Benzos Question about barbiturates (Butalbital) and diazepam (Valium)

[Mistasolodolo]

So I was recently prescribed Fioricet. 325mg acetaminophen, 50mg butalbital, 40mg caffeine and 30mg codeine. I take 5mgs of Valium a day for anxiety reasons, would the butalbital in the fioricet work like a Valium? Or should I take valium with it? As far as I've seen, it seems I shouldnt have to take the valium as the butalbital is a barbiturate. Thank you!

 

[Mistasolodolo]

Any opinions are greatly appreciated

 

[Chadd1]

I don't think anyone is going to reassure you to take that cocktail, but then again nothing surprises me at this point in life.

 

[Mistasolodolo]

What cocktail? All of that is in a Fioricet capsule that I'm prescribed besides valium. Which is why I'm wondering if I would be better off just not taking the valium at all since there is the butalbital already in the Fioricet.

 

[kleinerkiffer]

Yeah, don't take Valium + butalbital. The butalbital should help with your anxiety and combining both can result in a nine-fold increase in activity.

 

[Keif' Richards]

There will not be a "9 fold" increase in effect when combining barbiturates, opiates and benzodiazepines, but there will be considerable synergy.

Your prescriber(s) is not out of line here. Both the Butalbital and Diazepam are in the small dosage range. Take everything as prescribed and be careful before driving or doing anything dangerous.

 

[kleinerkiffer]

There will not be a "9 fold" increase in effect when combining barbiturates, opiates and benzodiazepines, but there will be considerable synergy.

When benzodiazepines are co-administered with barbiturates, the sum effect of the drugs is far greater than would be expected considering the effect of both drugs separately. This is due to complementary mechanisms at the GABAA receptor, where benzodiazepines increase the rate of chloride channel opening while barbiturates increase the duration. A dose of a benzodiazepine causes a channel which normally opens once every 30 seconds to open 3 times faster, while a barbiturate causes the channel to pass three chloride ions per opening instead of the normal one. When combined, the channel is now passing nine ions every 30 seconds instead of one, a 9-fold increase in activity.

from Wikipedia

If you feel that the butalbital is not enough you can take your Valium, as Keif' Richards said, both are low dose, but maybe start with 2.5mg diazepam, just to be safe

 

[Chadd1]

OP you didn't make it clear that your doc wrote for Fioricet and Valium in the same script. Also can you say why you did not address your concerns with the doc, but instead chose to bring it to BL?

 

[pharmacologyfriend]

very helpful thread. I've taken butalbital and alprazolam or clonazepam or diazepam many times and always get a nice synergistic or potentiated effect. does anyone know why when you google something along the lines of "butalbital and diazepam interactions" the majority of the sites like rxlist (etc.) say "butalbital-acetaminophen-caff oral will decrease the level or effect of diazepam oral by altering drug metabolism." And "diazepam oral decreases levels of butalbital-acetaminophen-caff oral by speeding up drug metabolism. May cause liver problems."? (I'm not asking about the liver problems) thanks in advance for any light anyone may be able to shine on this for me.
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First time poster here, I've been using bluelight for years and I finally am curious enough about something to ask a question, and i very much look forward to helping others find answers to questions I may be able to answer on different topics based on my experiences and knowledge.

 

[kleinerkiffer]

very helpful thread. I've taken butalbital and alprazolam or clonazepam or diazepam many times and always get a nice synergistic or potentiated effect. does anyone know why when you google something along the lines of "butalbital and diazepam interactions" the majority of the sites like rxlist (etc.) say "butalbital-acetaminophen-caff oral will decrease the level or effect of diazepam oral by altering drug metabolism." And "diazepam oral decreases levels of butalbital-acetaminophen-caff oral by speeding up drug metabolism. May cause liver problems."? (I'm not asking about the liver problems) thanks in advance for any light anyone may be able to shine on this for me.
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First time poster here, I've been using bluelight for years and I finally am curious enough about something to ask a question, and i very much look forward to helping others find answers to questions I may be able to answer on different topics based on my experiences and knowledge.

Iirc butalbital is a general inducer of P450 enzymes, like CYP2D6 etc and diazepam is metabolized by those enzymes, so combining both will result in a faster metabolism of diazepam.

 

[Mistasolodolo]

Thanks all for the replies! And it was actually two different Drs. but he knew I was prescribed valium when he wrote me the script for the fioricet.. Thanks again everyone

 

[xivixive]

there is 30mg codeine in fioricet now?

 

[Mistasolodolo]

In certain fioricets yes!

 

[Kittycat5]

Yeah, Fioricet with Codeine. Thats not very original.

 

[Mracid]

At 15 times the benzo dose I merely get soome amnesia so 9 fold increase would be what I need to feeel ANYTHING from GABA system override. I agree that high dose of the combo to a weak CNS would be a bad IDEA so I would not advise it .

BUT I think this combination IS safe for the right person at the right dose.

 

[Istaay]

I've actually been prescribed both of those for a few years now since I was 16 & had a bad car accident, I don't think it's a dangerous cocktail at all and I take them at the same time just don't take more then prescribed

 

[rave23]

Take the medicine as prescribed by your doctor, assuming he knows about everything you take.

It's such a small amount that honestly, a bit of drowsiness is all you should expect.