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Caffeine and Headache

Caffeine can be a double-edged sword for those with headache--it can serve as a treatment or, in some cases, can cause withdrawal or a phenomenon known as "rebound" headache. The important thing to remember is that with education and moderation, caffeine can be one of the most effective treatments for headache.

Caffeine as a headache treatment

Caffeine is a common ingredient in many prescription and over-the-counter headache medications (see list below). Because analgesics work more quickly and more efficiently with caffeine, patients are able to take less medication. Caffeine additives make pain relievers 40% more effective. Caffeine also helps the body absorb medications more quickly, allowing the patient to feel relief sooner. By adding caffeine and, in turn, taking less medication, the patient reduces the risk for potential side effects and reduces the risk of habitual or addictive usage.

Common Over-the-Counter Drugs Containing Caffeine
Drug Name Caffeine Content
Anacin Maximum Strength 32 mg.
Anacin Tablets and Caplets 32 mg.
Aspirin-Free Excedrin Caplets 65 mg.
Excedrin Extra Strength Caplets and Tablets 65 mg.
Excedrin Migraine 65 mg.
Goody's Extra Strength Tablets 16.25 mg.
Goody's Extra Strength Headache Powder 32.50 mg.
Goody's Cool Orange Powder 65 mg.
Midol Menstrual Maximum Strength Caplets 60 mg.
NoDoz Maximum Strength 200 mg.
Pain Reliever Plus Tablets 65 mg.
Vanquish Caplets 33 mg.
Vivarin 200 mg.
Common Prescription Drugs Containing Caffeine
Drug Name Caffeine Content
Ergotamine/Caffeine Suppositories (Migergot) 100 mg.
Ergotamine/Caffeine Tablets (Cafergot) 100 mg.
Fiorinal Capsules 40 mg.
Fiorinal with Codeine Capsules 40 mg.
Fioricet Tablets 40 mg.
Orphenadrine Citrate, Aspirin and Caffeine (Norgesic ) 30 mg.
Orphenadrine Citrate, Aspirin and Caffeine (Norgesic Forte) 60 mg.
Synalgos-DC 30 mg.

Note: The drugs listed are some of the more common drugs containing caffeine; all medications containing caffeine are not included. Always check the labels of over-the-counter medications for caffeine content. Or, ask your health care provider or pharmacist about the caffeine content of your medications.

Caffeine sources

Beverages

  • Chocolate milk, chocolate milkshakes, hot chocolate and chocolate drinks
  • Cocoa mix, malt powder, chocolate flavoring
  • Cola and other sodas, like Mountain Dew (regular and diet)
  • Coffee
  • Tea
  • Chocolate or coffee liqueurs

Note: Caffeine-free and decaffeinated beverages also contain small amounts of caffeine.

Foods

  • All chocolate products including brownies, cake, eclairs
  • Chocolate candy including fudge and chocolate-covered coconut, raisins, and peanuts
  • Chocolate-covered graham crackers (or chocolate-flavored graham crackers)
  • Chocolate ice cream or pudding
Caffeine and Withdrawal

Caffeine withdrawal from normal caffeine usage is rare. However, with excess use, over 500 mg daily (approximately 5 cups of coffee) over a long period of time, sudden cessation could cause symptoms of withdrawal. Patients can avoid caffeine withdrawal by limiting their daily consumption, being educated about sources of caffeine and by gradually decreasing the consumption rather than ending use abruptly.

Caffeine and Rebound Headache

Rebound headache is a condition that develops from the overuse or misuse of any headache medication, including caffeine-containing medication. While caffeine-containing medications can be beneficial, these medications--combined with consuming caffeine (coffee, tea, soft drinks or chocolate) from other sources--make you more vulnerable to a rebound headache.

Relief from rebound headache can only be accomplished by completely quitting all headache medication. However, this should only be done under the supervision of a physician.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/6/2011...#9645


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