Can't find Fioricet? Here are the best alternatives for tension headaches in 2026, including prescription and OTC options your doctor may recommend.
When your pharmacy tells you Fioricet is out of stock — again — it's natural to wonder: what else can I take? Tension headaches don't wait for supply chains to sort themselves out, and you need relief now.
The good news is that several effective alternatives exist, both prescription and over-the-counter. But switching medications is always a conversation to have with your doctor. This guide will help you understand your options so you can have an informed discussion.
Fioricet is a combination medication containing three active ingredients:
This three-pronged approach is what makes Fioricet particularly effective for tension-type headaches — the kind that feel like a band of pressure around your head. It's been on the market for decades and remains one of the most commonly prescribed medications for this condition.
For a deeper look, see our guide on what Fioricet is and how to take it.
What it is: An over-the-counter combination of Acetaminophen (500 mg) and Caffeine (65 mg).
How it compares: Excedrin Tension Headache contains two of the three ingredients in Fioricet — Acetaminophen and Caffeine — but at different doses and without the barbiturate (Butalbital). It works on pain and blood vessel constriction but doesn't provide the muscle-relaxing, sedative effect of Butalbital.
Who it's good for: Patients with mild to moderate tension headaches who don't need the barbiturate component. It's available without a prescription, so it's an immediate option while you look for Fioricet.
What to watch for: Don't exceed the recommended dose. If you're already taking other Acetaminophen-containing products, be careful not to exceed 4,000 mg of Acetaminophen per day total.
What it is: An over-the-counter NSAID (nonsteroidal anti-inflammatory drug) available as Aleve or prescription-strength Naproxen.
How it compares: Naproxen works differently from Fioricet — it reduces inflammation and pain through prostaglandin inhibition throughout the body. It doesn't have a sedative or muscle-relaxant component, but it's effective for many types of headaches, including tension headaches.
Who it's good for: Patients who can tolerate NSAIDs and want a straightforward pain reliever without barbiturate-related risks like dependence. Naproxen has a longer duration of action than many pain relievers, providing up to 12 hours of relief.
What to watch for: NSAIDs can cause stomach irritation, GI bleeding, and kidney issues with prolonged use. Not recommended for patients with a history of stomach ulcers or kidney disease.
What it is: A tricyclic antidepressant used at low doses for preventive treatment of tension-type headaches and migraines.
How it compares: Unlike Fioricet (which treats headaches after they start), Amitriptyline is taken daily to reduce the frequency and severity of headaches over time. It works by affecting serotonin and norepinephrine levels in the brain.
Who it's good for: Patients with chronic tension headaches (15 or more headache days per month) who need preventive therapy rather than just acute relief. If you've been taking Fioricet frequently, your doctor may suggest a preventive approach to reduce your overall headache burden.
What to watch for: Common side effects include drowsiness, dry mouth, weight gain, and constipation. It takes several weeks to reach full effectiveness.
What it is: An anticonvulsant medication (brand name Topamax) also used for chronic headache prevention.
How it compares: Like Amitriptyline, Topiramate is a preventive medication, not an acute treatment. It reduces headache frequency through effects on neurotransmitters and ion channels in the brain.
Who it's good for: Patients with frequent or chronic headaches who haven't responded well to other preventive treatments. Some patients prefer it over Amitriptyline because it tends to cause weight loss rather than weight gain.
What to watch for: Side effects can include tingling in the hands and feet, cognitive slowing ("brain fog"), taste changes, and kidney stones. Requires careful dose titration.
Some patients take Fioricet with Codeine, which adds 30 mg of codeine phosphate (an opioid) to the standard formula. If you take this version, your alternatives will be different, and switching medications requires close coordination with your prescriber. Do not substitute standard Fioricet for the codeine-containing version without medical guidance.
This guide is meant to inform, not replace medical advice. Before changing your headache treatment:
If the issue is simply that you can't find Fioricet in stock, try Medfinder first — you may be able to locate a pharmacy that has it. Check our guide on how to find Fioricet in stock near you for more strategies.
Not being able to fill your Fioricet prescription is stressful, especially when you're in pain. But you're not without options. OTC combinations like Excedrin Tension Headache or Naproxen can bridge the gap for acute relief, while preventive medications like Amitriptyline and Topiramate may be worth discussing if you've been using Fioricet frequently.
The right alternative depends on your specific situation — your headache pattern, your medical history, and what you've tried before. Work with your healthcare provider to find the best path forward.
You focus on staying healthy. We'll handle the rest.
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