Your guide to OTC headache relief

A headache can feel like more than just an inconvenience, it can derail your entire day.

Whether it’s a dull tension headache or the throbbing pain of a migraine, finding quick and effective relief is often the top priority.

That’s when many people instinctively reach for the medicine cabinet. But with shelves full of over-the-counter options — ibuprofen, acetaminophen, aspirin, combination products — how do you know which one is right for your type of headache?
 

There are a lot of choices in the drug store when it comes to pain relief, and they work in different ways.

• Ibuprofen (Advil/Motrin) belongs to the group of medications called non-steroidal anti-inflammatory drugs. NSAIDs work by blocking cyclooxygenase (COX) and enzyme that is involved with causing inflammation. This tricks the body thus reducing inflammation. Ibuprofen can start working within 30 minutes. Recommended for short term use, as long term use carries the risk of stomach bleeding, kidney damage, and increased risk of heart attack and stroke. NSAIDs also interact with blood thinners and diuretics/certain blood pressure medications.
• Aspirin works best in those with migraines, typically working within 30 minutes. It’s recommended to use a higher dose in those with migraines (talk to your doctor for specific dosing information). It carries a risk of bleeding, bruising and salicylate toxicity.
• Naproxen sodium (Aleve) can elevate liver enzymes, cause abdominal pain, nausea, bruising and photosensivity. People with a history of stomach ulcer, heart attack, stroke should not use. Naproxen can last a long time in the body.
• Acetaminophen (Tylenol) works well for a migraine, takes about 45 minutes to work. If you have more than 3 alcoholic drinks per day, acetaminophen is not an optimal choice.
• Combination products (Excedrin) include not only acetaminophen and caffeine but also some aspirin as a boost. These medications include approximately 130 mg of caffeine. Caffeine acts by constricting the blood vessels and enhances absorption. Keep in mind caffeine can raise blood pressure and, in some cases, can trigger migraines. Regular caffeine consumption can make this option ineffective over time.

Which one would be best for you? It depends.

“The type of headache matters,” said Rebecca Bernardi APN-CNP, an advanced practice clinician with Endeavor Health. “For mild to moderate migraines, NSAIDs may work best because they reduce inflammation. For a general tension headache, acetaminophen can be very effective.”

Determining the type of headache requires details. Take note when a headache strikes: Does this happen at a certain time of day? Are there foods that bring this on? Hormonal changes? Family history? Where does it hurt – over the eye or ear, is it a head band sensation? Does it come and go?

If you’re still having pain with one type of medication, it may be helpful to alternate the type of pain reliever you take. The medications work differently and could work together to fight your pain. Take care not to exceed the daily maximum dose of either medication, and spread the doses out as recommended.

Mild to moderate headaches that are relatively short-lived can be relieved by over-the-counter medications. For severe migraines, it’s probably best to see a doctor who can prescribe the best medication.

You may need to try a few different medicines before finding one that works best for your headaches.

“If you are taking over-the-counter medication every day for more than a week, or if you find over-the-counter remedies aren’t relieving your pain, schedule an appointment with your primary care provider,” Bernardi said. “All over-the-counter headache medications can cause rebound headaches. This is more likely to happen when you’re taking these medications more than the recommended amount or for more than 10 days per month.”

Headache prevention 101

Try these tips in combination with over-the-counter therapy to maximize headache relief.

* Identify triggers
* Get regular sleep 
* Exercise regularly 
* Manage stress (try journaling, meditation, yoga or visualization)
* Stretching
* Apply cold/warm compresses to head/neck 
* Adjust lighting 
* Hydrate with water

Be sure to connect with your primary care provider to follow up on headaches and discuss which medication may be right for you.

Learn about foods and habits that can trigger headaches.