Migraines affect around 1 in 7 people in the UK — making it one of the world’s most common disabling conditions. Yet many people don’t know the most effective treatments available without a prescription. Here’s the pharmacist’s guide.

Types of Headache: Why It Matters

Tension-type headache — the most common type. A dull, pressure-like pain, often described as a “tight band” around the head. Usually bilateral. Responds well to paracetamol or ibuprofen. Linked to stress, dehydration, eye strain. Migraine — typically unilateral (one side), pulsating, moderate to severe, often with nausea and sensitivity to light and sound. May be preceded by an “aura” (visual disturbances, tingling). Cluster headache — extremely severe, unilateral, around the eye. Requires specialist treatment. Medication-overuse headache — caused by taking OTC painkillers too frequently (more than 10–15 days per month).

Best OTC Treatments for Tension Headache

Paracetamol 1000mg or ibuprofen 400mg at onset. Take early — waiting until pain is severe reduces effectiveness. Caffeine combined with paracetamol or aspirin (Anadin Extra, Solpadeine Headache) enhances analgesic effect. Stay hydrated.

Treating Migraines OTC

Ibuprofen 400mg at onset — one of the most effective OTC treatments for migraine. Take as soon as the headache phase begins (not in aura). Aspirin 900mg — strong evidence, comparable to ibuprofen. Sumatriptan 50mg — a triptan medication, available as a P-medicine from UK pharmacies (Imigran Recovery). Triptans are migraine-specific: they work by constricting the dilated blood vessels driving migraine pain. They are more effective than standard analgesics for true migraine.

Managing Nausea

Nausea is a prominent migraine feature and also slows gastric emptying, reducing absorption of oral pain relief. Domperidone or metoclopramide (prescription) taken before the analgesic speeds absorption and treats nausea. OTC: ginger tablets, buccastem (prochlorperazine buccal) — available from pharmacies.

Migraine Prevention — Supplements with Evidence

  • Magnesium 400mg/day — strong RCT evidence for reducing migraine frequency. NICE includes it in guidance as a consideration.
  • Riboflavin (Vitamin B2) 400mg/day — reduces frequency in several clinical trials. Very safe.
  • CoQ10 300mg/day — some evidence for frequency reduction.

Shop Migraine Medicines at Chemist 2 Customer. Related: Pain Relief 101, Ibuprofen vs Paracetamol.