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Caffeine and Headache

 
 
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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
Anacin Tablets and Caplets
Aspirin-Free Excedrin Caplets
Excedrin Extra Strength Caplets and Tablets
Excedrin Migraine
Goody's Extra Strength Tablets
Goody's Headache Powder
Midol Menstrual Maximum Strength Caplets
NoDoz Maximum Strength
Pain Reliever Plus Tablets
Vanquish Caplets
Vivarin
32 mg.
32 mg.
65 mg.
65 mg.
65 mg.
16.25 mg.
32.5 mg.
60 mg.
200 mg.
65 mg.
33 mg.
200 mg.

Common Prescription Drugs Containing Caffeine

Drug Name

Caffeine Content

Ergotamine/Caffeine Suppositories (Migergot)
Ergotamine/Caffeine Tablets (Cafergot )
Fiorinal Capsules
Fiorinal with Codeine Capsules
Fioricet Tablets
Fioricet with Codeine Capsules
Orphenadrine Compound (Norgesic )
Orphenadrine Compound Forte (Norgesic Forte)
Synalgos-DC

100 mg.
100 mg.
40 mg.
40 mg.
40 mg.
40 mg.
30 mg.
60 mg.
30 mg.

Note: The drugs listed are some of the more common drugs containing caffeine; all drugs containing caffeine are not included. Always check the labels of over-the-counter drugs for the 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 or Surge (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, makes you more vulnerable to a rebound headache.

Relief from rebound headache can only be accomplished by completely quitting all 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: 11/2/2006