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5 Best OTC medicines for headache and migraine


It is widely recognised that insufficient water intake will cause a headache or aggravate an existing one. We all get busy during the day and by the time lunchtime or home time comes around you haven't had any water at all. Coffee and tea don't count as they are diuretics and will dehydrate you even further. Two litres per day should sort out any dehydration as a cause of headache. (1,2)


A daily dose of 400 to 800 milligrams of magnesium is one of the easiest and safest OTC medicines for headache and migraine. Vinck and Nechifor in the university of Adelaide work magnesium in the central nervous system, discuss the role of magnesium in pain management, including headaches and acute migraine attacks. They report that magnesium works by inhibiting the pain producing nmda receptors. Ibuprofen/Paracetamol combo These are the most effective OTC medications for headache and migraine. Each is good on it’s own, but together they are better than opioids, without all the nasty side effects. Ibuprofen is an anti-inflammatory and paracetamol is believed to act on the central nervous system to wind back pain. According to the NPS (4), The proportions of participants achieving at least 50% maximum pain relief over 6 hours were:

  • 69% with paracetamol/ibuprofen 500/200 mg

  • 71% to 73% with paracetamol/ibuprofen 1000/400 mg

  • 52% with ibuprofen 400 mg alone

  • 7% to 11% with placebo.

Derry, Derry and Moore 2013 found that the number needed to treat (NNT) for paracetamol/ibuprofen 1000/400 mg versus ibuprofen alone was 5.4 (95% CI 3.5 to 12). Fewer participants needed rescue medication after treatment with the combination than with ibuprofen alone. Care needs to be taken when using this combo regime. Paracetamol is known to cause liver damage if taken too frequently as in the case of headache or migraine, and Ibuprofen can cause a duodenal ulcer if taken without food. Only use this combination when the headache is acute and only for 24 hours. This combo should take the headache away or reduce it significantly pretty much within an hour. If it doesn’t then you need to see a qualified health practitioner to see if there is something else going on


I am a huge believer in sleep being a medicine and it is one of the most effective treatments for headache and migraine. Sleep together with water is one of the best ways to get rid of a headache or sleep off a migraine.


Palmitoylethanoloamide (PEA) is the latest OTC on the market for pain, including headache and migraine. There are mixed results, but it is worth a shot. PEA is not a medicine, rather a supplement which is similar to the marijuana molecule, but is not marijuana. Quite often combining PEA with Magnesium and Ibuprofen, headache and migraine sufferers can keep their pain at comfortable levels. The great thing about PEA is that it is quite often effective and can be used with other prescription drugs and supplements as there are no known drug interactions with PEA and the side effects are almost non-existent.


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