HomeDrug ClassesBarbiturate / Opioid / NSAID Combinations

Barbiturate / Opioid / NSAID Combinations: Uses, Common Brands, and Safety Info

Barbiturate/Opioid/NSAID combinations are used for moderate to severe pain. Common brands include Fiorinal with Codeine and Ascomp with Codeine. Safety considerations include the risk of dependence, addiction, respiratory depression, and gastrointestinal side effects. Medical supervision is crucial for proper use.


Barbiturate/Opioid/NSAID combinations are a class of medications that consist of a combination of a barbiturate, an opioid, and a nonsteroidal anti-inflammatory drug (NSAID). These combinations are primarily used for the management of moderate to severe pain. The barbiturate component of these combinations helps to relieve pain by acting as a sedative and muscle relaxant. It works by binding to specific receptors in the central nervous system, resulting in a calming effect. Opioids, on the other hand, are potent pain relievers that act on the nervous system to decrease the perception and response to pain. NSAIDs, such as ibuprofen or aspirin, provide anti-inflammatory effects and help reduce pain and swelling.

Common Brands

There are several common brands of barbiturate/opioid/NSAID combinations available on the market. Some of the commonly prescribed ones include:

  • Fiorinal with Codeine: This combination contains butalbital (a barbiturate), codeine (an opioid), and aspirin (an NSAID).

  • Ascomp with Codeine: This combination contains butalbital, codeine, and aspirin.

  • Esgic-Plus: This combination contains butalbital, acetaminophen (an analgesic), and caffeine.

It is important to note that brand names may vary depending on the country. Consult with a healthcare professional for specific recommendations and availability.


While barbiturate/opioid/NSAID combinations can effectively relieve pain, they come with certain safety considerations. These combinations should only be used under the guidance and prescription of a healthcare professional. Due to the inclusion of opioids, there is a risk of dependence, addiction, and respiratory depression. Patients should strictly adhere to the prescribed dosage and duration to minimize these risks. NSAIDs, particularly when combined with barbiturates and opioids, can increase the likelihood of gastrointestinal side effects such as stomach ulcers and bleeding. Long-term use of these combinations should be avoided to minimize these risks. Individuals with a history of substance abuse, respiratory conditions, impaired liver or kidney function, and certain medical conditions may be at higher risk of experiencing adverse effects. It is crucial to inform the prescribing healthcare professional about any pre-existing medical conditions and current medications to ensure the safe and appropriate use of these combinations. In conclusion, barbiturate/opioid/NSAID combinations are utilized for the management of moderate to severe pain. These combinations include a barbiturate, an opioid, and an NSAID, each providing unique pain-relieving effects. However, due to the potential for dependence, addiction, and respiratory depression associated with opioids, as well as the risks of gastrointestinal side effects with NSAIDs, these combinations should be used cautiously under medical supervision.