Medications That Can Cause Headaches
A variety of medications can aggravate a migraine. Learn how to track your meds to avoid triggering symptoms.
There are a variety of medications — some of which you might take for another condition — that can either lead to, or aggravate, a migraine.
You'll need to work with your doctor and pharmacist to figure out if any of the drugs are triggering your types of headache. You can start by using a medication tracker, headache diary, or calendar to keep track of all of your medicines. People with vision problems or those who have difficulty reading can use a simple color-coded chart that lists all medicines, each labeled with a unique color. Use sticky colored labels or colored markers to match your medication bottles with that chart. Then check off those colored blocks when you take the medicine. Tracking your intake of medications will help your doctor to pinpoint what's causing your headache.
A survey by the National Headache Foundation found that 89 percent of people with migraine also have other health conditions, which means they may be taking drugs to manage those conditions too. The most common co-occurring conditions are depression, anxiety disorder, chronic fatigue, asthma, and fibromyalgia.
First, Make a Medication List
"You should tell all of your doctors and [your] pharmacist what medicines you're on, since most people seek help from their primary care doctor instead of a neurologist or headache specialist," says Seymour Diamond, MD, executive chairman of the National Headache Foundation, director and founder of the Diamond Headache Clinic, and the director of the Inpatient Headache Unit at Saint Joseph Hospital, all in Chicago. "Sometimes other doctors who don't deal with headaches [have] no concept of the effect that different drugs or combinations might have for a migraine sufferer. But usually, any headache expert that deals with difficult cases will be able to help you identify which drugs are causing your headaches."
Dr. Diamond says that migraine sufferers should know that certain specific drugs are typical triggers for a big headache, such as:
Any kind of stimulant, such as diet pills
Birth control pills or any other type of hormone therapy
Drugs that contain nitrates, such as blood pressure medications. Nitrates increase vasodilation (swelling of blood vessels), which can result in a migraine
"Certain cardiac medicines, especially any related to the nitrates, nitroglycerin, or even a nitro patch for angina all can precipitate a migraine," Diamond says. "You should keep a diary to track the drugs you take [and the] symptoms that result, and then consult with your doctor because there might be some other medication that he can use as a substitute."
With help from your doctor, you may be able to find alternative medications to manage other medical conditions as well.
Opioids and Barbituates: A Warning
A recent study published in the journal Headache found that migraine sufferers who overuse opioids and barbiturates, including butalbital, codeine, and oxycodone, to treat their migraine are actually at risk for developing chronic migraine. This is defined as having migraines on 15 or more days per month.
Researchers surveyed more than 8,000 people with episodic migraines (migraines less than 15 days per month). Among that group, those who took these types of drugs for as few as eight days out of a month were two times as likely to develop a chronic migraine one year later, compared to others who didn’t take the drugs. The researchers recommended that migraine sufferers set limits on how often they take opioids and barbiturates to treat the pain.
You can break the cycle by stopping use of opioids and barbiturates. Your headache may seem worse for three to five days, and you may also have nausea and vomiting. But after this period, the symptoms will begin to improve.
On the other hand, other medications for migraines, such as triptans and non-steroidal anti-inflammatory medications (e.g. ibuprofen), do not increase the risk of developing a chronic migraine.
Migraine prevention requires special attention to your medications — whether they are medications for other conditions, or pain medications such as oxycodone which can make migraines worse.