Q. I have a question concerning Fiornal and it's generic form also. I am currently 4 months pregnant and my OBGYN prescribed Fiornal for my headaches. Is this acceptable to take since it does contain aspirin?

A. Fiorinal should not be used in pregnancy. Although it has been on the market a long time as a headache remedy, and is very effective for some headache patients, pregnancy brings a new set of "rules" regarding safety for the mother and baby.

Fiorinal has 3 ingredients: aspirin, butalbital and caffeine. Butalbital is in the barbiturate group of drugs, used as a sleeping medication or tension-reliever. It is not used much on its own anymore as it can be addicting, and there are newer, safer drugs for this purpose. Furthermore it has been shown to increase the risk of birth defects in humans.

Aspirin has caused birth defects in animal models though not in humans. Aspirin has caused bleeding problems if taken in the last 3 months of pregnancy. Caffeine in small amounts has not been proven unsafe, but high doses have the potential to cause birth defects.

http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202103.html

http://www.ama-assn.org/special/migraine/treatmnt/drug/fiorinal.htm

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