Updated on February 6, 2024
6 min read

Butalbital Addiction: Symptoms, Detox, Withdrawal, and Treatment

Key Takeaways

What is Butalbital?

Butalbital is a barbiturate that affects the central nervous system (CNS) and is used to treat tension headaches. It has an intermediate duration of action compared to other over-the-counter (OTC) medications.

Butalbital is often combined with acetaminophen and caffeine as a pain reliever. It's best stored at room temperature, away from moisture and heat. For more information on butalbital, check the packaging of the product.

Though used mainly for headaches, butalbital can also be used as a sedative to treat:

  • Anxiety
  • Seizures
  • Insomnia

Online Therapy Can Help

Over 3 million people use BetterHelp. Their services are:

  • Professional and effective
  • Affordable and convenient
  • Personalized and discreet
  • Easy to start
Find a Therapist

Answer a few questions to get started

Woman drinking coffee on couch

Butalbital, Acetaminophen, & Caffeine

Acetaminophen is a commonly used pain reliever and fever reducer. Meanwhile, caffeine is a stimulant that increases the effect of pain relievers. 

The combination of butalbital, acetaminophen, and caffeine is only available with a doctor's prescription. It can be taken in the following forms:

  • Tablet
  • Capsule
  • Solution

What is the Dosage of Butalbital?

The dosage for butalbital will depend on the person and the strength of the medication. However, for people aged 12 and over, the dosage is one or two capsules every 4 hours as needed. A doctor must determine the dosage for children under 12.

If you miss a dose of butalbital, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not double dose.

Get Professional Help

BetterHelp can connect you to an addiction and mental health counselor.

Find a Therapist

Answer a few questions to get started

Rehab Together

What is Butalbital Used For?

Butalbital is used primarily in treating tension headaches, also known as stress headaches. These headaches are characterized by the following:

  • Dull, aching head pain
  • Lasts between 30 minutes and 7 days
  • Tightness or pressure across the forehead or on the sides and back of the head
  • Tenderness in the scalp, neck, and shoulder muscles
  • Mild or moderate intensity that isn't aggravated by activity
  • Non-pulsating feeling
  • Does not cause nausea or vomiting or sensitivity to light or sound

Butalbital should not be used for the treatment of migraine headaches. It is a prescription drug that should only be used under the professional advice of a licensed healthcare provider. 

Side Effects of Butalbital

There are several side effects of butalbital, including:

  • Decreases in reaction time
  • Loss of motor coordination or balance
  • Slower thinking
  • Dizziness or lightheadedness
  • Lethargy
  • Drowsiness
  • Nausea
  • Vomiting
  • Stomach pain and cramps
  • Shallow breathing or shortness of breath due to respiratory depression

Rare Side Effects of Butalbital

Rare side effects of butalbital include:

  • Allergic reaction and rash (skin reaction)
  • Difficulty breathing
  • Difficulty swallowing
  • Dry mouth
  • Indigestion and heartburn
  • Tinnitus
  • Leg pain or leg cramps

Butalbital in breast milk can also cause poor feeding and vomiting in infants. If you are breastfeeding, it is best to avoid using butalbital.

Side Effects of Butalbital, Acetaminophen, & Caffeine

Both butalbital and caffeine use can lead to low, moderate, or high physical dependence. Fortunately, caffeine withdrawal is typically a milder and less serious issue.

On the other hand, acetaminophen is not a habit-forming substance. But it can have serious effects, such as liver damage, in high doses. 

Phone, Video, or Live-Chat Support

BetterHelp provides therapy in a way that works for YOU. Fill out the questionnaire, get matched, begin therapy.

Get Started

Answer a few questions to get started

Woman drinking coffee on couch

Is Butalbital Addictive?

Butalbital has a high potential for addiction and physical dependence on the drug. Tolerance to this medication, as well as other barbiturates, can occur in a relatively short period. This often leads to higher dosages and more potential for misuse.

Barbiturate overdoses can occur easily due to how quickly a tolerance can develop. Some signs of butalbital addiction include:

  • Obtaining butalbital without a prescription
  • Overuse or taking higher doses than specified in the prescription
  • Using butalbital in ways not typically prescribed, such as snorting it or mixing it with other drugs
  • Appearing tired, lethargic, or intoxicated
  • Slurred speech, issues with coordination, and decreased mental and physical reaction times 
  • Spending significant periods alone
  • Defensive or angry behavior when someone attempts to discuss medication usage or drug abuse
  • Problems with attention and with memory
  • Irritability, restlessness, or sensitivity
  • Continuing to use butalbital, despite experiencing negative side effects and consequences
  • Porphyria, a buildup of natural chemicals that produce porphyrin (a compound essential for the function of hemoglobin) in the body
  • Withdrawal symptoms

Dangers Of Butalbital Addiction

Misusing butalbital can lead to long-lasting health effects. A person with a butalbital addiction will likely develop a tolerance for the drug. They may mix it with other drugs or alcohol to maintain the initial high.

Combining butalbital with alcohol can also increase the risk of respiratory depression and liver failure. Long-term and consistent use of barbiturates can lead to chronic symptoms, including:

  • Irritability
  • Memory loss
  • Decreased function
  • Shifts in alertness

Butalbital Overdose Symptoms

Some people experiencing opioid addiction will use butalbital to enhance the effects of whatever drug they are taking. This is dangerous because taking butalbital with narcotics can lead to overdose or accidental death.

Symptoms of a barbiturate overdose, such as butalbital, include:

  • Drowsiness
  • Confusion
  • Coma
  • Respiratory depression
  • Trouble breathing
  • Persistent nausea and vomiting
  • Severe dizziness
  • Slow or slurred speech
  • Staggering
  • Ringing in the ears

Complications From a Butalbital Overdose

Complications that may occur from a butalbital overdose include:

  • Head and spinal injuries from falls
  • Pneumonia from depressed gag reflex
  • Muscle damage from lying on a hard surface for an extended period

If you suspect someone is overdosing, call 911 immediately. An untreated butalbital addiction can be life-changing or fatal.

Butalbital Withdrawal

Butalbital addiction is likely to cause uncomfortable withdrawal symptoms when use is quickly stopped. These withdrawal symptoms generally occur within 2 to 4 days of stopping butalbital use.

Withdrawal symptoms of butalbital include:

  • Seizures
  • Psychosis
  • Tremors
  • Restlessness
  • Insomnia
  • Anxiety

If severe withdrawal symptoms go untreated or are not quickly recognized, the following may occur:

  • Hypothermia
  • Failure of blood circulation
  • Death

Treatment Options for Butalbital Abuse

Detoxing from butalbital or any harmful substance can be dangerous. Reach out to a healthcare professional for proper treatment.

Available treatment options for butalbital abuse include:

Butalbital: Common Questions and Answers

Common questions associated with butalbital use and addiction include:

What Kind of Drug is Butalbital?

Butalbital is a barbiturate drug, which is a class of CNS depressants. This class of medication acts on the central nervous system as a depressant. They are effective as anticonvulsants, but they also carry habit-forming potential. Benzodiazepines have replaced barbiturates in recent years for several types of treatment. 

Is Butalbital the Same as Fioricet?

Fioricet is not the same as butalbital, but it does contain this barbiturate compound. Fioricet is a brand-name drug containing butalbital, acetaminophen, and caffeine in one oral tablet or capsule. This medication is very similar to esgic, fiorinal, orbivan, repan, margesic, phrenilin, and phenobarbital, all of which contain butalbital and some form of pain reliever. 

Is Butalbital Used for Anxiety?

Though it is used primarily to treat tension headaches, butalbital can also be prescribed to treat anxiety. This was once more common, but now most medical professionals prescribe benzodiazepines instead.

What are the Possible Side Effects of Acetaminophen, Butalbital, and Caffeine?

In addition to those listed above, possible adverse effects of the combination of acetaminophen, butalbital, and caffeine include:

  • Liver damage or liver disease
  • Kidney disease
  • Abdominal pain
  • Irritability
  • Constipation
  • Nervousness
  • Tremors
  • Increased urination
  • Dark urine
  • Fainting
  • Confusion
  • Rapid heart rate
  • Difficulty sleeping

Get matched with an affordable mental health counselor

Find a Therapist

Answer a few questions to get started

Updated on February 6, 2024
6 sources cited
Updated on February 6, 2024
  1. U.S. Food and Drug Administration. “Butalbital, Acetaminophen, Caffeine, and Codeine Phosphate Capsules for Oral Use.” FDA. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020232s041lbl.pdf

  2. National Library of Medicine. “Butalbital.” NLM. https://pubchem.ncbi.nlm.nih.gov/compound/Butalbital

  3. National Institute of Health. “Harmful Drug Interactions.” NIH https://www.niaaa.nih.gov/sites/default/files/publications/Harmful_Interactions.pdf

  4. National Highway Traffic Safety Administration. “2013–2014 National Roadside Study of Alcohol and Drug Use by Drivers.” NHTSA https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/documents/13013-nrs_drug_092917_v6_tag.pdf

  5. Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Butalbital. [Updated 2019 Jun 30]. Available from: https://www.ncbi.nlm.nih.gov/sites/books/NBK501481/

  6. Silberstein, S D, and D C McCrory. “Butalbital in the treatment of headache: history, pharmacology, and efficacy.” Headache vol. 41,10 : 953-67. doi:10.1046/j.1526-4610.2001.01189.x, https://pubmed.ncbi.nlm.nih.gov/11903523/

Related Pages