Headache — what to take?

Types of headache and how to recognise them

Tension-type headache is the most common form - it presents as bilateral pressure, like a tight band around the head, of mild to moderate intensity. It typically appears in the evening after a long day at the office and is not aggravated by routine physical activity.

Migraine is different: pulsating pain, usually unilateral, accompanied by nausea, sensitivity to light and sound, lasting 4-72 hours. Cluster headache is a rare but extremely intense form, localised around one eye.

Secondary headache arises from another cause - sinusitis, hypertension, dehydration, alcohol use, sleep apnoea, chronic analgesic overuse. If the pain is new, unusual or rapidly worsening, the cause must be investigated.

What you can take for an occasional headache

For a mild-to-moderate tension headache, paracetamol 500-1000 mg is the first choice - good safety profile, does not irritate the stomach. Maximum dose in adults is 4 g/24h, and less in people with liver impairment.

Ibuprofen 200-400 mg is an effective alternative, especially when there is also an inflammatory component (sinus, muscular). Take it with food to protect the stomach; it is contraindicated in people with ulcer, kidney disease or in the last trimester of pregnancy.

Acetylsalicylic acid (aspirin) 500 mg remains effective, but is not given to children under 16 (Reye syndrome risk). Combinations with caffeine (paracetamol + aspirin + caffeine) act faster.

Golden rules for OTC analgesics

• Do not exceed recommended doses and do not combine two NSAIDs simultaneously.
• Do not take analgesics more than 10-15 days per month - risk of medication-overuse headache (MOH).
• Hydrate: many headaches clear up after 500 ml of water.
• If pain returns within 4h, increasing the dose in an adult is safer than taking a second dose too quickly - but respect the MDD.

Non-pharmacological measures that work

Rest in a dark room, apply a cold compress to the forehead or a warm one to the nape, try deep breathing techniques. A mint or chamomile tea can help, as can a handful of almonds (magnesium helps in migraine).

For chronic headache, keep a diary - you will identify triggers (stress, sleep, food, hormonal cycle) and can prevent episodes.

When to see a doctor

Some headaches are warning signals and should not be ignored. See the dedicated section below for the full list of symptoms requiring immediate evaluation.

For recurrent headaches or those that affect your quality of life, talk to your family doctor - there are effective preventive treatments (beta-blockers, topiramate, triptans for migraine) that are not OTC but can make a difference.

Medical disclaimer: the information in this guide is for informational purposes only and does not replace the advice of a physician or pharmacist. For diagnosis and treatment, consult a healthcare professional.