Excedrin vs. Advil: Which OTC Medicine Is Best For Headache and Migraine?
Key takeaways:
While many people get headaches every now and then, some people have migraines. Migraines are a neurological condition, often defined by painful headaches, that can be severe and last up to a few days.
Several medications are available to help treat or prevent migraines. Some are available over-the-counter (OTC), and others are only available with a prescription.
Two common OTC migraine treatments are Advil Migraine and Excedrin Migraine. Advil Migraine contains ibuprofen, while Excedrin Migraine contains three active ingredients.
Migraines are a neurological condition, often defined by painful headaches, that affect over 29 million people in the U.S. — with 3 in 4 people being women. When you have a migraine, you may feel pain on one or both sides of your head. Some people also have sensitivity to light and sound, while others may develop nausea and vomiting. These symptoms can all come together to create an intense experience.
Thankfully, many medications are available to treat or prevent migraine symptoms. They work in different ways to offer varying amounts of relief.
Advil Migraine and Excedrin Migraine are two convenient, over-the-counter (OTC) options you can find at your local pharmacy. But is one better than the other?
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What is Advil Migraine?
Advil and Advil Migraine are oral medications that contain the same active ingredient and dosage: ibuprofen 200 mg. But Advil Migraine comes as a liquid-filled capsule that helps it absorb into your body more quickly than traditional Advil tablets.
Regardless of branding, ibuprofen belongs to a group of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It helps reduce inflammation (swelling) and pain. This comes in handy when treating many types of pain, including:
Tooth pain
Mild arthritis pain
Muscle aches
How does Advil Migraine work?
Much of the pain you feel in your body, including migraine pain, can be linked to chemicals called prostaglandins. These inflammation-causing chemicals are released during an injury or illness and can lead to pain, redness, and swelling. Cyclooxygenase (COX) is an enzyme (protein) that helps your body create prostaglandins.
Ibuprofen and other NSAIDs work by blocking COX enzymes. Without these enzymes, your body makes fewer prostaglandins. This contributes to inflammation control and pain relief.
What is Excedrin Migraine?
Excedrin Migraine is another oral OTC migraine medication. One of the key differences between Advil Migraine and Excedrin Migraine is that Excedrin Migraine is a combination medicine with three active ingredients:
250 mg acetaminophen (Tylenol)
250 mg aspirin
65 mg caffeine
When you put all three of these ingredients together, they form a strategic combination that can be helpful in treating migraines.
How does Excedrin Migraine work?
Aspirin is an NSAID. So, it works the same way as the ibuprofen in Advil Migraine — it blocks COX to treat pain and swelling. But what about acetaminophen? And why is there caffeine?
Let’s start with acetaminophen. Unlike NSAIDs, acetaminophen doesn’t reduce inflammation. But it’s an effective pain reliever that’s thought to work by blocking pain signals in your central nervous system.
Caffeine works in another way. Blood vessels inside your brain may also play a role in migraines. Blood vessels sometimes dilate (become wider) before or during migraine attacks. Caffeine helps constrict those blood vessels, which helps relieve pain. Caffeine also makes pain relievers like acetaminophen and aspirin more effective.
Which works better for migraines: Advil Migraine or Excedrin Migraine?
Advil Migraine and Excedrin Migraine are both effective for treating migraines. Research shows that the ingredients in Excedrin Migraine are more effective at reducing migraine pain than ibuprofen. The ingredients in Excedrin Migraine also kick in about 20 minutes faster. But, there are still some things to consider before choosing between these two OTC products (we’ll get into side effects in a bit).
| Advil Migraine | Excedrin Migraine | |
|---|---|---|
| Ingredients | Ibuprofen 200 mg | Acetaminophen 250 mg
Aspirin 250 mg Caffeine 65 mg |
| Dose | 2 capsules with a glass of water | 2 tablets with a glass of water |
| Maximum daily dose | No more than 2 capsules within 24 hours | No more than 2 tablets within 24 hours |
Keep in mind: Both medications are taken by mouth. This can be a problem if you’re experiencing significant nausea with your migraine. If this is the case, your migraines may be better treated by a prescription migraine medication that comes in another form, such as a nasal spray or injection.
What are the key differences between Advil Migraine and Excedrin Migraine?
Advil Migraine and Excedrin Migraine are comparable medications. But these key differences separate the two:
Different ingredients: Advil Migraine contains ibuprofen. Excedrin Migraine, on the other hand, is a combination medication that contains aspirin, acetaminophen, and caffeine.
Differences in how they work: Advil Migraine only works one way, which is by blocking COX. Excedrin Migraine has three ingredients that work in different ways to relieve your symptoms.
Time to start feeling relief: Excedrin Migraine may start working slightly faster for some people.
What are common side effects of Advil Migraine and Excedrin Migraine?
All medications, including OTC medications, can cause side effects to some degree.
When it comes to OTC migraine medications, there are some general side effects to keep in mind. If you find yourself using either medication more than 2 days per week, consider talking to your healthcare provider about other treatment options. This is because overusing these medications can cause medication overuse headaches (MOH) — also known as rebound headaches. This is when you can experience a new or worsening headache or migraine on top of your current symptoms.
Otherwise, side effects are more medication specific.
NSAID side effects
Advil Migraine and Excedrin Migraine both contain NSAIDs, which are known to be tough on the stomach. They can cause stomach upset and raise the risk of stomach ulcers, although ibuprofen may cause less stomach irritation than aspirin.
If you have a history of stomach issues, your healthcare provider may recommend avoiding NSAIDs altogether, if possible. This includes conditions like peptic ulcer disease, inflammatory bowel disease, or a previous gastric bypass surgery.
Another issue with NSAIDs is they can worsen your bleeding risk. And if you’re also taking blood thinners or oral corticosteroids, your risk of stomach bleeding may be even higher. And although the risk is relatively small, all NSAIDS (except aspirin) can raise the likelihood of certain heart problems, including heart attack or stroke.
Caffeine side effects
The caffeine in Excedrin Migraine could pose a problem for anyone who is prone to sleep issues, like insomnia, trouble falling asleep, or trouble staying asleep.
Just as with caffeinated drinks, if you get too much caffeine from Excedrin Migraine, you could get caffeine withdrawal headaches when you stop using the medication. Plus, caffeine itself may also trigger migraines.
Acetaminophen side effects
Acetaminophen is generally considered safe at recommended doses. It’s well-tolerated, too.
However, taking too much acetaminophen can be tough on your liver. If you take Excedrin Migraine with other products that contain acetaminophen — such as Tylenol or various cough and cold products — you can raise your chances of liver damage.
What’s more, if you drink more than three alcoholic drinks per day while consistently taking Excedrin Migraine, your risk for liver damage may be even higher.
Can I take Advil Migraine and Excedrin Migraine together?
No. Taking Advil Migraine and Excedrin Migraine together isn’t recommended. Doubling up on these medications may raise your risk of side effects without providing additional migraine-treating benefits.
It’s best to stick to just one OTC medication to treat your migraines. But if one medication isn’t working well enough on its own, talk with your healthcare provider about trying a different OTC or prescription medication. Certain migraine medical devices are also available.
Can Tylenol help headaches and migraines?
Yes, Tylenol (acetaminophen) can help treat headaches and migraines. Tylenol is a potential alternative option if you can’t take NSAIDs. But it’s more effective in combination with other migraine-fighting ingredients, like in Excedrin Migraine.
The bottom line
Several medications can treat and prevent migraines. Many of the initial go-to treatment choices are OTC medications like Excedrin Migraine and Advil Migraine. While both products are effective, Excedrin Migraine may have a slight edge over Advil Migraine.
Still, the “best” migraine treatment medication is different for everyone. Make sure to speak with your healthcare provider to find the right migraine treatment for you.
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References
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