Understanding What Pain Med to Use for Headaches: A Comprehensive Guide

October 7, 2025 •

4 min read

According to the World Health Organization, headaches are one of the most common nervous system disorders, with up to half of the adult population experiencing a headache at least once a year. Understanding what pain med to use for headaches, based on the type and severity, is crucial for effective and safe relief. This guide explores both over-the-counter and prescription options.

Quick Summary

This guide details the different types of pain medications for headaches, including over-the-counter options like acetaminophen and NSAIDs for tension headaches, and prescription treatments such as triptans for migraines. It discusses their mechanisms, appropriate usage, potential side effects, and important precautions for selecting the right relief. Information is also provided on when to consult a healthcare provider for your symptoms.

Key Points

Start with OTC meds for mild pain: For typical tension headaches, over-the-counter NSAIDs (ibuprofen, naproxen) or acetaminophen are the first and most accessible line of defense.
Choose based on headache type: NSAIDs are effective for headaches involving inflammation, while acetaminophen is a better choice for those with stomach issues.
Caffeine can boost relief: Some combination pain relievers containing caffeine can be more effective for mild-to-moderate migraines, but must be used sparingly to avoid rebound headaches.
Prescription options for severe migraines: Triptans and newer CGRP antagonists are specifically designed to treat moderate to severe migraines that don't respond to OTC drugs.
Beware of medication overuse: Taking pain medication too frequently (more than twice a week) can lead to rebound headaches, making the condition worse.
Combine with lifestyle changes: Non-medication strategies such as adequate sleep, stress management, and rest in a dark, quiet room are important for managing and preventing headaches.
Seek medical advice for serious symptoms: A doctor should be consulted for severe, frequent, or worsening headaches, or if they are accompanied by other red flag symptoms like fever or vision changes.

Identifying Your Headache Type

Before determining the right medication, it's helpful to understand the most common types of headaches:

Tension-Type Headaches: The most prevalent type, characterized by mild-to-moderate, steady, pressing pain, often feeling like a tight band around the head.
Migraine Headaches: These can cause moderate to severe throbbing pain, typically on one side of the head, and may be accompanied by nausea, vomiting, and sensitivity to light and sound.
Sinus Headaches: Resulting from sinus inflammation, this type causes pain and pressure in the face, forehead, and around the eyes.
Cluster Headaches: Severe, recurring headaches that appear in clusters and are concentrated around one eye.

Over-the-Counter (OTC) Pain Relievers

For mild to moderate headaches, many people find sufficient relief with OTC medications. These are generally the first line of treatment.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs work by reducing inflammation and blocking pain-causing substances in the body. They are particularly effective for headaches with an inflammatory component, such as tension headaches or mild migraines.

Ibuprofen: Available under brand names like Advil and Motrin. It works quickly, typically providing relief within 30 minutes, and lasts for about 4 to 6 hours.
Naproxen Sodium: Sold as Aleve, this NSAID lasts longer than ibuprofen, providing pain relief for 8 to 12 hours. It may take longer to feel the full effect.
Aspirin: Another NSAID that is effective for headaches but can cause stomach irritation. It is generally not recommended for children or teenagers due to the risk of Reye's syndrome.

Acetaminophen

Often sold under the brand name Tylenol, acetaminophen is an effective pain reliever and fever reducer but does not have significant anti-inflammatory effects. It is a good alternative for individuals who cannot take NSAIDs due to stomach issues, kidney problems, or other health conditions. However, it is crucial not to exceed the maximum daily dose to avoid liver damage.

Combination Medications

Some OTC products, like Excedrin Migraine, combine a pain reliever (aspirin, acetaminophen) with caffeine. The addition of caffeine can enhance the pain-relieving effects and is particularly useful for mild-to-moderate migraines. However, overuse can lead to rebound headaches.

Prescription Medication for Migraines

For severe migraines that do not respond to OTC treatments, a doctor may prescribe more specialized medications.

Triptans

These are migraine-specific prescription drugs that work by constricting blood vessels in the brain and blocking pain pathways.

Sumatriptan: (Imitrex) Available in various forms, including pills, nasal sprays, and injections.
Rizatriptan: (Maxalt).
Zolmitriptan: (Zomig).

CGRP Antagonists (Gepants)

This is a newer class of medication approved for the treatment and prevention of migraines. Gepants block the calcitonin gene-related peptide (CGRP), a protein involved in pain signaling.

Ubrogepant: (Ubrelvy) for acute treatment.
Rimegepant: (Nurtec ODT) for acute treatment and prevention.

Other Prescription Options

Other options include older medications like ergotamine derivatives and anti-nausea medications. Opioids and barbiturates are generally avoided for headache treatment due to the high risk of dependence and side effects.

Comparison of Common Headache Medications


Feature	Acetaminophen	Ibuprofen	Naproxen Sodium	Triptans	CGRP Antagonists
Best For	Mild to moderate tension headaches and fever; alternative for those with stomach issues.	Tension headaches, mild migraines, and pain with inflammation.	Long-lasting relief for tension headaches and mild migraines.	Moderate to severe migraines.	Acute and/or preventive migraine treatment.
Mechanism	Blocks pain signals in the brain.	Reduces inflammation and blocks pain-causing substances.	Reduces inflammation and blocks pain-causing substances.	Constricts blood vessels in the brain; blocks pain pathways.	Blocks CGRP pain signaling.
Side Effects	Liver damage with overuse or high doses.	Stomach upset, ulcers, and risk of heart problems.	Stomach upset, ulcers, and risk of heart problems.	Tingling, sleepiness, flushing, chest tightness.	Nausea, constipation.
Precautions	Do not exceed maximum daily dose (4g); avoid with heavy alcohol use or liver disease.	Not recommended for those with stomach ulcers, kidney disease, or heart conditions.	Not recommended for those with stomach ulcers, kidney disease, or heart conditions.	May not be suitable for people at risk of stroke or heart attack.	Check for strong medication interactions; some have specific contraindications.
Availability	Over-the-counter (OTC).	OTC.	OTC.	Prescription only.	Prescription only.

Non-Pharmacological and Alternative Approaches

Medication isn't the only solution. Many people find relief through lifestyle adjustments and alternative therapies:

Lifestyle Changes: Regular exercise, adequate sleep, and managing stress can help prevent or reduce the frequency of headaches.
Rest: Lying down in a quiet, dark room is a classic remedy for migraines.
Temperature Therapy: Applying a cold compress to the forehead or neck can help relieve migraine pain. Some people also find a heating pad helpful for tension headaches.
Biofeedback: A technique that teaches you to control certain bodily functions, like muscle tension, to manage pain.

When to See a Doctor

While most headaches can be managed at home, certain symptoms require professional medical attention. You should see a doctor if:

Your headaches are severe, frequent, or interfere with daily life.
You suspect your headaches are a sign of a more serious underlying condition.
You experience the "worst headache of your life" suddenly.
Your headache is accompanied by fever, stiff neck, confusion, balance loss, numbness, weakness, or vision changes.
You need to take OTC medication more than a couple of times per week to manage headaches.

Note: For reliable information on managing chronic conditions, including headaches, it is beneficial to consult reputable health resources. The Mayo Clinic provides comprehensive information on migraines and other headaches.

Conclusion

Choosing the right medication for a headache depends on the specific type and severity. For common tension headaches, OTC options like NSAIDs or acetaminophen are typically effective. For migraines, prescription medications like triptans or gepants may be necessary. It is crucial to use medications as directed to avoid side effects and prevent medication overuse headaches. Combining medication with non-pharmacological approaches like lifestyle changes and relaxation techniques can lead to better long-term outcomes. If your headaches are severe, frequent, or accompanied by concerning symptoms, consulting a healthcare provider is the safest and most effective course of action.

Frequently Asked Questions

Acetaminophen (Tylenol) is a pain reliever and fever reducer but lacks anti-inflammatory properties. Ibuprofen (Advil), an NSAID, provides pain relief by reducing inflammation. For headaches with an inflammatory component, ibuprofen might be more effective, while acetaminophen is often safer for people with sensitive stomachs.

It is generally not recommended to take acetaminophen and ibuprofen at the same time. While it may be done under medical supervision, it increases the risk of side effects. It is safer to choose one, and if it doesn't work, wait for the appropriate time before taking the other, or consult a doctor.

Prescription triptans are typically recommended for moderate to severe migraines that are not adequately relieved by over-the-counter medications. They are most effective when taken shortly after the start of a migraine attack.

A medication overuse headache, or rebound headache, is caused by taking pain medication too frequently. To prevent it, limit your use of acute headache medications to no more than a few times per week.

Yes, some natural remedies can help. These include using cold or hot compresses, staying hydrated, getting adequate sleep, practicing relaxation techniques, and for migraines, magnesium and riboflavin supplements have shown some evidence of efficacy.

Side effects vary by medication. NSAIDs can cause stomach upset, ulcers, and increase the risk of heart problems. High doses of acetaminophen can lead to liver damage. Triptans can cause tingling, sleepiness, and chest tightness.

Most NSAIDs, like ibuprofen and naproxen, should be taken with food or milk to minimize stomach irritation. Acetaminophen can typically be taken with or without food, but if you have a sensitive stomach, taking it with food might be better.

A headache is a medical emergency if it is the 'worst headache of your life', comes on suddenly, or is accompanied by other serious symptoms such as a stiff neck, high fever, confusion, seizures, or numbness or weakness on one side of the body. Seek immediate medical attention.

Combination medications, such as those with caffeine, can be effective but carry a higher risk of medication overuse headache if used too often. Always check the labels to avoid accidentally doubling up on ingredients like acetaminophen.