Headache Medicine

Headache medicines help relieve or prevent headache pain. Some are available over the counter, while others require a prescription.

These medicines work in different ways. Some reduce inflammation, some block pain signals in your brain and others affect blood vessels involved in certain types of headaches, like migraines.

The best option depends on the type of headache you have and its severity. A healthcare provider can help you pick the right one.

How do headache medicines work?

Each medication works in a different way. But the goal is to reduce pain and/or prevent future attacks. Here’s how this works:

• Blocking pain signals: Some medicines affect nerve signals and chemicals involved in pain.
• Reducing inflammation: Certain types lower swelling and irritation around your nerves and blood vessels.
• Preventing the release of pain chemicals: Some drugs stop your nerves from releasing chemicals that trigger pain.
• Calming nerve activity: Preventive types may stabilize nerve signals in your brain and reduce how often headaches happen.

What should I know about OTC pain relievers?

Over-the-counter (OTC) medicines may help relieve headache pain. They’re generally safe when you use them as directed. Keep these tips in mind:

• Read the label: Check the active ingredient and follow the instructions carefully.
• Avoid taking too much: Don’t take more than the recommended dose for your age or more often than directed. As a general rule, try to limit over-the-counter headache medicines to two days or fewer per week to reduce the risk of rebound headaches.
• Talk to your healthcare provider: Ask your provider before using these medicines, especially if you take other medications or have certain medical conditions.
• Use caution with children: Avoid giving children aspirin because it can cause Reye’s syndrome.
• Avoid certain combinations: Don’t mix headache medicines — especially those that contain caffeine or prescription pain medicines — unless your healthcare provider tells you it’s safe.

What are the types of headache medicine?

There are two main types:

• Acute: You take these when a headache or migraine starts. They may relieve pain and other symptoms during an attack.
• Preventive: You take these regularly to prevent headaches from happening or to make them less frequent or less severe. You might use these if you have migraines often.

Acute headache medicines

Examples of acute medicines to relieve headache symptoms include:

• OTC analgesics (acetaminophen)
• OTC nonsteroidal anti-inflammatory drugs (NSAIDs, like aspirin, ibuprofen and naproxen)
• Combination analgesics (acetaminophen, aspirin, caffeine, or sumatriptan and naproxen)
• Triptans (like sumatriptan, rizatriptan, zolmitriptan)
• Ergot derivatives (dihydroergotamine)
• Gepants (rimegepant, ubrogepant, zavegepant)
• Anti-nausea medicines (which may be used along with other treatments if you have nausea or vomiting)

Preventive headache medicines

Your provider might recommend preventive treatments if you have frequent headaches (for example, more than four per month) or if your headaches are severe or interfere with your daily activities.

Examples of preventive medications to reduce the frequency or severity of headaches include:

• Antiseizure meds (topiramate, valproic acid)
• Antidepressants (such as amitriptyline, nortriptyline, venlafaxine and duloxetine)
• Blood pressure meds (like propranolol, metoprolol, timolol and candesartan)
• CGRP monoclonal antibodies (eptinezumab, erenumab, fremanezumab, galcanezumab)
• CGRP gepants (atogepant, rimegepant)
• OnabotulinumtoxinA (used for chronic migraine)

Your provider will usually check how well the medication is working after about six to eight weeks. If you have side effects or the medicine isn’t helping, they may adjust the dose or slowly lower it to stop it. Don’t stop taking these on your own unless your provider says it’s safe.

What headache medicines are safe for children?

Several headache medicines are safe and effective for children when used as directed by a healthcare provider. The most common options include:

• OTC pain relievers (acetaminophen, ibuprofen): These are the first used to treat headaches in kids.
• OTC NSAIDs (ibuprofen, naproxen): These may reduce pain and inflammation. They can be effective for migraine attacks.
• Some triptans (rizatriptan, sumatriptan, zolmitriptan, almotriptan): These prescriptions may help with migraines in older children and adolescents when OTC medicines don’t work.
• Preventive medicines (topiramate, propranolol, amitriptyline, fremanezumab): These prescriptions may help if your child has frequent or severe migraines.

A provider should always guide treatment in children. They can recommend the safest option and the correct dose based on your child’s age, weight and health history.

What are the different forms of headache medicines?

These come in several forms, including:

• Tablets or capsules
• Oral liquids or solutions
• Nasal sprays
• Injections
• IV infusions

How should I take headache medicines?

Always follow your healthcare provider’s instructions and what’s written on the label. The exact way you should take a medicine depends on the type your provider recommends. Here’s an example of what those instructions might look like:

• Start with simple pain relievers first. You might start with OTC medicines like acetaminophen or NSAIDs.
• Take medicine early on in the headache. These often work best when you take them soon after symptoms begin.
• Use migraine-specific medicines if needed. If common pain relievers don’t work, your provider may prescribe medicines made specifically for migraines.
• Follow dosage instructions carefully. Taking headache medicines too often (more than twice a week) might lead to medication overuse headaches.
• Take preventive medicines regularly. If your provider prescribes preventive options, you’ll take them every day.

It may take some time to feel the full effects.

What are the dosage guidelines?

The dose depends on the specific medication, the type of headache and your overall health. It also varies based on your age and body size. Some you can take only when a headache starts, while others you can take every day to prevent headaches.

Your healthcare provider can work with you to find the safest and most effective treatment plan. Always follow the instructions on the medication label. If you’re unsure about how much to take or how often to take it, don’t hesitate to talk to your provider or pharmacist.

What are the common side effects?

Side effects vary depending on the type of medication. Many are mild, but some may require adjusting your treatment. Common ones include:

• Antidepressants: Dry mouth, sleepiness
• Antiseizure drugs: Tingling in your hands or feet, taste changes
• Blood pressure medicine: Low blood pressure, lightheadedness, fatigue
• CGRP antibodies (injections): Injection site reactions, constipation, elevated blood pressure, Raynaud’s
• Gepants: Dry mouth, nausea
• NSAIDs: Stomach irritation, heartburn
• Triptans: Flushing, tingling or tightness sensations

These are usually mild and temporary, but some medications can cause rarer and more serious risks.

How can I use headache medications safely?

Following your healthcare provider’s instructions is the first step. They may also recommend that you:

• Start with pain medicines that have a lower risk of dependence.
• Avoid opioid pain medicines when possible.
• Begin with the lowest effective dose.
• Use caution with stronger medicines or higher doses.
• Avoid taking headache medicine too often.

Is it possible to overmedicate?

Taking headache medicines too often may lead to medication overuse headaches. This can make headaches happen more frequently.

It can be tempting to take medicine often — especially if you have headaches or migraines most days. When pain blends days together, you may feel like you need a lot of medication just to get through.

But using headache medicines every day or almost every day may change how parts of your brain process pain. This includes over-the-counter medicines like aspirin, acetaminophen and ibuprofen, as well as medicines that contain caffeine. Prescription medicines like triptans can also cause this problem.

Newer medications called gepants appear to have a lower risk of causing medication overuse headache, but you should still use them as directed by your healthcare provider.

Taking acute (fast relief) medicines too often might also make preventive headache medicines work less effectively.

If you find yourself needing headache medicine frequently (more than two days a week), talk to your healthcare provider. They can help you find a safer plan to manage your symptoms.

How can I manage headache pain?

Follow these steps to help you manage symptoms:

• Take medicine at the first sign of symptoms and follow your provider’s instructions.
• Avoid using medicines too often, since overuse can make headaches happen more frequently.
• Keep a headache diary to track patterns and possible triggers.
• Rest in a cool, dark, quiet room and apply a cold compress during a headache.
• Try biofeedback, a technique that helps you learn to control certain body responses, like muscle tension and stress.
• Contact your provider if headaches become more frequent or harder to manage.

How can I increase the effectiveness of headache medicines?

Medicines often work better when you combine them with healthy daily habits. These may include:

• Getting regular physical activity
• Drinking enough water throughout the day
• Avoiding foods or drinks that trigger headaches, like processed foods or alcohol
• Getting enough sleep each night
• Practicing relaxation techniques to manage stress