How Each Over-the-Counter Migraine Treatment Fits into Your Plan
As a sufferer of migraine headaches, you know that leaving migraine pain untreated can rob you of quality of life and function.
But you also may be aware that there can be barriers to using prescription drugs including cost, side effects and general inconvenience.
So you may be looking for some over-the-counter pain relievers for treatment of migraine.
In this article, we will talk about some common over-the-counter medications which are used to treat acute migraine attacks.
We will also go over some recommendations for best use of these drugs.
Additionally, we will talk about prescription alternatives, in case that is something which interests you.
We will also go over supplements and lifestyle changes to consider in lieu of or in addition to over-the-counter medications.
The List: What Are Some OTC Migraine Medications?
Let’s begin by going over some of the over-the-counter remedies which you are likely to encounter if you walk into a store today and search for headache medications.
Note that many of these medications are not marketed specifically for migraines—at least not all the time.
Usually, they are marketed as general pain relievers. For this reason, they are sometimes known as non-specific medications.
- Aspirin: This medication is also called acetylsalicylic acid. It is classified as a non-steroidal anti-inflammatory drug (NSAID). There are a variety of aspirin products on the market. Most products are sold under the names Bayer and Excedrin.
- Naproxen sodium: Also an NSAID, this drug is used to treat a variety of inflammatory pain conditions, including migraine. The most common brand is Aleve.
- Ibuprofen: Yet another NSAID available over-the-counter is Ibuprofen. Popular brand names include Advil and Motrin.
- Acetaminophen: This pain reliever is also called paracetamol or APAP. While it does reduce inflammation to a degree, that is not its main mechanism of action. So what is that mechanism? Researchers still do not have a clear answer. Regardless, it has analgesic properties. It is often sold under the brand name Tylenol.
- Caffeine: The relationship between migraines and caffeine is complicated. But used appropriately, it may help to alleviate head pain. You can read in-depth on the topic in this article. There are some OTC pain relievers for migraine attacks which contain caffeine in conjunction with other active ingredients. For example, Excedrin Migraine combines aspirin, acetaminophen and caffeine.
Can You Take More Than One OTC Pain Reliever Simultaneously?
For severe headaches, you might be wondering if you can combine any of the medications listed above safely.
The answer is “yes,” but only with reference to acetaminophen and caffeine.
You cannot safely combine ibuprofen, naproxen, and/or aspirin.
The reason why is that they are all NSAIDs.
Therefore, if you combine them, you will be exceeding the safe dosage, and potentially serious health effects could occur.
Because acetaminophen and caffeine are not classified as NSAIDs, they can be combined with an NSAID.
This is why Excedrin Migraine is safe to take. It only contains a single NSAID (aspirin).
Advice for Safe and Effective OTC Migraine Treatment Use
Now that you are familiar with over-the-counter drugs which are commonly used to treat migraines and other types of headaches, let’s go over some recommendations to help you make the best use of these drugs.
1. Always look carefully at the list of ingredients.
It is important to know what is in the over-the-counter medication you are trying not just for reasons of safety, but also for reasons of efficacy.
Many people who suffer from headaches or other types of pain find that one form of NSAID may be more effective than another.
As this varies from person to person, you will need to figure out what is most effective for you.
2. Do not make assumptions about why a medication is working.
It is quite common for people who experience migraines to mistake them for tension headaches or sinus headaches.
This is not helped along by the way that different products are labeled.
A product which is marketed for treating migraines may contain the same ingredients as one which is marketed for tension headaches.
Two people who both have migraines could try two different products, each marketed toward a different type of headache.
If they both got results, each might make a different assumption about the type of headaches they are suffering.
The American Migraine Foundation also talks about confusion involving decongestants in OTC medications.
The foundation writes, “People with headaches frequently use OTC medicines containing decongestants, which are often sold to treat colds or sinuses … Research shows, though, that about 90% of these people have migraine, not sinus problems. Patients do not realize that the decongestants in these “sinus” medicines cause blood vessels to shrink. This action can to some extent help migraine pain.”
If one were to continue to use these products which contain decongestants, one would be unnecessarily ingesting them and subjecting one’s body to their side effects.
It would be better in this case to switch to another product which does not contain unnecessary ingredients.
3. Do not overuse pain medications.
It is important to be aware that there is a condition called “medication overuse headache” (MOH).
More commonly, these types of headaches are referred to as “rebound” headaches.
These are not universal. Not everybody experiences them. But for those who do, the following may trigger a cycle of rebound headaches:
- Taking too much of a medication.
- Using a medication too frequently.
Getting stuck in a headache rebound cycle is problematic, because it requires you to stop using the medication until the rebound cycle ceases.
This can, obviously, be an incredibly unpleasant experience. You are literally guaranteed to be in pain as you wait for your body to readjust.
It also means that you will not be able to use that medication to treat headaches from other causes during that time span. So if you are outdoors in the bright sun and the light triggers a headache, you will be out of luck—at least with that medication.
Overusing pain medications can have other complications as well.
NSAIDs can increase the chances of harmful stomach bleeding if they are overused. Some people may be more susceptible to this possibility than others.
Acetaminophen can pose dangers as well if it is not used appropriately. The American Migraine Foundation reports that “liver damage from acetaminophen overdose is the leading reason for liver transplants in the United States.”
The foundation urges particular caution in taking OTC pain medications if you have “health problems such as ulcers, kidney or liver troubles; taking lots of medications for other conditions.”
Prescription Medication Options for Treating Migraines
What if taking over-the-counter pain medications is not an ideal option for treating your migraines?
In addition to OTC medications or instead of them, you have some other options open to you. One of those is to look into prescription drugs.
These are separated into two categories. The first is abortive medications for acute head pain, and the second is preventative medications for chronic head pain.
Following are common migraine prevention prescription medications:
- Beta blockers: Some such medications are propranolol (Inderal), Timolol (Blocadren), atenolol (Tenormin), metoprolol (Toprol XL), and nadolol (Corgard).
- Antidepressants: The most common drug used in this class is tricyclic Amitriptyline.
- Anticonvulsants: Some of these are Divalproex (Depakote) and sodium valproate, gabapentin (Neurontin) and topiramate (Topamax).
Some less common preventative medications for migraines include:
- Botox: Yes, the same treatment which is used to tighten up skin and reduce the appearance of wrinkles also can be used to help prevent migraines. This appears to be a safe and well-tolerated preventative treatment. Unfortunately, is a bit convoluted and expensive to obtain.
- Anti-CGRP: This preventative treatment is newly approved by the FDA. It blocks a protein called “calcitonin gene-related peptide” (CGRP) which is involved in inflammation and pain of a migraine. So far, it appears to be virtually side effect free and well-tolerated, but we still do not have long-term data on its safety from a cardiovascular standpoint. To discover more, see “What is the Anti-CGRP Migraine Treatment?”
Supplements: Another OTC Migraine Treatment Option
Given that most of your preventative options for migraines involve potential side effects and long-term complications or currently lack long-term data and/or are expensive, you might still find yourself in search of another solution.
If that is the case, you can consider investigating supplements. There are a number of natural options which are backed by varying degrees of research and anecdotal data.
You do not need a doctor’s prescription to obtain herbs, vitamins or other natural supplements. You can get them over-the-counter at a local pharmacy or grocery store or online.
Note that not every migraine patient will get the same results from each of these natural treatments.
It can take some degree of trial and error to figure out what does and does not have a beneficial effect for you.
Also note that you combine multiple supplements and/or take supplements alongside standard over-the-counter pain relievers.
Let’s go over some of the supplements that you can consider trying.
- According to the American Migraine Foundation, “There is some evidence that migraineurs may have lower levels of brain magnesium either from decreased absorption of it in food, a genetic tendency to low brain magnesium, or from excreting it from the body to a greater degree than non-migraineurs. Studies of migraineurs have found low levels of brain and spinal fluid magnesium in between migraine attacks.” If you are interested in learning more about this topic, you can view our in-depth magnesium guide.
- Butterbur is extract of Petasites, a plant which shares the family of sunflowers. Multiple studies note the potential efficacy of butterbur, with one review stating, “The extract at higher dose (150 mg) showed a greater decreased frequency of migraine attacks and a greater number of responders (improvement >50%) after treatment over 3–4 months than the extract at lower dose (100 mg) and placebo.” Read all about butterbur for migraines. And make sure any butterbur you use is PA-free.
- The extract from the boswellia tree may help to reduce inflammation. There is some data which suggests that it might be useful if you suffer from cluster headaches. We still do not know much about boswellia at this time, but it may be worth a try.
- Feverfew is another herb which people take for brain health. One study mentions that it can produce a “significant reduction in pain intensity” as well as nausea, light and sound sensitivity, and vomiting.
- Ginger can be taken as an abortive over-the-counter treatment, with studies suggesting that taken early during a mild attack, it might prevent matters from getting worse. It is also believed that it might be able to work as a regular preventative over-the-counter option, but more research is needed in this area.
- Vitex, also known as “chaste tree berry extract,” appears to be a dopamine agonist. Early research shows possible effectiveness for PMS symptoms. It may be useful for treating migraines which are associated with the menstrual cycle.
- One vitamin to consider is vitamin D. As this study reports, a “dramatic reduction in the frequency and duration” of head pain may be associated with taking more vitamin D. There is also research showing that vitamin D taken in conjunction with calcium may be particularly valuable in certain cases.
- Melotonin may be worth a try. As reported here, taking 3 mg of melatonin per day may help to prevent migraines. This may be particularly worth a try if you believe that sleep-related issues are connected to your head pain.
- CoQ10. There is some initial research suggesting that CoQ10 may be able to help with migraine prevention.
- Riboflavin. Taking large doses of riboflavin over a period of months may be able to prevent migraines.
Research into supplements for migraines is ongoing, so check regularly to see if any new studies have cropped up which can provide you with more ideas to experiment with.
Don’t Forget About Lifestyle Changes and Home Remedies for Managing Migraines
Something else which you could regard as an “over-the-counter” solution would be lifestyle changes. You can also put some other home remedies in this category as well.
You can change your diet and exercise plan without a trip to the pharmacy, but here are some over-the-counter items which I have found to be helpful in managing migraines, and which you might find useful as well:
- Cold packs: Sometimes putting ice on your face or head can help to take the edge off of migraine pain. But if you want to skip the mess and inconvenience of a bag of ice, you can try using a cold pack instead. It stays cold for longer and doesn’t drip all over everything. It also is more comfortable to hold.
- Lidocaine: I saw Lidocaine suggested as an idea for treating myofascial pain in a research article. I gave it a try and it has become a regular item in stock in my medicine cabinet. While it does not do much for a really intense migraine, I have noticed it has a significant mitigating effect with a low level one. It seems like putting the patch on the tight neck muscles that become involved makes a difference.
- Tiger balm, CBD oil, and other pain relieving topical treatments: I do not find ointments in this category to be nearly as helpful as Lidocaine, which is an actual topical anesthetic. But they can help a little bit. The Tiger Balm provides some sensory distraction for me, and I have found that CBD oil does well to relieve some of the localized aching which happens in the tight neck, shoulder and back muscles during or after a migraine.
- TENS unit: If you have ever had physical therapy, there is a chance that perhaps someone allowed you to try a TENS unit. TENS stands for “transcutaneous electrical nerve stimulation.” Some alternative healthcare practitioners such as chiropractors use these as well. This device acts on opioid receptors, and can help fight pain. It has not been definitively proven to be useful for migraines. But I have found it to be helpful, and there are plenty of other anecdotes you will stumble across for the use of TENS for various types of head pain (as well as some unrelated pain conditions). What many people are not aware of is that you can purchase one of these over-the-counter at a regular drugstore. They are actually quite reasonably priced.
So that gives you a few more over-the-counter products to consider as further potential weapons in your arsenal against pain.
Conclusion: There are Many Over-the-Counter Treatment Options to Try for Migraine Headaches
Whether you cannot get to see a doctor at this time or simply cannot or do not wish to rely on prescription medications to manage your migraines, there are many over-the-counter possibilities worth considering.
We have talked about over-the-counter pain medications, natural supplements and topical remedies in-depth.
Hopefully, one or more of these ideas will provide you with some relief. For the best possible results, be diligent in using your chosen over-the-counter pain treatments, and combine them with healthy lifestyle choices to fight against pain.