Over-the-Counter Migraine Medicine: What’s the Best Option for Migraine Relief?

When a migraine hits and you need quick relief, you might head to your local pharmacy. But as you’ll quickly realize, there are a lot of migraine medications on the shelves. So how do you know which one to pick?

Learn which active ingredients you should look for in over-the-counter (OTC) migraine medicines and how these compare to one another.

What are the best OTC migraine medicines?

Usually, there are a handful of ingredients you can expect to see on the label of an OTC migraine medication. They all target the main symptom of a migraine — head pain. These include:

• Acetaminophen (Tylenol)

• Ibuprofen (Advil, Advil Migraine, Motrin)

• Naproxen (Aleve)

• Aspirin

• Caffeine

You can find these ingredients on their own or combined together in one pill. And with all OTC migraine medicines, the best time to take them is right when your migraine pain starts.

With all of these options, it can be difficult to tell which one to choose. It can help to look at how the ingredients differ when it comes to how long they take to work, how much you need to take, and potential risks. Keep in mind that the brand-name and generic versions of OTC migraine medications should both work well. Here’s a breakdown of some of the most effective ones.

EXPERT PICKS: WHAT TO READ NEXT

• Natural remedies: Prescription and over-the-counter treatments can be effective for migraine relief. But if you’re interested in giving natural and home remedies a try, check out this review from experts to see which ones might be worth a shot.

• Real stories: When a migraine hits, it can affect your ability to work and do your normal day-to-day activities. Read about how three real people living with chronic migraines manage their symptoms every day.

• Which is best: Both products can help provide migraine relief, but is one better than the other? Read about how Advil Migraine and Excedrin Migraine compare.

1. Acetaminophen

Acetaminophen is a pain reliever that works well for migraine treatment. It’s thought to work by blocking certain brain chemicals that make you sense pain.

Onset: When you take acetaminophen by mouth, it usually takes about 45 minutes to kick in for migraine pain. And it may work faster on an empty stomach.

Dosage forms: Acetaminophen is available in dosages ranging from 325 mg to 650 mg. This includes tablets and capsules, an oral liquid, and powder packets. Combination products like Excedrin Migraine contain 500 mg of acetaminophen per dose (2 tablets).

Potential risks: Acetaminophen can damage your liver, especially if you take too much. This can be particularly risky if you have liver problems, or if you have more than 3 alcoholic drinks per day. In this case, ask your healthcare team before taking it.

Each acetaminophen product has a maximum recommended daily dosage on the label. For adults, this usually ranges from 3,000 mg to 4,000 mg of acetaminophen in a 24-hour period. Keep track of this amount to avoid taking too much, especially if you’re taking multiple products with acetaminophen. If you have a higher risk of liver damage, your healthcare team may recommend a lower amount.

2. Ibuprofen

Ibuprofen belongs to a group of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs work by blocking the effects of cyclooxygenase (COX) — an enzyme (protein) that’s involved in causing inflammation.

Onset: For migraine pain, ibuprofen should start working within 30 minutes, but it may take up to 2 hours to feel relief. You’ll notice that Advil Migraine limits the dosage to no more than 2 capsules in 24 hours. That’s to prevent rebound headaches, which we’ll cover later.

Dosage forms: For adults, OTC ibuprofen is available as 200 mg tablets, capsules, and liqui-gels. Of the available dosage forms, the liqui-gels may work the fastest. Higher-dose forms of ibuprofen are also available, but you’ll need a prescription from your prescriber.

Potential risks: Short-term NSAID use isn’t usually a big deal for most people. But long-term or high-dose ibuprofen has several risks. These include an increased risk of heart attack and stroke, stomach bleeds, and kidney damage. If you have a history of these conditions, check with your healthcare team before taking ibuprofen.

Similar to acetaminophen, be sure to monitor how much ibuprofen you’re taking, especially if you’re taking a few different products that contain ibuprofen. It’s possible to take too much, which increases the risk of serious side effects. Follow the instructions on the product label to stay within a safe amount. For most people, the maximum OTC daily amount is 1,200 mg. And take the lowest, most effective dose for the shortest time possible.

3. Naproxen

Naproxen is another NSAID available OTC for migraine pain. But some research suggests that naproxen may not work very well for migraine pain in many people.

Onset: For migraine pain, naproxen may start providing relief within 30 minutes to 1 hour of taking a dose. And compared to ibuprofen, naproxen lasts longer in your body. In general, you typically need to take it less often throughout the day.

Dosage forms: OTC naproxen is available as 220 mg tablets, capsules, and liqui-gels.

Higher-dose forms of naproxen are available with a prescription from your prescriber.

Potential risks: Naproxen has similar risks as ibuprofen, and it can also be harder on your stomach. So, it’s best to check with your healthcare team before taking naproxen to ensure it’s safe for you.

It’s also possible to take too much naproxen. Unless otherwise directed, stick to the instructions on the product label. It will usually say you can take up to 660 mg (3 tablets) in a 24-hour period.

4. Aspirin

Like ibuprofen and naproxen, aspirin is an NSAID. It’s available OTC and with a prescription.

Onset: For migraine pain, aspirin typically starts working within 30 minutes of taking a dose.

Dosage forms: OTC aspirin is available in dosages ranging from 81 mg to 650 mg. The 81 mg tablets (also called low-dose aspirin) are more often used for preventing blood clots. So, you’ll typically take higher doses for migraine pain. OTC combination migraine products with aspirin typically contain 500 mg per dose (2 tablets).

Potential risks: Aspirin doesn’t have the same cardiovascular risks as other NSAIDs. But it can increase the risk of bleeding. And while rare, it’s also linked to a life-threatening condition called Reye’s syndrome. For this reason, people younger than 19 years old should avoid taking aspirin since Reye’s syndrome is more common in this age group.

Taking too much aspirin can result in a serious condition called salicylate toxicity. Symptoms include rapid breathing, confusion, and ringing in your ears. Be sure to follow the recommended dosing on your product’s label to minimize this risk. 

5. Caffeine

Caffeine is found in both OTC and prescription migraine medications. It’s thought to work by blocking a chemical in the brain to help lower pain sensations. And it may boost the effects of other OTC migraine medications (like acetaminophen or aspirin) when it’s combined with them.

Dosage forms: OTC combination migraine products typically contain 130 mg of caffeine per dose (2 tablets). This is roughly the amount of caffeine in a cup of coffee, depending on brewing time. Alternatively, some people may take caffeine (as drinks, foods, or tablets) at the same time as other pain relievers.

Potential risks: Caffeine can increase blood pressure. If you have high blood pressure or heart disease, talk to your healthcare team before taking any medication with caffeine.

Caffeine can also trigger migraine headaches for some people. Occasional use for migraine relief might be OK. But regularly ingesting caffeine (through medications, foods, or drinks) can make it less effective for migraine pain. This can also lead to dependency and caffeine-withdrawal headaches.

6. Combination OTC migraine medications

As mentioned above, you can find some of these ingredients together in combination products. Excedrin Migraine is one popular example. It contains acetaminophen, aspirin, and caffeine. You can find this combination as brand-name Excedrin Migraine and as generic versions.

If you’re taking Excedrin Migraine for relief, you shouldn’t take more than two tablets within 24 hours. Similar to Advil Migraine, this is to prevent rebound headaches.

Some research suggests that this combination may work better and faster than ibuprofen for migraine pain. But before giving it a try, check with your pharmacist or prescriber to ensure all of these ingredients are safe for you to take.

Take our quiz: OTC pain medications

What are some risks with OTC migraine medications, and who should avoid them?

We’ve covered several of the risks of each active ingredient above. But there are a few others that you should know about.

Rebound headaches

Rebound headaches (or medication overuse headaches) can happen with OTC migraine medications. They’re more likely to happen if you’re consistently taking more than the recommended amount or taking a medication more than 10 days per month. 

If you need frequent migraine relief, ask your healthcare team about preventive medication options. These treatments can help lessen migraine frequency.

Interactions

OTC migraine medications can potentially interact with other medications you’re taking. For example, NSAIDs can interact with blood thinners, certain blood pressure medications, and diuretics. And caffeine can interact with medications, too. Your pharmacist can review your current medication list to flag potential interactions up front.

Medical conditions

If you have certain medical conditions, some OTC migraine medications may not be safe for you to take. High blood pressure, heart problems, and kidney disease are just a few. Ask your healthcare team which options may be safest for your particular situation.

Why trust our experts?

Written by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Our editorial standards

Meet our experts