Dangers and risks
Butalbital can cause dependence or addiction. Mixing with alcohol, benzodiazepines, and other CNS depressants increases the risk of intoxication, respiratory depression, and liver toxicity when combined with paracetamol ( acetaminophen).
The use of butalbital and alcohol, benzodiazepines, and other CNS depressants can contribute to coma, and in extreme cases, fatality.
Side effects
Side effects for any psychoactive drug are difficult to predict, though butalbital is usually well tolerated. Commonly reported side effects for Fioricet, some of which tend to subside with continued use, include:
Dizziness Respiratory depression (impaired breathing) Drowsiness Intoxicated feeling Light-headedness Nausea Sedation Euphoria Severe impairment of judgment Diarrhea Memory Loss Constipation
The risk and severity of all side effects are greatly increased when butalbital (or butalbital-containing medications) are combined with other sedatives (ex. ethanol, opiates, benzodiazepines, antihistamines).
In particular, butalbital, especially when combined with other sedatives (e.g. opioids), can cause life-threatening respiratory depression and death.
Inhibitors of the hepatic enzyme CYP3A4 may also increase the risk, severity, and duration of side effects, many drugs inhibit this enzyme as do some foods such as grapefruit and the blood orange.
Taking butalbital-based medications with some other drugs may also increase the side effects of the other medication.
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