From the Guidelines
For the treatment of cephalalgia, or headache, the most effective analgesic medications are nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen sodium, as well as the combination agent acetaminophen plus aspirin plus caffeine, as evidenced by studies 1. These medications have been shown to be effective in reducing headache pain and are considered first-line treatments. The following are some key points to consider when using these medications:
- Take medication at the first sign of headache rather than waiting until pain becomes severe
- Stay hydrated and consider resting in a dark, quiet room while the medication takes effect
- If your headache is accompanied by fever, stiff neck, confusion, or is the "worst headache of your life," seek immediate medical attention
- For recurrent or severe headaches that don't respond to over-the-counter options, consult a healthcare provider as prescription medications may be needed Some specific medication dosages that may be effective for headache pain relief include:
- Aspirin 500-1000mg every 6 hours
- Ibuprofen 400-600mg every 6-8 hours
- Naproxen sodium 220-440mg every 8-12 hours
- Acetaminophen plus aspirin plus caffeine, with specific dosages varying depending on the formulation It's also important to note that acetaminophen alone has been shown to be ineffective for headache pain relief 1. In addition to these medications, other treatments such as triptans and ergotamines may be effective for some patients, but may have more limited evidence and potential side effects 1. Overall, the choice of medication will depend on the individual patient's needs and medical history, and should be made in consultation with a healthcare provider.
From the FDA Drug Label
The efficacy of sumatriptan tablets in the acute treatment of migraine headaches was demonstrated in 3, randomized, double-blind, placebo-controlled trials. Acetaminophen was offered to patients in Trials 2 and 3 beginning at 2 hours after initial treatment if the migraine pain had not improved or worsened Additional medications were allowed 4 to 24 hours after the initial treatment for recurrent headache or as rescue in all 3 trials.
Analgesic medications for cephalalgia (headache) include:
- Sumatriptan: a 5-HT1 agonist for the acute treatment of migraine headaches
- Acetaminophen: offered as a rescue medication for migraine pain that has not improved or worsened after initial treatment with sumatriptan 2 Note: The FDA label does not provide a comprehensive list of analgesic medications for cephalalgia, only those mentioned in the context of the sumatriptan trials.
From the Research
Analgesic Medications for Cephalalgia (Headache)
- The primary goals of acute migraine therapy are to reduce attack duration and severity, and current evidence-based therapies for acute migraine attacks include:
- Acetaminophen 3
- Four nonsteroidal anti-inflammatory drugs (NSAIDs): ibuprofen, naproxen, diclofenac potassium, and acetylsalicylic acid 3, 4, 5
- Seven triptans: sumatriptan, rizatriptan, eletriptan, zolmitriptan, almotriptan, frovatriptan, and naratriptan 3, 4, 5
- NSAID-triptan combinations 6
- Dihydroergotamine (DHE) 4, 5
- Non-opioid combination analgesics 3
- Anti-emetics 3, 5
- Over-the-counter medications, such as acetaminophen, ibuprofen, naproxen, and aspirin, have shown strong efficacy when used as first-line treatments for mild-to-moderate migraine attacks 3
- Triptans are effective for migraine relief, with standard dose triptans achieving better outcomes than ergots, and most triptans achieving equal or better outcomes compared with NSAIDs, ASA, and acetaminophen 4
- Combining triptans with NSAIDs and other agents for the acute treatment of migraine suggests better outcome efficacy measures than the use of single agents 6
- Acute treatments with gepants, antagonists to receptors for the inflammatory neuropeptide calcitonin gene-related peptide, such as rimegepant or ubrogepant, can eliminate headache symptoms for 2 hours in 20% of patients 7
- A 5-HT1F agonist, lasmiditan, is also available for acute migraine treatment and appears safe in patients with cardiovascular risk factors 7