Highlights
- Most headaches can be treated with over-the-counter medication, but some do need prescription medicines.
- Over-the-counter headache medications often work well for common headaches.
- The majority of prescription medications are targeted towards treating migraine and cluster headache types.
- A new headache should be checked by a doctor to ensure it’s not a symptom of a more serious condition.
- Find the lowest price on headache medications with the help of BidRx.
Headaches are one of the most common ailments, whether as symptoms of a condition, caused by treatment, or a condition in their own right. There are multiple options to treat headaches, and finding the right one can make a real difference in quality of life.
About Headache Medication
Headache treatment depends heavily on the type of headache, what triggers it, and why. For most headaches, finding the trigger and managing it with over-the-counter medication is the most common treatment plan.
For some types of headache, however, particularly migraine, prescription medication can be a front-line treatment to both manage and prevent headaches. If you experience a new form of headache with no clear explanation, see a doctor to get examined and ensure the headache isn’t a symptom of a larger problem.
Here are the most common medications recommended for treating headaches.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Non-steroidal anti-inflammatory drugs, usually shortened as NSAIDs, mitigate pain signals and are among the most commonly available headache medications. NSAIDs are often combined with other medications and chemicals, including other NSAIDs.
NSAIDs are generally used to reduce symptoms of manageable pain. Some NSAIDs, such as naproxen, are available in both consumer and prescription strength, or may be included in a prescription drug. If you’re prescribed a stronger version, review possible outcomes with your doctor.
Warnings and Contraindications — NSAIDs
NSAIDs should be used with caution if you have:
- A gastrointestinal condition
- Heart disease
- A history of cerebrovascular events (strokes or mini-strokes)
- Kidney disease
Side Effects — NSAIDs
NSAID side effects are often gastrointestinal and include:
- Nausea and/or vomiting
- Gastric bleeding or ulcers
- Indigestion
- Diarrhea
Drug Interactions — NSAIDs
NSAIDs should not be taken with:
- Diuretics
- Blood thinners
- Selective serotonin reuptake inhibitors (SSRIs)
- Antihypertensives
- Antibiotics
With over-the-counter medication in particular, following dosage and timing rules is particularly important. Read the label carefully and follow all instructions for use.
It’s recommended to avoid alcohol when regularly taking NSAIDs.
Opioids
One of humankind’s earliest pain treatments, opioids block pain signals directly by binding to specific receptors. As opioids can be habit-forming, they are rarely used for ongoing headache management, although for people with severe headaches, they may be prescribed a few doses to be used as needed. Opioids are not recommended for migraine, as evidence is increasingly showing that they are ineffective.
Warnings and Contraindications — Opioids
Opioids should not be used by people with a previous history of addiction without a doctor’s supervision. Older adults using opioids may be at greater fall risk due to drowsiness. Learn the signs of habituation and the psychological aspects of addiction before using opioids.
If you find your headaches, even minor ones, are becoming more frequent or more intense, discontinue opioid use completely and contact your doctor.
Side Effects — Opioids
Opioids can cause:
- Nausea and/or vomiting
- Constipation
- Itching
- Drowsiness
Opioids as a class can become less effective when used frequently, requiring either an increase in dosage or weaning off the medication.
Drug Interactions — Opioids
Opioids should not be taken with other depressant drugs, including alcohol, and should only be taken in combination with immunosuppressive drugs under a doctor’s orders.
Triptans
Primarily used for migraine and cluster headaches, triptans were first put on the market in the 1990s. They work by stimulating serotonin receptors in the blood vessels and nerve endings of the brain. Triptans are primarily used when over-the-counter medication is ineffective, and include:
- Sumatriptan (Imitrex/Sumavel)
- Eletriptan (Relpax)
- Rizatriptan (Maxalt)
- Zolmitriptan (Zomig)
- Frovatriptan (Frova)
- Almotriptan (Axert)
- Naratriptan (Amerge)
Warnings and Contraindications — Triptans
If you have a heart condition, don’t take triptans. Triptans are generally contraindicated for people who are pregnant.
Side Effects — Triptans
Triptans generally have few side effects when they’re used at the correct dosage and taken as prescribed. The most common side effect was a recurrence of migraine, which is rare.
Drug Interactions — Triptans
Drugs that also affect serotonin, including antidepressants, shouldn’t be taken with triptans. They also shouldn’t be taken with ergot alkaloids, as this raises the risk of coronary spasm.
Ergot Alkaloids
Derived from the ergot fungus, ergot alkaloids were the most common treatment for migraine and cluster headaches before the triptan class was put on the market. While their primary usage has shifted to other sectors of medicine, they may still be used to treat migraine if triptans are ineffective or not recommended.
The most common ones on the market are ergotamine (Ergomar) and dihydroergotamine (Migranal/Migergot)
Warnings and Contraindications — Ergot Alkaloids
Avoid ergot alkaloids if you have:
- Heart disease
- Liver disease
- Kidney disease
- Any circulatory condition, such as Reynaud’s disease
If you’re treating HIV, check your medication regimen carefully with your doctor before taking any ergot-based drugs.
Side Effects — Ergot Alkaloids
The most common side effect of ergot alkaloids is nausea and/or vomiting. With higher doses or overdose, ergot alkaloids can have serious effects on the heart and circulatory system. A sudden increase in blood pressure is a particular risk. If prescribed, only take them at the dosage and timing as prescribed.
Drug Interactions — Ergot Alkaloids
Ergot alkaloids should not be taken with:
- Macrolide antibiotics
- Triptans
- Antifungal medication
- Protease inhibitors
Antihypertensives
Commonly used to treat high blood pressure, some antihypertensives also have shown strong evidence of reducing the frequency and severity of migraines. Precisely why remains a matter of study, and many doctors tend to take a “two birds with one stone” approach when patients have both conditions.
Common classes of antihypertensives used for migraine include:
- Beta blockers
- Metoprolol (Lopressor)
- Nebivolol (Bystolic)
- Propranolol (Inderal LA, Inderal XL, or InnoPran XL)
- Timolol
- Calcium channel blockers
- Nifedipine (Procardia)
- Verapamil (Calan)
- Diltiazem (Cardizem)
- Angiotensin receptor blockers
- Candesartan (Atcand)
- Telmisartan
Warnings and Contraindications — Antihypertensives
If you have any of the following, only take antihypertensives on doctor’s recommendation:
- Liver disease
- Kidney disease
- Heart disease not being treated with antihypertensives
People who are pregnant or could become pregnant shouldn’t take antihypertensives.
Side Effects — Antihypertensives
If you take antihypertensives, you may experience:
- Dizziness
- Back pain
- Non-migraine headache
- Cold-like symptoms, such as a runny nose
They also may interfere with kidney testing and may raise potassium levels in the body.
Drug Interactions — Antihypertensives
You should not use antihypertensives if you also take:
- Vasodilators
- Diuretics
- Other heart or blood pressure medications
- Lithium
- NSAIDs
Anticonvulsants
Also called anti-seizure medication, the primary use of anticonvulsants is to help manage seizures and convulsions caused by unusual electrical activity in the brain. However, two medications in particular, divalproex sodium (Depakote) and topiramate (Topamax), have been shown to be useful as preventative measures for migraine.
Warnings and Contraindications — Anticonvulsants
Do not take any anticonvulsant if you have liver disease or any pancreatic condition. If you’re pregnant or might become pregnant, don’t use anticonvulsants unless a doctor has cleared you to do so. Divalproex sodium should not be used to prevent migraines while pregnant.
If you have thoughts of suicide or are experiencing sudden changes in mood, contact your doctor right away. If you’ve ever had a mood disorder, tell your doctor before starting an anticonvulsant.
Topiramate may increase body temperature while reducing sweating, leading to a higher risk of dehydration. Report any vision issues you might experience immediately when using topiramate.
When using divalproex sodium, seek help if you experience the following:
- Appetite
- Upper stomach pain that may spread to your back
- Persistent nausea or vomiting
- Darkening of the urine
- Facial swelling
- Jaundice
These are signs of liver or pancreatic damage that will need to be treated immediately.
Side Effects — Anticonvulsants
Possible side effects you may find when taking anticonvulsants include:
- Gastrointestinal issues, including:
- Nausea
- Vomiting
- Diarrhea
- Pain in the stomach
- Constipation
- Headache
- Back pain
- Dizziness
- Drowsiness
- Muscle weakness
- Tremors
- Memory issues
- Sudden changes in mood
- Insomnia
- Easier bruising or bleeding
- Cold and flu-like symptoms, such as:
- Fever
- Runny nose
- Sore throat
- Coughing or other breathing problems
- Trouble walking and with coordination
- Swelling in the extremities
- Tingling or numbness in the extremities
- Vision problems
- Tinnitus
- Skin rash
- Hair loss
- Weight gain or weight loss
- Changes to the sense of taste
- Nervousness
Drug Interactions — Anticonvulsants
Ask your doctor before taking any of the following while using anticonvulsants:
- Opioids
- Sleep medication
- Muscle relaxers
- Antidepressants
Do not combine anticonvulsants.
Tricyclic Antidepressants
While tricyclic antidepressants have largely been replaced for mental health treatments, they’ve shown efficacy as preventative medication for both migraines and tension headaches. Modern antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), have not shown similar effects.
Amitriptyline has performed the best in studies on migraine prevention and is generally the first drug used. Nortriptyline can be used instead if amitriptyline is contraindicated.
Warnings and Contraindications — Tricyclic Antidepressants
Tricyclic antidepressants can have cardiac and neurological effects that can be potentially fatal in the case of overdose. Only use tricyclic antidepressants as prescribed and do not attempt to “catch up” if you miss a dose.
Do not take tricyclic antidepressants without a doctor’s permission if you’ve experienced any of the following:
- Heart disease or a cardiac event
- Liver disease
- Diabetes, especially if prescribed amitriptyline
- Glaucoma or other vision issues
- Difficulty urinating
- Any history of mental illness, particularly schizophrenia or bipolar disorder
Side Effects — Tricyclic Antidepressants
The most common side effects of tricyclic antidepressants include:
- Gastrointestinal symptoms, including:
- Constipation or diarrhea
- Nausea
- Vomiting
- Pain in the mouth
- Dry mouth
- Changes to sense of taste
- Black tongue
- Changes in weight
- Appetite changes
- Less-frequent urination
- Rash or itching
- Swelling of the breasts regardless of gender
- Increased blood pressure
- Blurred vision
- Tingling and numbness in hands and feet
- Loss of libido, including difficulty having an orgasm and erectile dysfunction
Drug Interactions — Tricyclic Antidepressants
Do not take any tricyclic antidepressant if you’ve used an SSRI in the last five weeks or an MAO inhibitor in the last 14 days.
Check with your doctor before taking tricyclics if you take any of these medications:
- Any other class of antidepressant
- Anti-anxiety or mood disorder medication
- ADHD medication or other stimulants
- Any cold or allergy medication, prescription or over-the-counter
- Antihistamines
- Parkinson’s disease treatments
- Gastrointestinal medication
- Overactive bladder medication
- Bronchodilators, including asthma medication
Get the Lowest Price for Headache Medications with BidRx
Controlling your headache shouldn’t mean a tighter budget. BidRx helps you cut down on medication prices by having pharmacies bid on your prescription. Just pick the bid that works best for you and have the medication shipped to your door, or pick it up locally, depending on the offer you choose.
Visit our medication page to get started on getting the lowest price for your headache medication with BidRx.
