Migraines are severe headaches that often occur on one side of the head. It comes with many other unpleasant symptoms, like nausea, vomiting, and sensitivity to sound and light. These symptoms range from mild to severe and may last for a while.
Although many people need prescription treatments to deal with chronic migraines, there are numerous over-the-counter treatment options too.
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Over-the-counter (OTC) treatments don't require a prescription from a doctor, and they are readily available in pharmacies and most grocery stores. OTC treatments can treat milder forms of migraines, and they may prevent them from getting worse if they are taken early.
Each OTC medication comes with its pros and cons, so it's a good idea to speak with your doctor or pharmacist if you are experiencing migraines and want to try OTC medication.
Numerous OTC medications can help with migraine attacks, including:
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). It works by slowing or stopping the body from producing substances that cause pain, inflammation, and fever.
Naproxen is also an NSAID, and it can help provide migraine relief for those with milder symptoms. The effectiveness of naproxen in treating migraines varies in studies.
One meta-analysis¹ found it to be more effective than placebo in reducing headache intensity, rendering pain-free at 2 hours, and improving migraine-associated symptoms. Another meta-analysis reported² that it is barely more effective than a placebo. It is less effective for migraines than ibuprofen and could cause more side effects. Therefore, even at doses of 500mg or 825mg, naproxen is ineffective in treating migraines.
Acetaminophen or paracetamol is another pain-relieving OTC medication, but it may not be as effective as ibuprofen and naproxen. Like NSAIDs, acetaminophen is an analgesic and antipyretic agent. However, it lacks the peripheral anti-inflammatory properties that NSAIDs have.
Aspirin seems to be an effective treatment for migraine headaches when taken in higher doses, between 900 to 1300mg, providing migraine pain relief within an hour. Lower doses of aspirin, between the doses of 81 and 325mg, taken regularly may also be able to prevent migraines or reduce the number of them that occur.
Before taking high doses of aspirin or low doses several days in a row, check with your doctor to ensure it won't interact with any medications you are on or worsen any of your current health conditions.
One OTC made specifically for migraines is Excedrin, which contains two different types of painkillers — aspirin and acetaminophen. Excedrin also has caffeine. The aspirin works to reduce inflammation and pain, the acetaminophen addresses pain, and the caffeine narrows the blood vessels in your head to reduce pain.
Caffeine enhances the pain-relieving capabilities of aspirin and acetaminophen, meaning that lower doses can be used to achieve the same result.
OTC medications are generally safe to take within the recommended dose every once in a while without doctor supervision. However, that doesn't mean they don't still produce the risk of side effects.
NSAIDs can cause indigestion, stomach ulcers, bleeding, drowsiness, headaches, liver or kidney issues, and sometimes allergic reactions. Acetaminophen may also lead to allergic reactions. Symptoms include hives, difficulty breathing, or swelling of the face. It can cause liver damage if taken too often or at too high of doses.
Aspirin can cause nausea, vomiting, fast heartbeat, fast breathing, and more. Children should not take aspirin if they have or are recovering from a viral infection like flu or chickenpox due to the risk of developing Reye's syndrome.
Finally, the caffeine present in Excedrin may cause a person to feel anxious, shaky, or nauseous, in addition to the other side effects that can be caused by acetaminophen and aspirin.
If you or someone you know experiences any serious side effects or allergy reaction, stop taking the medication and seek urgent medical care immediately.
Migraine cocktails are a mixture of medications that can help with severe migraine attacks. Doctors often give it to help relieve severe symptoms as quickly as possible. People sometimes also take a combination of these medications for migraines at home.
If you visit an urgent care clinic or emergency department for severe migraine, you might also receive a combination of drugs through an IV, which many healthcare professionals also call a migraine cocktail.
There isn't necessarily a standard combination of drugs that make up an official migraine cocktail "recipe," but they usually include NSAIDs, antiemetic medications (for nausea and vomiting), fluids to help with hydration, and magnesium. Migraine cocktails are typically administered to those that have had a severe migraine for over 72 hours that haven't responded to other lines of treatment.
If you suffer from severe migraines frequently, your doctor may also prescribe a combination of medications that you can take at home to avoid going to the emergency room.
It is important to note that combining painkillers or other medications without medical supervision or discussing the types and doses with your doctor could cause serious interactions, side effects, or overdose.
While OTC medications can help migraines, one unfortunate side effect of using them frequently is increased headaches. This can make it difficult to balance the right frequency and dose to relieve the pain from headaches without leading to more frequent headaches that require more medication to treat.
Medication overuse headaches is a clinical diagnosis characterized by a person using painkillers at least two or three days per week while experiencing chronic daily headaches.
It's common in people who suffer from migraines, and the best line of treatment is to discontinue the overused medications. If you're reaching for OTC medications more than two or three times a week, talking to your doctor about other treatment options might be helpful.
One of the best ways to treat migraines is by avoiding your triggers as much as possible. Some of the most common migraine triggers include:
Hormones (changes in estrogen and progesterone levels)
Certain foods, like chocolate, dairy products, and artificial sweeteners
Changes in sleep
Although these are the most common migraine triggers, each person’s body is different. It can take some time to figure out what triggers your migraines, but once you do, you can take steps to avoid certain foods, bright lights, dehydration, and other triggers to prevent migraines from coming back.
It is always important to talk to your doctor about migraines, especially if they seem to be getting more frequent or severe.
Migraine headaches are notoriously painful to deal with, and they can be difficult to treat. Fortunately, some OTC medications can help with the pain occasionally, but it's easy to overuse them when migraines arise frequently. Those with more frequent and severe cases should see a doctor for more comprehensive solutions to treat migraine attacks.
Ibuprofen | MedlinePlus
Acetaminophen | StatPearls
Acetaminophen | MedlinePlus
Aspirin | MedlinePlus
Caffeine | MedlinePlus
Medication-overuse headache | StatPearls
Top 10 migraine triggers and how to deal with them | American Migraine Foundation
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