Over-the-Counter Medications for Migraine or Tension Headaches

Tension headaches and migraines are fairly common, and most people who experience them try over-the-counter (OTC) medications before talking to their healthcare provider about prescription options. It is a good idea to try these less powerful options first, as non-prescription medications often relieve the symptoms of migraines and other types of headaches with fewer side effects than prescription-strength drugs.1
Another benefit of over-the-counter medications, of course, is that you can get them whenever you need them. But it’s important that you talk to your healthcare provider about your headaches just to make sure you don’t have another medical condition that may require treatment of another kind. Also be sure to run any OTC drugs you intend to take by your healthcare provider or pharmacist to ensure that they are safe for you and won’t pose any drug or supplement interactions.
Tylenol (acetaminophen)
Tylenol (acetaminophen) is a common choice for alleviating tension headaches. While it is not commonly used for the treatment of migraines, studies show that when Tylenol is combined with an anti-nausea medication like Reglan (metoclopramide), the combination is as effective as sumatriptan—a prescription medicine for treating migraines.2
Acetaminophen is a very well-tolerated medication, making it a good alternative if you can’t take nonsteroidal anti-inflammatories (NSAIDs).3
It’s important to note that the leading cause of liver failure in the western world is misuse or overdose of acetaminophen.5 Prolonged use can cause liver or kidney damage and may be life-threatening, and it should never be mixed with alcohol. If you have liver disease, check with your practitioner or healthcare professional before taking acetaminophen.
Keep in mind that acetaminophen is present in some combination pain medications, like Excedrin, Percocet, and Anexsia. Be sure to consider the total amount of acetaminophen you take from all sources if you use these medications.
Advil, Motrin IB (ibuprofen)
Ibuprofen is often used for the treatment of tension headaches, as well as mild to moderate migraines. It is an NSAID, which means that it works by reducing pain and inflammation.
In certain circumstances, ibuprofen can be slightly more effective and works faster than acetaminophen for headache relief.
Ibuprofen can cause stomach upset and may increase the risk of bleeding. Easy bruising, slow healing, nose bleeds, dark stools, spitting up blood, and red or pink urine are all signs of bleeding. You should not use this medication if you have kidney or heart disease, or a history of stomach bleeding.
Aleve (naproxen)
Like ibuprofen, naproxen is an NSAID. It works in the same way and carries the same risks as ibuprofen. Naproxen can reduce the symptoms of tension headache.
Ecotrin, Bufferin, Ascriptin (aspirin)
While it has lost some popularity in recent years, aspirin is still among the most commonly used NSAIDs, particularly among older individuals. Aspirin has several mechanisms that make it an anti-inflammatory, a blood thinner, and a pain reliever.
It is often effective in reducing the symptoms of migraines and tension headaches, but aspirin is more likely to cause bleeding than other blood thinners and can also cause other side effects, including a rash or ringing in the ears. Aspirin may also cause a severe allergic reaction, which manifests with facial swelling and breathing difficulties.7
Because of the side effects and medication interactions, you should check the recommended dose with your healthcare provider before using aspirin for headaches or migraines.
You should not take aspirin in combination with other NSAIDs unless your healthcare provider specifically tells you to.
A Word From Verywell
Over-the-counter medications can be a valuable tool in managing your migraines or headaches. Remember, what works well for someone else may not work as well for you, so you may need to try a few to decide which one works best for you.
It’s also important to know that taking too much over-the-counter medication for your headaches and migraines can trigger medication overuse headaches.