What medication is used for headaches?

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Last updated: February 10, 2025 • View editorial policy

From the Guidelines

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line therapy for headaches, specifically aspirin, ibuprofen, naproxen sodium, and the combination agent acetaminophen plus aspirin plus caffeine.

Medication Options

  • Aspirin: effective for acute treatment of migraine 1
  • Ibuprofen: effective for acute treatment of migraine 1
  • Naproxen sodium: effective for acute treatment of migraine 1
  • Acetaminophen plus aspirin plus caffeine: effective for acute treatment of migraine 1
  • Triptans (e.g. naratriptan, rizatriptan, sumatriptan, zolmitriptan): effective for acute treatment of migraine, especially in patients who do not respond to NSAIDs [(1, 2)]
  • Dihydroergotamine (DHE) nasal spray: effective for acute treatment of migraine 2 ### Important Considerations
  • Acetaminophen alone is not effective for acute treatment of migraine [(1, 2)]
  • Antiemitics should be used to treat nausea and vomiting, which are common symptoms of migraine [(1, 3)]
  • Nonoral routes of administration should be considered for patients with nausea or vomiting [(1, 3)]

From the Research

Medications for Headaches

  • Acetaminophen is used to treat mild or moderate migraines 4, 5, 6
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are used to treat mild or moderate migraines 4, 5, 6
  • Triptans (5-HT1 receptor agonists) are used to treat moderate or severe migraine 4, 5, 6
  • Antiemetic drugs are used to treat nausea and vomiting associated with migraines 4
  • Isometheptene is used to treat mild or moderate migraines 4
  • Gepants, such as rimegepant or ubrogepant, are used to treat acute migraine 6
  • Lasmiditan, a 5-HT1F agonist, is used to treat acute migraine 6
  • Opioids, such as short-acting opioids, may be considered for severe migraine attacks when other treatments are contraindicated or ineffective 7

Specific Medications for Migraines

  • Sumatriptan, the first triptan used, is effective but can induce adverse events 4
  • Second-generation triptans (zolmitriptan, naratriptan, rizatriptan, and almotriptan) were developed to increase the benefit-to-risk ratio in migraine management 4
  • OnabotulinumtoxinA is used as a preventive treatment for migraines 8, 6
  • Calcitonin gene-related peptide monoclonal antibodies are used as preventive treatments for migraines 6

Considerations for Medication Use

  • Medication-overuse headache (MOH) is a chronic daily headache caused by frequent use of acute medications 8
  • The risk of MOH is increased with frequent use of butalbital, opioids, triptans, and combination analgesics 8
  • Acute migraine treatment should be limited to 2 or fewer days per week to avoid MOH 8
  • Patients with cardiovascular disease should avoid triptans due to vasoconstrictive properties 6

References

Research

Migraine: diagnosis, management, and new treatment options.

The American journal of managed care, 2002

Research

Opioids can be useful in the treatment of headache.

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2013

Research

Medication-overuse headache.

Continuum (Minneapolis, Minn.), 2012

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.