Neurology and Neurosurgery

OTC migraine medications: your questions, answered

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Find out how to effectively use OTC medications, avoid rebound headaches and what other remedies can help you have more migraine-free days.


By Hida Nierenburg, MD, Neurology and Headache Medicine, Nuvance Health


Migraines can feel like your worst enemy, turning an ordinary day into a painful ordeal that makes you miss life’s joys. If you’re one of the millions struggling to manage migraines with over-the-counter (OTC) medications, you’re not alone! Understanding migraines and the treatments available can help you reduce the frequency and severity of your headaches, so you can get back to enjoying life.


Take back control by understanding migraines, the do’s and don’ts of OTC medications and how to have fewer headache days.



How do I know if I have a migraine or just a headache?


We’ve all had headaches, but migraines are a different animal altogether. A headache usually causes dull, aching pain, whereas a migraine is often a severe throbbing or pulsing pain, usually on one side of the head. 


Migraines can also come with a slew of other symptoms like nausea, vomiting and sensitivity to light and sound. Different types of migraines exist, such as migraines with aura (visual disturbances) and without aura. The bottom line: A migraine is a headache that makes you quite sick.


There are two main types of migraines. You may have chronic migraines if you have headaches more than 15 days per month and have symptoms on at least eight of those days. You may have episodic migraines if you experience them fewer than 15 days per month.



How do I confirm I have a migraine?


If you suspect your headaches are migraines, it’s time to see a headache neurologist. Diagnosis typically involves a thorough physical exam and a detailed history of your symptoms. Your doctor might also order imaging tests, like an MRI, to rule out other potential causes of your headaches. This comprehensive approach helps ensure you get the right diagnosis and treatment plan.



How do I stop my migraine?


Stopping a migraine involves both prevention and rescue strategies:


Migraine prevention: The best offense is a good defense. Preventive medications can reduce the frequency and intensity of your migraines. Avoiding common triggers like certain foods, dehydration, stress and lack of sleep can also help. Everyone’s triggers are different; keeping a migraine diary can be invaluable in identifying yours.



Migraine rescue treatment: A rescue plan is crucial when a migraine strikes. If you have never experienced a migraine before and need immediate relief, OTC medications like ibuprofen, aspirin and acetaminophen can help stop it from getting worse. Taking an appropriate medication at the first sign of a migraine can be effective, but timing is key. A proper migraine rescue medication should help get you back to normal function within two hours. 


Do OTC migraine medications work?


Everyone experiences migraines differently, from unique triggers to frequency and intensity. Some people may get relief from straightforward treatment, like OTC medications. These can be effective for both episodic and chronic migraines if used correctly. But OTC medications are likely ineffective if your migraine or any other symptom lasts longer than two hours.


OTC pain relievers can be a good first line of defense if you have episodic migraines with mild to moderate attacks of pain. Be sure to take the medication as soon as symptoms start to get the best results. You should get relief within 30 to 60 minutes of taking an OTC medication.


If migraines are a regular part of your life, OTC medications might not always cut it. People with migraines often need a combination of prescription medications and lifestyle changes to manage migraines effectively. If you have migraine, a migraine-specific rescue treatment should be part of your toolkit. 



Should I use OTC migraine medications to get relief?


While OTC medications can provide relief, overusing them can lead to rebound headaches. A rebound means your migraine symptoms come back after the medication wears off. This can create a vicious cycle of more frequent headaches. It’s crucial to follow the dosage instructions and talk to your doctor about the best way to use OTC migraine medications.


If you use a combination of analgesics, such as acetaminophen and caffeine, more than 10 days per month, it can lead to medication overuse headaches. Non-steroidal anti-inflammatory agents like ibuprofen can lead to medication-induced headaches if used more than 15 days per month.


If you are using OTC medications for migraines, not getting relief within two hours and experiencing rebound headaches, speak with your doctor about other treatment options.



How else can I get rid of a migraine ASAP?


While migraines can make you want to hide in the dark, there is light when it comes to treatment options. While there is no cure for migraine, there are many migraine relief options, from prescription medications and injections to wearable devices.


Your doctor can help you determine the best migraine treatment for you, depending on the type of migraine you have and your lifestyle. We treat migraines in two main ways:


Acute migraine treatments, such as triptans or gepants, are usually in pill form. Acute migraine treatments should work within two hours. Like people with asthma can feel reassured having an inhaler on hand, you can have peace of mind keeping a rescue migraine medication on standby. 


Preventive migraine treatments can help reduce your headache days as well as decrease the intensity of attacks. These treatments come in various forms, including oral, injections and wearable devices.


Non-medical remedies can provide significant relief. To prevent migraine, aim to avoid your triggers as much as possible. For example, avoid spicy foods, stay hydrated and find ways to de-stress if those are your migraine triggers.



When you feel a migraine coming on:


  • Rest in a dark, quiet room: Sensory overload can worsen migraines. Find a calm space where you can relax without bright lights or loud noises.


  • Apply a cool compress: A cool cloth or ice pack on your forehead can help reduce pain.


  • Stay hydrated: Dehydration can trigger migraines, so make sure you are drinking plenty of water.


  • Drink a beverage with caffeine: A small amount of caffeine can sometimes help relieve migraine pain, but be cautious not to overdo it, as too much caffeine can lead to rebound headaches.



The bottom line: Migraines can be rough! Understanding migraines and treatment options can make a big difference. OTC medications can be a helpful part of your migraine management plan, but it’s essential to use them wisely and in conjunction with preventive strategies. Don’t hesitate to seek professional help to develop a comprehensive approach tailored to your needs. With the right plan, you can reduce your migraine days and get back to enjoying your life.