From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
For postconcussion headaches, acetaminophen (Tylenol) is typically recommended as the first-line treatment at a dose of 500-1000mg every 6 hours, not exceeding 4000mg daily, as it does not increase bleeding risk, which is crucial after head injury, as noted in various studies including 1 and 2. The choice of medication is based on the need to balance effective pain management with the risk of exacerbating the injury.
- Acetaminophen is preferred due to its safety profile regarding bleeding risk, which is a significant concern in the acute phase of a head injury.
- If acetaminophen is not effective, NSAIDs like ibuprofen (Advil, Motrin) at 400-600mg every 6-8 hours may be considered, but their use should be delayed 24-48 hours after injury due to bleeding concerns, as discussed in 1.
- For persistent headaches, medications such as amitriptyline starting at 10-25mg at bedtime, gradually increasing if needed, or topiramate starting at 25mg daily and slowly titrating up, may be prescribed by a doctor, as mentioned in general management strategies for post-concussive symptoms 3, 4.
- Lifestyle modifications are also crucial: maintaining regular sleep patterns, staying hydrated, avoiding alcohol and caffeine, and gradually returning to normal activities can help manage symptoms and support recovery.
- It is essential to monitor the severity of headaches and seek immediate medical attention if they worsen, are accompanied by vomiting, confusion, or visual disturbances, as these could indicate a more serious condition requiring urgent evaluation, a principle that underlies the management of post-concussive symptoms 5.