Rebound headaches

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Causes

By Mayo Clinic staff

Nearly any pain reliever can contribute to rebound headaches. But some medications are more likely to lead to rebound headaches than are others.

  • Simple pain relievers. Common medications such as aspirin, acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin, others) may contribute to rebound headaches — especially if you exceed the recommended daily dosages.
  • Combination pain relievers. Over-the-counter pain relievers that contain a combination of caffeine, aspirin and acetaminophen (Excedrin, others) are common culprits. This group also includes prescription medications such as Fioricet, Fiorinal and Esgic, which also contain the sedative butalbital.
  • Migraine medications. Various migraine medications have been linked with rebound headaches, including ergotamine (Ergomar, others) and triptans (Imitrex, Zomig, others). Interestingly, the ergot dihydroergotamine appears to have a lower potential for leading to this problem.
  • Opiates. Painkillers derived from opium or from synthetic opium compounds include combinations of codeine and acetaminophen (Tylenol with Codeine No. 3 and No. 4, others). These can lead to rebound headaches as well.

Daily doses of caffeine — from your morning coffee, your afternoon soda, or any pain reliever or other product containing this mild stimulant — may fuel rebound headaches as well. Read product labels to make sure you're not wiring your system with more caffeine than you realize.

DS00613

Dec. 8, 2007

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