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Barbiturates such as butalbital and narcotics such as codeine can be habit-forming when taken in higher than recommended doses over long periods of time.
Fiorinal with Codeine, a strong narcotic pain reliever and muscle relaxant, is prescribed for the relief of tension headache caused by stress and muscle contraction in the head, neck, and shoulder area.
It combines a sedative-barbiturate (butalbital), a narcotic pain reliever and cough suppressant (codeine), a non-narcotic pain and fever reliever (aspirin), and a stimulant (caffeine).

Side Effects

Fiorinal-with-Codeine side effects that you should report to your health care professional or doctor as soon as possible:

More common side effects may include:
- Nausea;
- Drowsiness;
- Dizziness;
- Abdominal pain;

Additional side effects, which can be caused by this drug's components, may include:
- Tremors;
- Stomach upset;
- Peptic ulcer;
- Light-headedness;
- Lack of clotting;
- Kidney damage;
- Irritability;
- Intoxicated feeling;
- Internal bleeding;
- High blood sugar;
- Hepatitis;
- Blocked air passages;
- Anemia;


Fiorinal-with-Codeine is contraindicated if you have any of the following conditions:
- If you are being treated for a kidney, liver, or blood clotting disorder;
- If you are older or in a weakened condition;
- If you are sensitive to or have ever had an allergic reaction to butalbital, codeine, aspirin, caffeine, or other pain relievers;
- If you have a tendency to bleed too much;
- If you have addison's disease (an adrenal gland disorder);
- If you have asthma due to aspirin or other nonsteroidal anti-inflammatory drugs such as motrin;
- If you have chronic (long-lasting or frequently recurring) tension headaches and your prescribed dose of fiorinal with codeine does not relieve the pain;
- If you have difficulty urinating;
- If you have ever developed dependence on a drug;
- If you have nasal polyps (growths or nodules);
- If you have peptic ulcer;
- If you have porphyria (an inherited metabolic disorder affecting the liver and bone marrow);
- If you have severe liver damage;
- If you have severe vitamin k deficiency;
- If you have swelling due to fluid retention;
- If your prostate gland is enlarged;
- If your thyroid gland is not working well;


Do not take Fiorinal-with-Codeine with any of the following drugs:
- Valproic acid (depakene);
- Tranquilizers such as librium, xanax, and valium;
- Theophylline (theo-dur, others);
- Steroid drugs such as prednisone;
- Sleep aids such as nembutal and halcion;
- Oral diabetes drugs such as micronase;
- Oral contraceptives;
- Nonsteroidal anti-inflammatory drugs such as motrin and indocin;
- Narcotic pain relievers such as darvon and vicodin;
- Methotrexate (rheumatrex);
- Insulin;
- Divalproex (depakote);
- Blood-thinning drugs such as coumadin;
- Beta-blocking blood pressure drugs such as inderal and tenormin;
- Antihistamines such as benadryl;
- Antigout medications such as benemid and anturane;
- Antidepressant drugs such as elavil, nardil, and parnate;
- Acetazolamide (diamox);
- 6-mercaptopurine (purinethol);



The safety and effectiveness of butalbital have not been established in children under 12 years of age.


The usual dose of Fiorinal with Codeine is 1 or 2 capsules taken every 4 hours. Do not take more than 6 capsules per day.


Symptoms of an overdose of Fiorinal with Codeine are mainly attributed to its barbiturate and codeine ingredients.

Symptoms attributed to the barbiturate ingredient of Fiorinal with Codeine may include:
- Slow or troubled breathing;
- Shock;
- Low blood pressure;
- Drowsiness;
- Dizziness;
- Confusion;
- Coma;

Symptoms attributed to the codeine ingredient of Fiorinal with Codeine may include:
- Troubled and slowed breathing;
- Pinpoint pupils;
- Loss of consciousness;
- Convulsions;

Symptoms attributed to the aspirin ingredient of Fiorinal with Codeine may include:
- Vomiting;
- Seizures;
- Ringing in the ears;
- Restlessness;
- Rapid breathing;
- High fever;
- Delirium;
- Deep;
- Abdominal pain;

Though caffeine poisoning occurs only at very high doses, it can cause:
- Tremor;
- Restlessness;
- Rapid heartbeat;
- Irregular heartbeat;
- Insomnia;
- Delirium;
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