ask the pharmacist
Richard Wenzel, Pharm. D. Diamond Inpatient Headache Unit Presence-Saint Joseph Hospital Chicago, Illinois
“ Thus, seemingly a simply task, taking an aspirin may not be so simple in reality.”
every day for the treatment of either migraine or other types of headaches is generally a poor idea. Daily or near-daily use of acute medications( including aspirin) places the individual at risk of developing rebound headache, which is a phenomena where too much medication consumption can actually increase the frequency and / or severity of the migraine attacks.
Individuals experiencing other headache disorders are also at risk of developing rebound headache if they repeatedly utilize their acute medication. As a general rule, patients should limit their acute medication use to an“ as needed” basis on 3 or fewer days per week. Patients needing acute drugs 4 or more days per week, particularly when this occurs multiple weeks per month, should consider seeing a physician. Thus, seemingly a simply task, taking an aspirin may not be so simple in reality. What should patients do? First, determine if an over-the-counter product( OTC) such as aspirin is appropriate; individuals who
experience debilitation( e. g. need to lay down and avoid work, home, or social activities) with the majority of their headaches are poor candidates for OTC products, regardless of whether the patient believes they have migraine or“ headache”. These individuals should seek a physician’ s evaluation. Individuals who experience headache on 15 or more days per month, again regardless of whether the patient believes they have migraine or“ headache”, should also seek a physician’ s help.
Patients who believe they have migraine should follow aspirin’ s migraine-dosing recommendations, while those without migraine should follow the aspirin’ s“ headache”– dosing recommendations. Over time, if aspirin fails to provide acceptable relief, then those patients should consider utilizing a different OTC product( e. g. ibuprofen) or consider an appointment with a physician. HW
30 HEAD WISE | Volume 3, Issue 1 • 2013