Pharmacists can play a vital role in educating patients about headaches and can help to limit their impact on the patient.
What is a Headache?
Headaches are a very common condition that most people will experience many times throughout their lifetime. A headache is characterized as a pain in the head or face that is often described as a pressure that is throbbing, constant, sharp, or dull. Headaches can differ in presentation depending on the type of headache, the location, and the severity. For some, headaches can be very debilitating and an inconvenience to daily living activities.
Around 96% of people have experienced a headache at least once during their lifetime.1 Headaches can affect anyone, including children and adults.1,2 There are many types of headaches, such as migraine headaches, tension headaches, sinus headaches, and drug-induced headaches.1 Tension headaches are the most common type of headache and are often managed with OTC medications. Additionally, many patients can treat their headaches at home with the right lifestyle modifications and medications.
Pharmacists can play a vital role in educating patients about headaches and can help to limit their impact on the patient. In addition to patient education, pharmacists can also recommend the patient visit their provider to discuss treatment options as OTC products may not be effective for all patients.3
When a patient presents seeking advice from a pharmacist, pharmacists should first seek to understand the symptoms and the frequency of the patient’s headaches. The Characteristics of Headaches for Referral chart (below) provides a list of items to look for when determining whether a patient should be referred to seek additional medical attention. If a patient is determined to be eligible for self-treatment, pharmacists can recommend a variety of non-pharmacological and OTC treatments for patients.
When to Refer Patients to Seek Medical Attention
Although headaches are often self-managed and are rarely dangerous, if the headache is accompanied by other characteristics, advise the patient to seek medical attention. Some examples of these characteristics are:1-4
Non-Pharmacological Treatment of Headaches
Patients should attempt to treat their migraines first without using medication.Helping patients identify their individual triggers and educating them about the importance of avoiding them could reduce the frequency of headaches.1
There are certain lifestyle factors that are common triggers of headaches.It is important for patients to recognize what triggers their headaches in an efforts to prevent a headache from occurring. Common triggers include, but are not limited to:1,2
OTC Treatment of Headaches
Patients often reach out to pharmacists to seek advice on how to select OTC products. The chart below summarizes many of the OTC products available while also indicating their place in therapy. As with any recommendation, pharmacists must ask if the patient is on any additional medications, has medication allergies, or has any other underlying conditions prior to making an OTC recommendation.
As a pharmacist assesses patients and considers recommendations, there are special populations that one should remain mindful of.6-8,10 Patients who are pregnant or breastfeeding have special considerations to ensure the safety of the fetus or child. Patients who are less than 18 years old or over the age of 65 years old may have dosing and other medication considerations to ensure optimal safety.
Headaches are a common condition that patients can experience at any age. Counseling patients on how to self-manage their headache pain is important and allows a sense of autonomy for each individual’s health management. Having general knowledge on headache management is essential for providing recommendations to patients and knowing when to refer them to their providers. Although this article aims to summarize key information regarding supporting patients with headaches, always be sure to reference drug information resources if unsure and refer patients when necessary.
1. Headaches. Cleveland Clinic. Reviewed August 29, 2022. Accessed November 6, 2023. https://my.clevelandclinic.org/health/diseases/9639-headaches
2. Ambizas EM, Ambizas AH. Nonprescription treatment options for migraine. US Pharm. 2016;41(1):31-34.
3. Acute therapy: Why not over-the-counter or other nonspecific options? American Migraine Foundation. July 30, 2016. Accessed November 6, 2023. https://americanmigrainefoundation.org/resource-library/acute-therapy-why-not-otc-options/
4. American Headache Society. The American Headache Society position statement on integrating new migraine treatments into clinical practice. Headache. 2019:59(1):1-18. doi:10.1111/head.13456
5. Ullman S. Can wearable ice packs really relieve migraine attacks? Everyday Health. January 24, 2023. Accessed November 6, 2023. https://www.everydayhealth.com/migraine/can-headache-hats-really-relieve-migraine-attacks/
6. Ibuprofen. Prescribing information. BASF. Updated December 21, 2022. Accessed November 6, 2023. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=8ea0e303-3967-4d71-8255-ac42a841ce28
7. Naproxen. Prescribing information. Reddy’s Laboratories. Updated January 16, 2023. Accessed November 6, 2023. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=29fc5a16-49ed-41ca-a296-bee34d1d12f6
8. Acetaminophen. Prescribing information. Mallinckrodt Pharmaceuticals. Updated January 3, 2019. Accessed November 6, 2023. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=9f7cca9d-4230-49d7-b805-a1fbc73e31c9
9. Acetaminophen, aspirin, and caffeine. Prescribing information. GSK. Updated March 28, 2023. Accessed November 6, 2023. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2c8df1c7-7864-48df-939c-d9ae22e0f52c
10. Aspirin. Prescribing information. Bayer. Updated June 15, 2021. Accessed November 6, 2023. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3f3fcba9-fdb9-46ce-a1dd-8271d2b3555c
11. Acetaminophen and children: Why dose matters. Mayo Clinic. June 30, 2022. Accessed November 6, 2023. https://www.mayoclinic.org/healthy-lifestyle/childrens-health/in-depth/acetaminophen/art-20046721
12. Ibuprofen dosing table for fever and pain. Healthychildren.org. Updated August 31, 2023. Accessed November 6, 2023. https://www.healthychildren.org/English/safety-prevention/at-home/medication-safety/Pages/Ibuprofen-for-Fever-and-Pain.aspx