What is fioricet ?

Fioricet contains a combination of acetaminophen, butalbital, and caffeine. Acetaminophen is a pain reliever and fever reducer. Butalbital is in a group of drugs called barbiturates. It relaxes muscle contractions involved in a tension headache. Caffeine is a central nervous system stimulant. It relaxes muscle contractions in blood vessels to improve blood flow.

Fioricet is used to treat tension headaches that are caused by muscle contractions.

Fioricet® (Butalbital, Acetaminophen, and Caffeine Tablets USP) is supplied in tablet form for oral administration.

Each tablet contains the following active ingredients:
butalbital USP . . . . . . . . . . . .50 mg
acetaminophen USP . . . . . . 325 mg
caffeine USP . . . . . . . . . . . . .40 mg

Butalbital has generalized depressant effect on central nervous system and, in very high doses, has peripheral effects. Acetaminophen has analgesic and antipyretic effects mediated by a metabolite which acts at cannabinoid receptors, contrary to popular belief it is not an antiinflammatory at safe levels (it becomes toxic at doses above 1,000mg per dose and/or 3,000mg per day). Caffeine is thought to produce constriction of cerebral blood vessels and serves to counteract the sedative effect of butalbital.

Butalbital has a half-life of about 35 hours. Acetaminophen has a half-life of about 1.25 to 3 hours, but may be increased by liver damage and after an overdose. Caffeine has a half-life of about 5 to 7 hours

US Brand Name

1. 1. Anolor 300
  2. Dolgic LQ
  3. Esgic
  4. Esgic-Plus
  5. Ezol
  6. Fioricet
  7. Geone
  8. Margesic
  9. Medigesic
  10. Nonbac
  11. Pacaps
  12. Repan

Descriptions

Butalbital, acetaminophen, and caffeine combination is used to relieve symptoms of tension (or muscle contraction) headaches.

Butalbital belongs to the group of medicines called barbiturates. Barbiturates act in the central nervous system (CNS) to produce their effects.

Acetaminophen is used to relieve pain and reduce fever in patients. It does not become habit-forming when taken for a long time. But acetaminophen may cause other unwanted effects when taken in large doses, including liver damage.

When butalbital is used for a long time, it may become habit-forming, causing mental or physical dependence. However, people who have continuing pain should not let the fear of dependence keep them from using narcotics to relieve their pain. Physical dependence may lead to withdrawal side effects if treatment is stopped suddenly. However, severe withdrawal side effects can usually be prevented by gradually reducing the dose over a period of time before treatment is stopped completely.

Caffeine is a CNS stimulant that is used with pain relievers to increase their effect. It has also been used for migraine headaches. However, caffeine can also cause physical dependence when it is used for a long time. This may lead to withdrawal (rebound) headaches when you stop taking it.

This medicine is available only with your doctor’s prescription.

This product is available in the following dosage forms:

- Tablet
- Capsule
- Solution

What other Drugs will Affect Gabapentin (Neurontin)?

Do not take NEURONTIN if you are allergic to gabapentin or any of the other ingredients in NEURONTIN. See the end of this Medication Guide for a complete list of ingredients in NEURONTIN.

Tell your doctor about all other medicines you use, especially:

hydrocodone (Lortab, Vicodin, Vicoprofen, and others);
morphine (Kadian, MS Contin, Oramorph, and others); or
naproxen (Naprosyn, Aleve, Anaprox, and others).

This list is not complete and other drugs may interact with gabapentin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Medications known to interact with gabapentin

acetaminophen / propoxyphene
aspirin / caffeine / propoxyphene

Balacet (acetaminophen / propoxyphene)
Belbuca (buprenorphine)
Bunavail (buprenorphine / naloxone)
Buprenex (buprenorphine)
buprenorphine
buprenorphine / naloxone
Butrans (buprenorphine)

Darvocet A500 (acetaminophen / propoxyphene)
Darvocet-N 100 (acetaminophen / propoxyphene)
Darvocet-N 50 (acetaminophen / propoxyphene)
Darvon (propoxyphene)
Darvon Compound 32 (aspirin / caffeine / propoxyphene)
Darvon Compound-65 (aspirin / caffeine / propoxyphene)
Darvon-N (propoxyphene)

levomethadyl acetate

Orlaam (levomethadyl acetate)

PC-CAP (aspirin / caffeine / propoxyphene)
PP-Cap (propoxyphene)
Propacet 100 (acetaminophen / propoxyphene)
propoxyphene
Propoxyphene Compound 65 (aspirin / caffeine / propoxyphene)

sodium oxybate
Suboxone (buprenorphine / naloxone)
Subutex (buprenorphine)

Trycet (acetaminophen / propoxyphene)

Wygesic (acetaminophen / propoxyphene)

Xyrem (sodium oxybate)

Zubsolv (buprenorphine / naloxone)

What is Gabapentin?

Gabapentin is an anti-epileptic medication, also called an anticonvulsant. It affects chemicals and nerves in the body that are involved in the cause of seizures and some types of pain.

Gabapentin is used in adults to treat nerve pain caused by herpes virus or shingles (herpes zoster).

The Horizant brand of gabapentin is also used to treat restless legs syndrome (RLS).

The Neurontin brand of gabapentin is also used to treatseizures in adults and children who are at least 3 years old.

NEURONTIN is a prescription medicine used to treat:

Pain from damaged nerves (postherpetic pain) that follows healing ofshingles (a painful rash that comes after a herpes zoster infection) in adults.
Partial seizures when taken together with other medicines in adults and children 3 years of age and older with seizures.

What is the Most Important Information I Should Know About Gabapentin?

Do not stop taking NEURONTIN without first talking to your healthcare provider. Stopping NEURONTIN suddenly can cause serious problems.

NEURONTIN can cause serious side effects including:

1. Suicidal Thoughts. Like other antiepileptic drugs, NEURONTIN may cause suicidal thoughts or actions in a very small number of people, about 1 in 500.

Call a healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you:

thoughts about suicide or dying
attempts to commit suicide
new or worse depression
new or worse anxiety
feeling agitated or restless
panic attacks
trouble sleeping (insomnia)
new or worse irritability
acting aggressive, being angry, or violent
acting on dangerous impulses
an extreme increase in activity and talking (mania)
other unusual changes in behavior or mood

How can I watch for early symptoms of suicidal thoughts and actions?

Pay attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings.
Keep all follow-up visits with your healthcare provider as scheduled.

Call your healthcare provider between visits as needed, especially if you are worried about symptoms.

Do not stop taking NEURONTIN without first talking to a healthcare provider.

Stopping NEURONTIN suddenly can cause serious problems. Stopping a seizure medicine suddenly in a patient who has epilepsy can cause seizures that will not stop (status epilepticus).
Suicidal thoughts or actions can be caused by things other than medicines. If you have suicidal thoughts or actions, your healthcare provider may check for other causes.

2. Changes in behavior and thinking –Using NEURONTIN in children 3 to 12 years of age can cause emotional changes, aggressive behavior, problems with concentration, restlessness, changes in school performance, and hyperactivity.

3. NEURONTIN may cause serious or life-threatening allergic reactionsthat may affect your skin or other parts of your body such as your liver or blood cells. This may cause you to be hospitalized or to stop NEURONTIN. You may or may not have a rash with an allergic reaction caused by NEURONTIN. Call a healthcare provider right away if you have any of the following symptoms:

skin rash
hives
difficulty breathing
fever
swollen glands that do not go away
swelling of your face, lips, throat, or tongue
yellowing of your skin or of the whites of the eyes
unusual bruising or bleeding
severe fatigue or weakness
unexpected muscle pain
frequent infections

These symptoms may be the first signs of a serious reaction. A healthcare provider should examine you to decide if you should continue taking NEURONTIN.

Gabapentin warnings

Gabapentin oral capsule comes with several warnings. Call your doctor if you start having more seizures or a different kind of seizure while taking this drug.

Suicide prevention

If you think someone is at immediate risk of self-harm or hurting another person:

• Call 911 or your local emergency number.

• Stay with the person until help arrives.

• Remove any guns, knives, medications, or other things that may cause harm.

• Listen, but don’t judge, argue, threaten, or yell.

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Drowsiness warning

Gabapentin can slow your thinking and motor skills and cause drowsiness and dizziness. It’s not known how long these effects last. You should not drive or use heavy machinery while taking this drug until you know how it affects you.

Depression warning

Using this drug increases your risk of suicidal thoughts and behavior. Talk to your doctor if you feel depressed or notice any changes in your mood or behavior. Also talk to your doctor if you are having thoughts of harming yourself, including suicide.

Multiorgan hypersensitivity/DRESS warning

This medication can cause multiorgan hypersensitivity. This is also known as a drug reaction with eosinophilia and systemic symptoms (DRESS). This syndrome can be life-threatening. Call your doctor right away if you have symptoms such as a rash, a fever, or swollen lymph nodes.

Allergy warning

Gabapentin can cause a severe allergic reaction. Symptoms can include:

trouble breathing
swelling of your throat or tongue
hives
rash

Don’t take this drug again if you have ever had an allergic reaction to it before. Taking it a second time after any allergic reaction to it could be fatal (cause death).

Alcohol interaction warning

Avoid drinking alcohol while taking gabapentin. Gabapentin can cause sleepiness, and drinking alcohol can make you even more sleepy. Alcohol can also make you more likely to feel dizzy and have trouble concentrating.

Warnings for people with certain health conditions

For people with epilepsy: Don’t stop taking gabapentin suddenly. Doing this can increase your risk of having a condition called status epilepticus. This is a medical emergency during which short or long seizures occur for 30 minutes or more.

Gabapentin can cause problems in children aged 3–12 years who have epilepsy. It raises their risk of thought problems as well as behavioral problems, such as being hyper and acting hostile or restless.

For people with kidney problems: Your body processes this drug more slowly than normal. This may cause the drug to increase to dangerous levels in your body. Talk to your doctor about whether this drug is safe for you.

Warnings for other groups

For pregnant women: The use of gabapentin has not been studied in humans during pregnancy. Research in animals has shown negative effects to the fetus when the mother takes the drug. However, animal studies don’t always predict the way humans would respond.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus. Call your doctor if you become pregnant while taking this drug.

If your doctor prescribes gabapentin for you while you’re pregnant, ask about the NAAED Pregnancy Registry. This registry tracks the effects of anti-seizure drugs on pregnancy. Information can be found at aedpregnancyregistry.org.

For women who are breastfeeding: Gabapentin may pass into breast milk and cause serious side effects in a breastfeeding child. Tell your doctor if you are breastfeeding. You should decide together if you should stop taking this drug or stop breastfeeding.

For seniors: Kidney function may decrease with age. You may process this drug more slowly than younger people. Your doctor may start you on a lowered dose so that too much of this drug does not build up in your body. Too much of the drug in your body can be dangerous.

For children: Gabapentin has not been studied in children for the management of postherpetic neuralgia. It should not be used in people younger than 18 years. This drug should not be used to treat partial seizures in children younger than 3 years.

How to take gabapentin ?

The gabapentin dosage your doctor prescribes will depend on several factors. These include:

- - the type and severity of the condition you’re using gabapentin to treat
  - your age
  - the form of gabapentin you take
  - other medical conditions you may have

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Forms and strengths

Generic: Gabapentin

- Form: oral capsule
- Strengths: 100 mg, 300 mg, 400 mg

Brand: Neurontin

- Form: oral capsule
- Strengths: 100 mg, 300 mg, 400 mg

Dosage for postherpetic neuralgia

Adult dosage (ages 18–64 years)

Typical starting dosage: Day 1, 300 mg; day 2, 600 mg (300 mg two times per day, spaced evenly throughout the day); day 3, 900 mg (300 mg, three times per day, spaced evenly throughout the day). Your doctor may further increase your dosage after day 3.
Maximum dosage: 1,800 mg per day (600 mg, three times per day, spaced evenly throughout the day)

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years has not been established.

Senior dosage (ages 65 years and older)

Your kidney function may decrease with age. Your body may get rid of this drug more slowly. Your doctor may start you on a lower dose so that too much of this drug does not build up in your body. Too much of the drug in your body can be dangerous. Your doctor may change your dose based on how well your kidneys are working.

Dosage for partial-onset seizures

Adult dosage (ages 18–64 years)

Typical starting dosage: 900 mg per day (300 mg, three times per day, spaced evenly throughout the day). Your doctor may increase your dose to 2,400–3,600 mg per day.

Child dosage (ages 12–17 years)

Typical starting dosage: 300 mg, three times per day, spaced evenly throughout the day. This can increase to 2,400–3,600 mg per day.

Child dosage (ages 3–11 years)

Typical starting dosage: 10–15 mg/kg/day, divided into three doses, spaced evenly throughout the day. Your child’s doctor may increase the dosage to meet your child’s needs.

Maximum dosage: 50 mg/kg/day.

Child dosage (ages 0–2 years)

Dosage for people younger than 3 years has not been established.

Senior dosage (ages 65 years and older)

Special considerations

Kidney problems: If you are older than 12 years and have kidney problems or are on hemodialysis, your dose of gabapentin will need to be changed. This will be based on how well your kidneys are working.

Gabapentin is used to treat Restless Legs Syndrome

Restless legs syndrome (RLS) is a disorder of the part of thenervous system that causes an urge to move the legs. Because it usually interferes with sleep, it also is considered a sleep disorder.

Causes of Restless Legs Syndrome

In most cases, doctors do not know the cause of restless legs syndrome; however, they suspect that genes play a role. Nearly half of people with RLS also have a family member with the condition.

Other factors associated with the development or worsening of restless legs syndrome include:

Chronic diseases. Certain chronic diseases and medical conditions, including iron deficiency, Parkinson’s disease, kidney failure,diabetes, and peripheral neuropathy often include symptoms of RLS. Treating these conditions often gives some relief from RLS symptoms.
Medications. Some types of medications, including antinausea drugs, antipsychotic drugs, some antidepressants, and cold and allergymedications containing sedating antihistamines, may worsen symptoms.
Pregnancy. Some women experience RLS during pregnancy, especially in the last trimester. Symptoms usually go away within a month after delivery.

Other factors, including alcohol use and sleep deprivation, may trigger symptoms or make them worse. Improving sleep or eliminating alcohol use in these cases may relieve symptoms.

Treatment for Restless Legs Syndrome

Treatment for RLS is targeted at easing symptoms. In people with mild to moderate restless legs syndrome, lifestyle changes, such as beginning a regular exercise program, establishing regular sleep patterns, and eliminating or decreasing the use of caffeine, alcohol, and tobacco, may be helpful. Treatment of an RLS-associated condition also may provide relief of symptoms.

Other non-drug RLS treatments may include:

Leg massages
Hot baths or heating pads or ice packs applied to the legs
Good sleep habits
A vibrating pad called Relaxis
Medications may be helpful as RLS treatments, but the same drugs are not helpful for everyone. In fact, a drug that relieves symptoms in one person may worsen them in another. In other cases, a drug that works for a while may lose its effectiveness over time.

Drugs used to treat RLS include:

Dopaminergic drugs, which act on the neurotransmitter dopamine in the brain.
Mirapex, Neupro, and Requip are FDA-approved for treatment of moderate to severe RLS. Others, such as levodopa, may also be prescribed.
Benzodiazepines, a class of sedative medications, may be used to help with sleep, but they can cause daytime drowsiness.
Narcotic pain relievers may be used for severe pain.
Anticonvulsants, or antiseizure drugs, such as Tegretol, Lyrica, Gabapentin ( Neurontin ), and Horizant.

Although there is no cure for restless legs syndrome, current treatments can help control the condition, decrease symptoms, and improve sleep.

Usual Adult Dose for Restless Legs Syndrome

Gabapentin enacarbil available under the trade name Horizant (R):
600 mg orally once daily with food at about 5 PM

Gabapentin is Used to Treat Nerve Pain

Nerve pain can be a symptom of many different conditions, includingcancer, HIV, diabetes, and shingles.

For some, nerve pain is frustrating; for others, nerve pain is devastating and life-changing.

Whether it feels like burning, pinpricks, or sudden shocks of electricity, nerve pain can disrupt your life at home and at work. It can limit your ability to get around. Over time, it can grind you down. Studies show that people with nerve pain have higher rates of sleep problems,anxiety, and depression.Your nervous system is involved in everything your body does, from regulating your breathing to controlling your muscles and sensing heat and cold.

There are three types of nerves in the body:

Autonomic nerves. These nerves control the involuntary or partially voluntary activities of your body, including heart rate, blood pressure, digestion, and temperature regulation.
Motor nerves. These nerves control your movements and actions by passing information from your brain and spinal cord to your muscles.
Sensory nerves. These nerves relay information from your skin and muscles back to your spinal cord and brain. The information is then processed to let you feel pain and other sensations.

Because nerves are essential to all you do, nerve pain and damage can seriously affect your quality of life.

When you have a serious medical condition such as cancer or HIV, dealing with the additional misery of nerve pain can be especially hard. But there is good news. While nerve pain can’t always be cured, it can be treated — and there are a lot of good options available.

Experts believe that 40 million Americans are living with nerve pain. The impact of nerve pain is tremendous. Both the costs to the healthcare system as well as loss of wages and productivity are staggering.

How Are Nerve Pain and Nerve Damage Treated?

In many instances, nerve damage cannot be cured entirely. But there are various treatments that can reduce your symptoms. Because nerve damage is often progressive, it is important to consult with a doctor when you first notice symptoms. That way you can reduce the likelihood of permanent damage.

Often, the first goal of treatment is to address the underlying condition that’s causing your nerve pain or nerve damage. This may mean:

Regulating blood sugar levels for people with diabetes
Correcting nutritional deficiencies
Changing medications when drugs are causing nerve damage
Physical therapy or surgery to address compression or trauma to nerves
Medications to treat autoimmune conditions

Additionally, your doctor may prescribe medications aimed at minimizing the nerve pain you are feeling. These may include:

Pain relievers
Tricyclic antidepressants
Certain anti-seizure drugs – Gabapentin

Complementary and alternative approaches may also help alleviate your nerve pain and discomfort. These include:

Acupuncture
Biofeedback
Hypnosis
Meditation

Gabapentin is Used to Treat Diabetic Peripheral Neuropathy

What is Diabetic Peripheral Neuropathy: A common complication of diabetes mellitus in which nerves are damaged as a result of hyperglycemia (high blood sugar levels)

Not many people are aware of the medical condition that is known as Diabetic Neuropathy however more and more people are being diagnosed with having it, and if you have been recently diagnosed with Diabetic Neuropathy then you will need to start to take drug to help manage and control that condition.

Causes of Neuropathic Pain

Exposure to drugs, alcohol, toxins Neuropathic Pain Surgical procedures/ Amputation Traumatic Nerve injury/ compression Metabolic disturbance Viral infection Neuropathic pain is a disease, like myocardial infarction is a disease. Myocardial infarction may be caused by smoking, or hypertension, or diabetes. Multiple different things contribute to the cause of myocardial infarction, but myocardial infarction is the disease. Similarly, neuropathic pain is a disease, and this slide shows many of the different conditions that can result in neuropathic pain.

But the pain is nonprotective. It is something that persists and behaves separately as a disease itself.Cancer related (disease or treatmentVascular related neurodegenerativeNutritional deficiency

The best drug you can take is the fast acting Gabapentin and one of the main reasons why many people who do have Diabetic Neuropathy will take that drug is that it is not only fast acting as mentioned but it is also a very low cost drug to purchase too.

Drugs associated with Diabetic Peripheral Neuropathy

If you do want to take Gabapentin to treat diabetic neuropathy then please do be aware there can be some side effects, and before you make a purchase of Gabapentin you will be best advised to find out what the side effect of Gabapentin when taking it to treat diabetic neuropathy, and if at any time you start to experience any of those side effects then please seek the advice of a Doctor or a medical professional.

Take Gabapentin as an Anticonvulsant

Anticonvulsants (also commonly known as antiepileptic drugs or as antiseizure drugs) are a diverse group of pharmacological agents used in the treatment of epileptic seizures. Anticonvulsants are also increasingly being used in the treatment of bipolar disorder and borderline personality disorder, since many seem to act as mood stabilizers, and for the treatment of neuropathic pain.

Anticonvulsants suppress the rapid and excessive firing of neurons during seizures. Anticonvulsants also prevent the spread of the seizure within the brain. Some investigators have observed that anticonvulsants themselves may cause reduced IQ in children. However these adverse effects must be balanced against the significant risk epileptic seizures pose to children and the distinct possibility of death and devastating neurological sequelaesecondary to seizures.

Anticonvulsants are more accurately called antiepileptic drugs (abbreviated “AEDs”), and are often referred to as antiseizure drugs because they provide symptomatic treatment only and have not been demonstrated to alter the course of epilepsy.

Gabapentin (Neurontin) has been approved as adjunctive therapy in adults with partial seizures with or without secondary generalization . Begin with 300 mg daily; increase to 900 to 1,800 mg daily given every 6 to 8 hours. Side Effects maybe: Somnolence, fatigue, ataxia, dizziness, gastrointestinal upset, dyspnea.

A gamma-aminobutyric acid (GABA) analog, gabapentin does not interact with GABA receptors. Its mechanism of action is unknown.

Gabapentin is well absorbed orally, circulates mostly unbound in the plasma and is excreted unchanged in the kidneys without appreciable metabolism in the body. Oral bioavailability is approximately 60 percent and is not affected by food. The half-life is five to seven hours and is related to the creatinine clearance. Therefore, excretion is decreased in patients with renal impairment and decreased cardiac function, and in elderly patients. Gabapentin can be removed from the system through hemodialysis.

In clinical studies, gabapentin was found to be effective in adults with refractory partial seizures and was also effective in preventing the progression of partial seizures to generalized tonic-clonic seizures.

Because gabapentin has no known pharmacokinetic interactions with any other antiepileptic drugs, it is useful in patients taking other antiepileptic medication.