Which Painkiller Is Best for a Headache?

Paracetamol, ibuprofen and aspirin can all ease a headache. Here is how to choose, how to use them safely, why taking them too often backfires, and when a headache needs a doctor.

Medically reviewed by Dr. Roshan Basnet, MBBS, MD (Internal Medicine) on 2026-09-06. See the medical review policy.

Quick answer: For most everyday headaches, one full adult dose of paracetamol, ibuprofen or aspirin, taken early, is enough. Ibuprofen and aspirin (anti-inflammatory painkillers) often work best for tension headaches and migraine; paracetamol is the gentlest on the stomach and is usually the safest choice in pregnancy. The single most important rule is not to take painkillers for headache on more than two to three days a week — frequent use causes "medication-overuse headache", where the painkillers themselves keep the headache going.

Key takeaways

• The main over-the-counter options are paracetamol (acetaminophen), ibuprofen, aspirin and naproxen.
• Take a full dose early, with food if it is an anti-inflammatory, rather than a small dose once the headache is severe.
• Paracetamol is easiest on the stomach; anti-inflammatory painkillers tend to be more effective for tension-type headache and migraine.
• Never exceed the daily maximum on the label, and do not combine two products that both contain the same ingredient.
• Using acute painkillers on 10–15 or more days a month for over three months can cause a daily "medication-overuse headache".
• Some headaches are warning signs. Sudden, severe, or headache with fever, a stiff neck, weakness, confusion or vision changes needs urgent medical care.

Which painkiller should I take for a headache?

All the common options can relieve a typical tension headache or a mild-to-moderate migraine. The best one for you depends on your health, other medicines, and what you can tolerate.

Paracetamol (acetaminophen)

Paracetamol is a sensible first choice for a routine headache. It rarely upsets the stomach, does not thin the blood, and is considered the safest option during pregnancy at the recommended dose. Follow the dose on the label and never take more than the stated daily maximum. The main danger is taking too much: an overdose, even a modest one taken over a day or two, can cause serious liver injury. Because paracetamol is hidden inside many cold, flu and combination pain remedies, check every product's ingredients so you do not take it from two sources at once. If you regularly drink alcohol, are underweight, or have a liver condition, ask a pharmacist how much is safe for you, and do not use it for more than about ten days without medical advice.

Ibuprofen, aspirin and other anti-inflammatory painkillers

Anti-inflammatory painkillers, known as NSAIDs, are often more effective than paracetamol for tension-type headache and for migraine attacks. Take them with or just after food to reduce stomach irritation, and use the lowest dose that works for the shortest time. They are not right for everyone. Speak to a pharmacist or doctor before using them regularly if you have or have had a stomach ulcer or indigestion, kidney disease, heart failure, poorly controlled blood pressure, or asthma that gets worse with these medicines, or if you take anticoagulant ("blood-thinning") medication. Ibuprofen and other NSAIDs are generally avoided in the second half of pregnancy. Aspirin should never be given to children or teenagers under 16 outside hospital because of a rare but serious condition called Reye's syndrome.

What about codeine and stronger painkillers?

Opioid painkillers such as codeine — often sold combined with paracetamol — are not recommended for ordinary headaches. The evidence that they help headache is weak, they cause medication-overuse headache faster than simple painkillers, and regular use can lead to tolerance and dependence. If simple painkillers are not controlling your headaches, the answer is a review with a doctor, not a stronger painkiller.

The biggest risk: medication-overuse (painkiller) headache

Painkillers taken too often for headache can, paradoxically, cause a constant headache of their own. This is called medication-overuse headache. It develops in people who already have a headache disorder (such as migraine or tension-type headache) and who use acute painkillers frequently for more than three months. The thresholds, based on international criteria, are:

• Simple painkillers (paracetamol, ibuprofen, aspirin, naproxen): on 15 or more days per month.
• Triptans, opioids, ergotamines and combination painkillers: on 10 or more days per month.

The result is a headache on 15 or more days a month that is often more frequent and more stubborn than the original one. The main treatment is to stop the overused medicine; reviews report that around half of people improve substantially within about eight weeks of stopping. To stay on the safe side, keep acute headache painkillers to no more than two days in any week, and see a doctor if you are needing them more often than that.

Things that help a headache without medicine

• Drink water — mild dehydration is a common, easily fixed trigger.
• Eat regularly; skipped meals and low blood sugar bring on headaches in many people.
• Keep a steady sleep routine, including at weekends.
• Watch your caffeine — both too much and sudden withdrawal can cause headache.
• Manage stress and take breaks from screens.
• Treat a headache early, when it is mild, rather than waiting for it to become severe.

When a headache needs a doctor, not a painkiller

Most headaches are harmless. Some are not. Get urgent medical help — call your local emergency number or go to an emergency department — if a headache:

• comes on suddenly and is extremely painful, like nothing you have felt before;
• follows a blow to the head;
• comes with a very high temperature, a stiff neck, a rash, or discomfort in bright light;
• comes with weakness or numbness, drooping of the face, vision loss, confusion, difficulty speaking or walking, or a seizure.

Make a routine appointment with a doctor if you have a new headache and are over 50, if your headaches are becoming more frequent or more severe, if a headache is consistently worse when lying down or when you cough or strain, if headaches wake you from sleep, or if you are pregnant and have a headache with swelling or visual disturbance. Also see a doctor if you are relying on painkillers for headache more than a couple of days a week.

Frequently asked questions

What is the best painkiller for a headache?

There is no single best one. Paracetamol is a good first choice if you want to avoid stomach effects or are pregnant. Ibuprofen or aspirin often works better for tension headaches and migraine. Try one at a full dose; if it reliably fails, a pharmacist can suggest an alternative.

Is ibuprofen or paracetamol better for headaches?

Ibuprofen tends to be more effective for tension-type headache and migraine because it reduces inflammation as well as pain. Paracetamol is gentler on the stomach and safer in pregnancy. If one does not work for you, the other may.

How often is it safe to take painkillers for a headache?

As a rule of thumb, no more than two days in any week for headache. Using acute painkillers on 10 to 15 or more days a month for several months can cause medication-overuse headache.

Can painkillers cause headaches?

Yes. Taken too frequently over months, painkillers and migraine medicines can cause a near-daily "medication-overuse headache". It usually improves once the overused medicine is stopped, though the headache can briefly get worse first.

What painkiller is safe in pregnancy?

Paracetamol at the recommended dose is generally considered the painkiller of choice in pregnancy. Anti-inflammatory painkillers such as ibuprofen and aspirin are usually avoided, especially after the middle of pregnancy. Always confirm with your midwife, pharmacist or doctor.

Why is my headache painkiller not working?

Common reasons are taking too low a dose, taking it too late, dehydration or a missed meal, caffeine withdrawal, or medication-overuse headache from frequent use. A headache that stops responding to usual painkillers, or that changes in pattern, should be reviewed by a doctor.

Medical disclaimer

This article is general health information and is not a substitute for professional medical advice, diagnosis or treatment. Doses and suitability differ from person to person. Always read the label, and check with a pharmacist or doctor before taking a painkiller if you have a health condition, take other medicines, are pregnant or breastfeeding, or are buying medicine for a child. Seek urgent care for any of the warning signs described above.

For related medicine and condition background, see Tylenol (acetaminophen), Ibuprofen and Ergotamine.

Educational information only. Always consult a qualified healthcare professional for medical advice.