Fioricet contains butalbital, tylenol and caffeine. It also comes with codeine in it. The butalbital is a barbituate. Hydro and Fioricet really aren't related at all, in my opinion. Fioricet works best for migraines, tension headaches and other headaches. It really doesnt' have anything but the tylenol (325mg) to battle pain such as back pain. For me personally, hydro doesn't touch my migraines but the Fioricet will help. Migraines are caused by the blood vessels in the back of the head swelling and putting pressure on the nerves, which causes the pain. However, the pain is not in the back of your head, but up front. Caffeine has been known to shrink those vessels. I used to drink lots and lots of coffee when I got migraines before i got in to see the neurologist. Comparing the two is like apples and oranges.