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.
Over-the-counter drugs
Most people reach for over-the-counter (OTC) medications when a headache hits.
While for many this is a good solution, 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 drugs, check to be sure that they're compatible with
the OTCs. Certain drugs shouldn't be mixed with others. If you have kidney or
liver problems, or are asthmatic or sensitive to aspirin,
please check with your doctor before taking any over-the-counter pain medications.
Another thing to keep in mind is that OTCs, especially ones 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 over-the-counter 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®.
Many choose this medication because it's unlikely to cause stomach irritation. The maximum daily dose of acetaminophen is 4 grams. 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, the maximum daily dose is lower. Speak your doctor or pharmacist for advice. Keep in mind that many over-the-counter products may contain acetaminophen as one of the ingredients.
- Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) found
in products like Motrin®
and Advil®.
There's a risk of stomach upset with NSAIDs, so don't take these drugs 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 or milk and with at least
8 ounces of water.
- Aspirin is acetylsalicylic acid. It can be found in many over-the-counter products. Due to its blood-thinning properties,
aspirin 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.
Aspirin 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 8 ounces of water.
Prescription medications
While over-the-counter medications do the trick for relieving the average headache,
some people are diagnosed with migraines. These aren't
the average headaches, and are caused by complex chemical changes in the brain.
Over-the-counter 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. They must be taken with caution and on your
doctor's advice only. They are:
- Ergotamines - This group of medications include dihydroergotamine and ergotamine. These medications can be taken
orally, by injection, as a suppository, or in a nasal spray.
- Triptans - These drugs are the newest type of treatment, and include
almotriptan (Axert®), eletriptan (Relpax®), naratriptan (Amerge®), rizatriptan (Maxalt®), sumatriptan (Imitrex®), and zolmitriptan (Zomig®).
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
and naproxen - Prescription-strength NSAIDS are often effective for many. However,
they are used less commonly because they can cause stomach upset.
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 should be taken for at least four to six weeks
before they become effective. Don't get discouraged if the first drug you try
doesn't work. Other options are available. These drugs include:
- medications used to treat high blood pressure or heart disease, such as
beta-blockers or calcium-channel blockers
- some types of antidepressant medications
- certain anticonvulsants, usually used to treat epilepsy
- non-steroidal anti-inflammatory drugs (NSAIDs)