From the Guidelines
Long-term use of Excedrin for migraines is not recommended due to the risk of medication overuse headaches and other potential side effects, and instead, patients should consider preventive medications such as candesartan, telmisartan, erenumab, fremanezumab, or galcanezumab as recommended by the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline for the management of headache 1.
Restrictions and Recommendations
When considering the use of Excedrin for migraines, it is essential to weigh the potential benefits against the risks. The guideline recommends against the long-term use of over-the-counter medications like Excedrin, which contains acetaminophen, aspirin, and caffeine, due to the risk of medication overuse headaches and other side effects 1.
Alternative Treatments
For patients experiencing frequent migraines, the guideline suggests considering preventive medications, which can reduce the frequency and severity of migraines without the risks associated with long-term over-the-counter use. Some recommended options include:
- Candesartan or telmisartan for the prevention of episodic migraine 1
- Erenumab, fremanezumab, or galcanezumab for the prevention of episodic or chronic migraine 1
- Other options such as lisinopril, oral magnesium, topiramate, propranolol, valproate, memantine, atogepant, and onabotulinumtoxinA injection may also be considered, although the evidence for these options is weaker 1
Important Considerations
It is crucial for patients to consult a healthcare provider before starting or continuing any medication regimen, especially if they have certain medical conditions or are experiencing frequent migraines. The healthcare provider can help determine the best course of treatment and ensure that the patient is aware of the potential risks and benefits associated with each option.
From the Research
Excedrin Long Term for Migraines Restrictions
- The use of Excedrin for migraines is a common practice, but its long-term effects and restrictions are not well-defined in the provided studies 2, 3, 4, 5, 6.
- However, it is known that Excedrin is an over-the-counter medication that contains a combination of acetaminophen, aspirin, and caffeine, which can be effective in treating migraine attacks 6.
- The American Headache Society recommends that triptans, such as sumatriptan, be used as first-line treatment for moderate to severe migraines, while Excedrin and other over-the-counter medications may be used for mild to moderate migraines 4.
- A study comparing Excedrin to eletriptan, a triptan, found that eletriptan was effective in treating migraine attacks in patients who were poor responders to Excedrin 3.
- Another study found that a combination of acetaminophen, aspirin, and caffeine was more effective than sumatriptan in the early treatment of migraine 6.
- The use of acute treatment, including Excedrin, should be limited to a maximum of ten days a month to prevent medication-overuse headache 4.
- It is recommended that patients with frequent or severe migraines consult with a healthcare professional to determine the best course of treatment and to discuss any potential restrictions or limitations on the use of Excedrin or other medications 2, 4.