal medications, such as oral contraceptives and hormone replacement therapy, also can worsen migraines. Some women, however, find their migraines occurring less often when taking these medications.
- Drinks. These include alcohol, especially wine, and too much caffeine, such as coffee.
- Stress. Stress at work or home can cause migraines.
- Sensory stimuli. Bright lights and sun glare can induce migraines, as can loud sounds. Strong smells — including perfume, paint thinner, secondhand smoke and others — trigger migraines in some people.
- Sleep changes. Missing sleep, getting too much sleep or jet lag can trigger migraines in some people.
- Physical factors. Intense physical exertion, including sexual activity, might provoke migraines.
- Weather changes. A change of weather or barometric pressure can prompt a migraine.
- Medications. Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines.
- Foods. Aged cheeses and salty and processed foods might trigger migraines. So might skipping meals or fasting.
- Food additives. These include the sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods.
How are migraines treated?
Migraine headaches are chronic. They can’t be cured, but they can be managed and possibly improved. There are two main treatment approaches that use medications: abortive and preventive.
- Abortive medications are most effective when you use them at the first sign of a migraine. Take them while the pain is mild. By possibly stopping the headache process, abortive medications help stop or decrease your migraine symptoms, including pain, nausea, light sensitivity, etc. Some abortive medications work by constricting your blood vessels, bringing them back to normal and relieving the throbbing pain.
- Preventive (prophylactic) medications may be prescribed when your headaches are severe, occur more than four times a month and are significantly interfering with your normal activities. Preventive medications reduce the frequency and severity of the headaches. Medications are generally taken on a regular, daily basis to help prevent migraines.
What medications are used to relieve migraine pain?
Over-the-counter medications are effective for some people with mild to moderate migraines. The main ingredients in pain relieving medications are ibuprofen, aspirin, acetaminophen, naproxen and caffeine.
Three over-the-counter products approved by the Food and Drug Administration for migraine headaches are:
- Excedrin® Migraine.
- Advil® Migraine.
- Motrin® Migraine Pain.
Be cautious when taking over-the-counter pain relieving medications. Sometimes overusing them can cause analgesic-rebound headaches or a dependency problem. If you’re taking any over-the-counter pain medications more than two to three times a week, report that to your healthcare provider. They may suggest prescription medications that may be more effective.
Prescription drugs for migraine headaches include:
Triptan class of drugs (these are abortives):
Calcium channel blockers:
Calcitonin gene-related (CGRP) monoclonal antibodies:
- Valproic acid.
- Gabapentin (Neurontin )
Your healthcare provider might recommend vitamins, minerals, or herbs, including:
Drugs to relieve migraine pain come in a variety of formulations including pills, tablets, injections, suppositories and nasal sprays. You and your healthcare provider will discuss the specific medication, combination of medications and formulations to best meet your unique headache pain.
Drugs to relieve nausea are also prescribed, if needed.
All medications should be used under the direction of a headache specialist or healthcare provider familiar with migraine therapy. As with any medication, it’s important to carefully follow the label instructions and your healthcare provider’s advice.
Alternative migraine management methods, also known as home remedies, include:
- Resting in a dark, quiet, cool room.
- Applying a cold compress or washcloth to your forehead or behind your neck. (Some people prefer heat.)
- Massaging your scalp.
- Applying pressure to your temples in a circular motion.
- Keeping yourself in a calm state. Meditating.