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Is Fioricet safe for pain management after forehead injury?

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Posted on Mon, 29 May 2017
Question: Yes, Dr. Rynne,
My wife works for the Post Office, and she had an accident there at work about 2 hours ago where she tripped over a hanging mail bag (that wasn't supposed to be there), getting her leg tangled up in it; then she flew over, smashing primarily her right upper occipital (right eyebrow) area into the hard concrete floor, witnessed by several people. (She hit her cheek, too, but from the swelling of her occipital bone, it appears the greatest impact was there.)
She is going to go to the hospital for a CT Scan (and whatever else they think necessary); however, she just wanted for the really intense pain to subside for a bit first.
Her 2 sisters are here (1 is an R.N. of about 10 years), and we are watching her that she doesn't fall asleep.
She is 60 and has a history of migraines and tension HAs since around her just prior to her change in life. So, the pain specialist lets her take Fioricet #3 (w/codeine) and sumatriptan (Imitrex) 6mg/0.5ml when they get really bad.
She has taken over the last 2 hours at separate times 2 of the Fioricets; however, of course, having smacked her face into concrete, she was wanting to take a shot. However, I thought I should check into doing that first, for I know those shots can have an effect on the blood circulation/pressure -- and I don't know what else.
So, would you advise against it, or do you think it would be okay?
Best regards, XXXXXXX
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Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
I wouldn't recommend it.

Detailed Answer:
I read your question carefully and I understand your concern.

First a little correction, you must be mistaken about the occipital bone thing, the occipital bone is in the back of the head, just over the neck, since you speak of eyebrow and cheek you must be referring to the frontal and maxillary bone respectively.

As for your question about Fioricet I wouldn't be in favor of taking a third one. Dosage is 1 to 2 pills at most every 4 hours with a maximum of 6 per day. So taking a third one so soon is too much and wouldn't be likely to be much effective. On the contrary it may cause side effects like drowsiness, confusion and dizziness (due to both codeine and butalbital present in Fioricet with codeine) which will make the evaluation difficult. That is because in evaluating for the possibility of brain lesions in a head trauma one of the main indicators is level of consciousness. So in a patients with a drop in the level of consciousness who has taken 3 Fioricets, it would be difficult for a doctor to understand whether its due to the drug or to something going on in the brain.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3657 Questions

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Is Fioricet safe for pain management after forehead injury?

Brief Answer: I wouldn't recommend it. Detailed Answer: I read your question carefully and I understand your concern. First a little correction, you must be mistaken about the occipital bone thing, the occipital bone is in the back of the head, just over the neck, since you speak of eyebrow and cheek you must be referring to the frontal and maxillary bone respectively. As for your question about Fioricet I wouldn't be in favor of taking a third one. Dosage is 1 to 2 pills at most every 4 hours with a maximum of 6 per day. So taking a third one so soon is too much and wouldn't be likely to be much effective. On the contrary it may cause side effects like drowsiness, confusion and dizziness (due to both codeine and butalbital present in Fioricet with codeine) which will make the evaluation difficult. That is because in evaluating for the possibility of brain lesions in a head trauma one of the main indicators is level of consciousness. So in a patients with a drop in the level of consciousness who has taken 3 Fioricets, it would be difficult for a doctor to understand whether its due to the drug or to something going on in the brain. I remain at your disposal for other questions.