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At our online pharmacy and many others, the most frequently prescribed medication is butalbital, the generic form of Fioricet. Patients are prescribed this medication for relief of tension headache. This article summarizes tension headache as well as butalbital to help patients make informed choices about their treatment.

Tension headache, also called “muscle contraction headache” or “stress headache” is a condition involving pain in the head, neck or scalp. It is typically a dull, achy feeling on both sides of the head, often associated with tightness of the muscles in the affected area. Tension headaches usually start in the middle of the day, typically building slowly and gradually. They can become quite severe, even more painful than a migraine headache. The pain may be worsened by noise or glare.

Tension headache is often the result of stress, anxiety or depression. It can also result from holding the head in a constant or awkward position for long times, for example when using a computer, typing or performing fine work using the hands. Other contributing factors may include excessive alcohol consumption, eyestrain, fatigue, excess caffeine, sinus infection and the flu.

Tension headache can be extremely uncomfortable and annoying, but is not dangerous. It is important to differentiate between tension headache and other conditions which result in head pain, however. If the pain is associated with vision changes, dizziness, nausea, vomiting, drowsiness, seizures or it does not respond to treatment, a physician should be consulted immediately.

While the mechanism behind tension headaches is not completely understood, there are a variety of treatments available with varying efficacy for patients. These include relaxation exercises, meditation, hot showers, biofeedback, a hot or cold pack placed on the point of pain, exercise and over the counter medication. Given the escalating nature of the headache, it is advisable to treat the pain as early as possible and prevent the pain from increasing in severity. For many patients, there is simply no substitute for Fioricet or butalbital. This medication is a combination of three ingredients (50 mg butalbital, 325 mg acetaminophen and 40 mg caffeine). For some reason, this combination of ingredients in this ratio of quantities is particularly effective in treating tension headache.

Butalbital is a barbiturate. It is responsible for relaxing the skeletal muscles in the head, neck and scalp. Acetaminophen is an analgesic (pain reliever) and antipyretic (fever reducer). Tylenol is acetaminophen. Caffeine is a central nervous stimulant found naturally in coffee. All the ingredients in Butalbital (Fioricet) are absorbed quickly. They are eliminated from the body in a variety of ways involving the liver and kidneys. It is interesting to note that while the caffeine and acetaminophen are eliminated from the body rather quickly (half of the drug is eliminated from the body in 3 hours), the butalbital component remains in the body much longer (half of the drug is eliminated in 35 hours).

While Fioricet and butalbital are safe medications, it is helpful to understand the precautions advised by the drug manufacturers when taking this medication. If you have a hypersensitivity to any of the components in butalbital, obviously you should consult a physician before taking the medication. Since the medication is cleared from the body by the kidneys and liver, any patient with impared liver or kidney function should consult a physician. The package insert for Fioricet also mentions that patients with porphyria should exercise the same caution, as should patients taking monoamine oxidase (MAO) inhibitors.

Fioricet and butalbital have other warnings as well. The medication can give patients a feeling of intoxication and euphoria, and may be habit forming.

Butalbital is a central nervous system depressant. This attribute accounts for the relaxation of skeletal muscle associated with tension headache, but it also carries the same risk as other CNS depressants. You should avoid driving or operating machinery when using this medication, as it can impair your mental and/or physical abilities. Alcohol can greatly strengthen the CNS depressant capability of the medication- avoid combining alcohol and butalbital.

Adverse reactions to butalbital and Fioricet include: drowsiness, dizziness, lightheadedness, sedation, shortness of breath, nausea, vomiting and abdominal pain. As with any medication, there have been a wide range of other rare adverse reactions reported.

In conclusion, Fioricet and butalbital are safe medications which are effective treatment for tension headaches. An educated patient is a safe patient, so it is important to understand the information in this article. If you do not understand the information in this article, or if you fall into any of the advisory categories, it is best to consult a physician before beginning treatment.