HEADACHE AND FACIAL PAIN: DRUGS FOR MILD-TO-MODERATE MIGRAINE AND TENSION-TYPE HEADACHE PAIN

* Nonsteroidal anti-inflammatory drug

How are nonprescription analgesics taken?

These drugs are taken as tablets, syrups or suppositories. Take nonsteroidal anti-inflammatory agents, such as aspirin, ibuprofen and naproxen, with a full glass of water and wait 15 to 30 minutes before lying down. To lessen stomach upset, take with food or an antacid. Sometimes these drugs are combined with caffeine, which enhances their effectiveness.

Physicians recommend that you take these drugs for no more than three days a week. Like most drugs for acute migraines, they should be taken at the earliest stages of a headache in hopes of stopping the attack. Do not take more than is recommended on the package label, unless directed by your physician. Acetaminophen-containing products should not be taken with alcohol or if you have been fasting.

What are the possible side effects?

Side effects of these medications may include:

· Cramps

· Diarrhea

· Dizziness

· Drowsiness

· Heartburn or indigestion

· Nausea or vomiting

Side effects from acetaminophen are rare; however, notify your physician if you notice any unusual symptoms.

When should I call my physician?

For nonsteroidal drugs, call your physician if you experience fainting; fast or irregular breathing or pulse; or swelling of the face, eyelids, mouth, lips or tongue.

For acetaminophen, call your physician if you have change in skin color, nausea, vomiting, stomach pain, diarrhea or other symptoms that cause severe discomfort.

In addition, inform your physician if the drug fails to relieve your headaches when taken in the proper dosage.

Are there drugs I shouldn't take with nonprescription analgesics?

Some medications interact poorly with these drugs, or contain dosages of the same drugs. That's why it is very important to tell your physician about all other medications you take. If you are taking more than an occasional dose of some analgesics, your physician may advise you to avoid drinking alcoholic beverages.

What does combining these drugs do?

Narcotic analgesics and aspirin used together may provide better pain relief than using either drug alone. Sometimes pain relief will come with lower doses of each drug. But care must be taken in their use because these narcotics can disturb normal brain function, impair coordination and thinking, and be habit-forming when used over a long time or in large doses. Aspirin and acetaminophen can cause other unwanted effects when overused.

How are narcotic analgesics taken?

These drugs are taken orally in tablet form; propoxyphene also comes in capsules. Take these drugs with food or a full glass of water to reduce stomach irritation. Use this medication only as directed by your physician. As with most other headache remedies, these drugs work best when taken as soon as you are sure that a migraine is on the way.

What are the possible side effects?

Side effects of these medications may include:

· Dry mouth

· Dizziness

· Drowsiness

· Heartburn

· Nausea or vomiting

· Mild stomach pain

· Blurred vision

· Constipation

Other side effects include sedation, loss of coordination and impairment of activities, such as driving.

When should I call my physician?

Call your physician if you think that the drug is becoming less effective after taking it for a few weeks. Do not try to make it work better by increasing the dose.

Also, call your physician immediately if you have clammy skin, confusion, trouble breathing, extreme weakness or other severe reactions.

In addition, before having any kind of surgery, notify the physician in charge that you are taking an opioid (i.e., narcotic) analgesic. Discontinue it for five days before surgery, unless your physician says otherwise.

Are there drugs I shouldn't take with narcotic analgesics?

Your physician may need to adjust your dosage of these drugs if you also are using certain other medications that can affect bleeding, aspirin's absorption by the body, or other factors. Avoid taking these medications with other central nervous system depressants, such as alcohol, antihistamines, sedatives and sleeping medications. Always tell your physician what other drugs you are taking.

What does combining these drugs do?

Combining these medications makes them more effective than their separate components. Butalbital, a barbiturate, relaxes you, while aspirin relieves your headache pain. Caffeine is believed to speed absorption of the drug into your body, thus enhancing its effectiveness.

How are these drugs taken?

These drugs are taken orally in tablet form; the preparations with caffeine also come in capsules. Take them with food or a full glass of water to reduce stomach irritation. Use these medications only as directed by your physician. Butalbital is a barbiturate and can become habit-forming over a long time or in large doses. In addition, caffeine can cause physical dependence. If you take a butalbital product daily, do not discontinue taking the medication because the withdrawal symptoms can be severe; talk to your doctor.

As with many other headache remedies, these drugs are most effective when taken as soon as you are sure that a migraine is beginning. Lying quietly in a dark room for a while after taking the medication also may help.

What are the possible side effects?

Some people have mild side effects, such as:

· Bloating

· Dizziness

· Drowsiness

· Heartburn or indigestion

· Nausea, vomiting or stomach pain

When should I call my physician?

Although rare, allergic reactions can occur. Call your physician immediately if your skin turns bluish or flushed, if you are coughing or have trouble breathing or swallowing, or if you feel severely dizzy or faint.

In addition, tell your physician if your headaches have become more frequent since you started taking the drug or if it no longer works as well as it did at first. If you need to use the medication more than two to three times a week, contact your physician. Do not try to make the drug work better by increasing the dose.

Are there drugs I shouldn't take with aspirin or acetaminophen/sedative combinations?

Your physician may need to adjust your dosage of certain other medications you are taking that can affect bleeding, aspirin's absorption by the body or other factors. Always tell your physician if you are taking other medications.