Headaches are painfully common: up to 90% of all people experience at least one a year. For some, headaches come regularly (like migraines or cluster headaches), while others get them only when life gets too stressful. It can take some good detective work to find out what works for you, but with a little advice from your pharmacist or doctor, you may be able to find relief.
Most people reach for over-the-counter (OTC) medications when a headache hits. While this is a good solution for many, OTCs are not without their own problems. Read the package instructions carefully, and don't hesitate to ask your pharmacist or doctor questions about the ingredients and dosages.
If you take prescription medications, check to be sure that they're compatible with the OTCs. Certain medications shouldn't be mixed with others. If you have kidney or liver problems, asthma, or if you are sensitive to ASA, please check with your doctor before taking any OTC pain medications. Children under 15 years of age should not use products containing ASA, as it has been linked to an increased risk of Reye's syndrome.
Another thing to keep in mind is that some medications (such as those that contain codeine) can cause rebound headaches or daily headaches if they're taken too often or for too long. If your headaches aren't relieved within a reasonable amount of time or if you seem to be taking an OTC for headache more than two times a week, check with your doctor to see if there might be another way of dealing with the pain.
It is easy to become overwhelmed by the number of OTC pain relievers at your local pharmacy. However, there are really only a few basic ingredients you need to familiarize yourself with. The following list will help clarify your options:
- Acetaminophen is found in preparations such as Tylenol®. The maximum daily dose of acetaminophen for adults is 4 g. This is equivalent to 8 of the extra-strength (500 mg) tablets or 12 of the regular-strength (325 mg) tablets. If you have liver disease or are on another medication that may be putting stress on the liver, the maximum daily dose is lower. Speak to your doctor or pharmacist for advice. Keep in mind that many OTC products may contain acetaminophen as one of the ingredients.
- Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) found in products like Motrin® and Advil®. Don't take these medications for more than a couple of days unless your doctor advises you to do so. To help to avoid stomach upset, take ibuprofen with food and with at least 250 mL (8 oz) of water. People who have ulcers or have a history of stomach bleeding should not take ibuprofen. Speak to your doctor or pharmacist for advice.
- Acetylsalicylic acid (ASA) is more commonly known as Aspirin® or Entrophen®. It can be found in many OTC products. Due to its blood-thinning properties, ASA shouldn't be taken by people who have blood clotting disorders or who are taking medications to thin the blood, unless recommended by a doctor. ASA can also be hard on the gastrointestinal system (stomach and intestines), so it's important to take it with food or milk and with at least 250 mL (8 oz) of water. Do not give products containing ASA to children under 15 years of age.
While OTC medications do the trick for relieving the average headache, some people are diagnosed with migraines. These aren't the average headaches, and they are caused by complex chemical changes in the brain. OTC medications sometimes help, especially if the headaches are caught early. More often, however, this disabling type of headache needs prescription medications.
Several specialized medications are available to provide relief from migraines. Because of possible side effects, however, these aren't for everyone. Talk to your doctor about which medication is appropriate for you. Migraine medications include the following:
- Ergotamines – This group of medications include dihydroergotamine (Migranal®) and ergotamine (as part of a combination of ingredients in various products). These medications can be taken orally, by injection, as a suppository, or in a nasal spray.
- Triptans – These medications include almotriptan, eletriptan, naratriptan, rizatriptan, sumatriptan, and zolmitriptan. These medications can be taken orally, by injection, or in a nasal spray.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) – These medications include ibuprofen and naproxen. Prescription-strength NSAIDS are often effective for many. These medications can be taken orally or as a suppository.
Quite often non-drug measures along with medications can help relieve a migraine headache. These include removing yourself from a noisy, brightly light room and lying down in a dark quiet room. Applying a wet face cloth or cool compress to the forehead can also help with the discomfort.
For migraine headache sufferers who experience frequent attacks, preventive medications are an option. These medications need to be taken daily. They don't work immediately and may need to be taken for at least 2 months to assess their benefit.
Don't get discouraged if the first medication you try doesn't work. There are many options available, so talk to your health care provider to see which is most appropriate for you.
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