For Headache Sufferers
Find my headache
We assume a doctor has first diagnosed your headache type.
Click on the type of headache to find out more about symptoms and the approach to treatment (video or information sheet formats).
Look at the Treatment Tables for your particular headache- these are taken from the British Association for the Study of Headache guidelines and will help you better understand the options available.
A shortcut to all information sheets is in the tabs below.
You can find out about upcoming Patient Events by clicking here
You may wish to print the treatment table/information sheets to bring to a consultation.
Download Migraine overview information sheet.
Download Migraine symptoms sheet.
Download Acute Treatments sheet.
Download Preventative Treatments sheet.
Download Menstrual Migraine sheet.
Download Pregnancy & Breastfeeding sheet.
Download Migraine & Stroke sheet.
Recommended acute treatments – simple analgesics and antiemetics
DRUG | DOSE | MAXIUMUM DOSE | INFORMATION |
|---|---|---|---|
Simple Analgesics | |||
ASPIRIN 144-148
| 600-1000 mg (UK doses are 300-900 mg) | 4000 mg (for oral dosing) | |
DICLOFENAC 149-152
| 25mg | 150mg | |
IBUPROFEN 153-155 | 400-600mg | 2400mg | |
KETOPROFEN 156,157
| 75-150mg | 150mg | |
NAPROXEN 158-160
| 250mg | 1000mg | |
PARACETAMOL 133,161
| 1000mg | 4000mg | |
TOLFENAMIC ACID 162
| 200mg | 400mg | |
Antiemetics
| |||
DOMPERIDONE 133
| 10mg | 30mg | Safety alert: MHRA-Domperidone |
PROCHLORPERAZINE 163-165
| 10mg | 0mg | |
METOCLOPRAMIDE 132,166,167
| 10mg | 30mg | Safety alert: MHRA-Metoclopramide |
Recommended acute treatments – triptans
DRUG | FORMULATION | STRENGTH | SINGLE DOSE | MAX/24 HOURS |
|---|---|---|---|---|
ALMOTRIPTAN 168,169
| TABLET | 12.5mg | 12.5mg | 25mg |
ELETRIPTAN 170
| TABLET | 40mg | 40mg | 80mg |
FROVATRIPTAN 171
| TABLET | 2.5mg | 2.5mg | 5mg |
NARATRIPTAN 172
| TABLET | 2.5mg | 2.5mg | 5mg |
RIZATRIPTAN 173
| TABLET ORODISPERS LYPOPHILLISATE | 5 mg/10 mg 10 mg 10 mg | 10 mg 10 mg 10 mg | 20 mg 20 mg 20 mg |
SUMATRIPTAN 137,174
| TABLET SPRAY SUBCUT INJ | 50 mg/100 mg 100 mg/ml or 200 mg/ml 6 mg | 50-100 mg 10 - 20 mg 6 mg | 300 mg 12 mg |
ZOLMITRIPTAN 175-177
| TABLET ORODISPERS SPRAY | 2.5 mg/5 mg 2.5 mg/ 5 mg 50 mg/ml | 5 mg 5 mg 5 mg | 10 mg 10 mg 10 mg |
DRUG | START DOSE | TITRATION | TRIAL STUDIED DAILY DOSES |
|---|---|---|---|
Amitriptyline 187-191
| 10-25 mg OD | 10 -25 mg | 25-150 mg |
Candesartan 192,193
| 2 mg OD | 2mg | 8-16 mg total/day |
Propranolol 187,194,195
| 10 mg BD | 10-20 mg BD | 120-240 mg total/day |
Topiramate 196-205
| 25 mg daily | 25 mg od | 25-200 mg total/day |
CGRP Monoclonal Antibodies
| |||
Erenumab 206-209
| 70-140 mg monthly | Max dose as per licensed indication | |
Fremanezumab 210
| 225 mg monthly 675 mg three-monthly | Max dose as per licensed indication | |
Galcanezumab 211-213
| 120-240 mg monthly | Max dose as per licensed indication | |
Onabotulinumtoxin A214-218
| 155-195 IU intramuscularly, as per PREEMPT protocol | Every 12 weeks |
DRUG | FORMULATION | STRENGTH |
|---|---|---|
FROVATRIPTAN 255,256
| TABLET | 2.5 mg twice daily on the days migraine is expected (generally from two days before until three days after bleeding starts). |
ZOLMITRIPTAN257
| TABLET | 2.5 mg twice or three times a day on the days migraine is expected (generally from two days before until three days after bleeding starts). |
Download Tension Type Information sheet.
Recommended acute treatments in tension-type headache
ANALGESIC | SINGLE DOSE | MAXIMUM DAILY DOSE |
|---|---|---|
Paracetamol 321-323
| 1000mg | 4000mg |
Aspirin 324,325
| 500-1000mg (UK doses are 300-900mg) | 4000mg (for oral dosing) |
Recommended preventive treatment in tension-type headache
DRUG | STARTING DOSE | TITRATION | MAXIMUM DOSE |
|---|---|---|---|
Amitriptyline 326-330
| 10mg | 10-25mg | 150mg |
Download Medication Overuse Headache information.
Recommended Acute Cluster attack treatments
Treatment | Formulation | Strength | Maximum Daily Dose |
|---|---|---|---|
Oxygen 373,374
| Inhalation through non-rebreathable mask | 7-15 L/min | No limit |
Sumatriptan 368 | Subcutaneous injection | 6mg | 12mg |
Sumatriptan 375
| Nasal spray | 20mg | 40mg |
Zolmitriptan 376-378
| Nasal spray | 5mg | 15mg |
Non-invasive vagal nerve stimulation 379
| Transcutaneous | As per specialist recommendation |
Recommended preventive treatments for cluster headaches
Name | Start Dose | Titration | Maximum Daily Dose | Comments |
|---|---|---|---|---|
Greater occipital nerve block 388,389
| Depot steroid + local anaesthetic | Not applicable | Not applicable | Different formulations of steroid & anaesthetic used* |
Verapamil 384
| 80 mg TDS | increase 80 mg every 2 weeks | 960 mg | ECG monitoring recommended |
* *There does not seem to be a difference between different local anaesthetics |
Download Paroxysmal Hemicrania information sheet.
Download Hemicrania Continua information sheet.
Download SUNCT or SUNA information sheet.
What you can do to help yourself and help your doctor.
Headache sufferers can use this diary to keep a track of how often they have headaches and how severe they are.
When are brain scans needed for a headache?
This is a guide to the phenomenon of 'incidental findings' - discoveries on scans that the doctors were not looking for.
What is migraine and how common is it?
Guide to common symptoms of migraine.
How to treat migraine attacks when they happen.
Treatments that can prevent migraine attacks starting.
Menstrual migraine treatment options.
Migraine treatment options during and after pregnancy.
Information about how migraine affects the chances of having a stroke.
A guide to amitriptyline use for migraine.
A guide to candersartan use for migraine.
A guide to propranolol use for migraine.
A guide to topiramate use for migraine.
A guide to using triptans for migraine.
A guide to verapamil use for cluster headache.
A guide to GON block for headache.
A guide to botox injections for chronic migraine.
Download our research information.