Triptans, beta blockers, antidepressants and other drugs prescribed for migraines come with serious risks. That's why migraine sufferers often reach for "safe" OTC painkillers like ibuprofen and acetaminophen. Unfortunately, reaching for them too regularly can raise risks as serious as those with Rx drugs. Let's take a look at those risks and how to avoid them.

February is Healthy Heart month, so we also take a look at the link between migraines and cardiovascular disease and ways to minimize your risks. Plus, we offer a way to keep stress from triggering migraines.

As always, we welcome your inputs about your own experiences as well as any topics you'd like us to address.

Amanda DiBenedetto

Linpharma Customer Education

OTC Painkillers Pose Special Risks for Migraine Sufferers

Just because we can buy painkillers like aspirin and acetaminophen at the grocery store doesn't mean we can use them for treating chronic migraine pain without risking serious side effects. The key is to recognize what the risks are and when they come into play. Let's take a look.

NSAIDs: This group of OTC painkillers includes non-steroidal anti-inflammatory drugs (NSAIDs). Aspirin, ibuprofen and naproxen are the most common and are marketed under brands such as Bayer, Advil, Motrin IB, and Aleve.

The Good: NSAIDs work by blocking COX enzymes. This reduces the body's level of prostaglandins-chemicals that increase the feeling of pain. NSAIDs also reduce fever and swelling.

The Bad: Taking NSAIDs over too long a period can raise the risks of: bleeding and perforation of the esophagus, stomach and small intestine; hepatitis and liver failure; disruption of white blood cells and blood platelets; and severe skin eruptions. In some cases, NSAIDs also lead to kidney damage and high blood pressure-of extra concern because migraines themselves are linked to a higher risk of cardiovascular disease.

APAPs: This group is made up of painkillers that include acetaminophen. Common OTC brands include Tylenol, Excedrin and Dristan Cold Maximum Strength.

The Good: Like NSAIDs, APAPs reduce fever and are thought to raise the body's threshold for pain by reducing prostaglandins. APAPs do not irritate the stomach lining so they can be important drugs for controlling chronic pain.

The Bad: Acetaminophen sends 80,000 people per year to the emergency room and is the leading cause of liver failure in the US. Alcoholic patients may develop liver damage after even modest doses of acetaminophen. Other risks can include renal failure, rash, high or low blood pressure, anxiety and rare cases of pancreatitis.

Reducing Pain - and Your Risks
  • Limit how long and how often you take NSAIDs and APAPs. If you're taking them for more than 10 days or you're taking them for fewer than 10 days but taking them regularly during the month you should talk with your doctor.
  • Take as low a dose as possible to control pain. A study found that 25% of regular NSAID users took more than the recommended dose. Stick to recommended amounts. In fact, experiment with how little of the medication you can take and still experience pain relief.
  • Look for alternatives. Remember that under the American Academy of Neurology guidelines for migraine prevention, NSAIDs are only recommended as a Level B option (moderate evidence for effectiveness) while Petasites (butterbur herb) is recommended as Level A (strong evidence for effectiveness). You may find that butterbur or nutritional supplements such as magnesium and riboflavin are effective and with lower risk of serious side effects.
  • Change what you drink. While using NSAIDs and APAPs, increase how much water you drink and avoid alcohol to help support your liver.
  • Talk with your doctor. Learn if any of your other medications could interact with NSAIDs or APAPs. Also talk about a migraine prevention plan that could help reduce your need for painkillers.

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Lower your extra "migraine risk" for heart disease

The Genetic Epidemiology of Migraine (GEM) Study found that migraine sufferers have an increased risk of cardiovascular disease. While further research is needed to determine why migraines are linked to these risk factors, you should do all you can to keep your heart healthy. Don't smoke or over-indulge in alcohol. Keep cholesterol, blood pressure, blood pressure and your weight all under control. Get quality sleep and regular exercise.
If a regular exercise program seems too difficult to maintain, remember that putting in 10-minute spurts of activity can add up to the 30- to 60-minute target level for daily activity. The secret, however, is to make sure that your are sleeping well and getting enough exercise.

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TRY THIS: Wireless fitness trackers are great for monitoring your sleep and activity levels and motivating you to get and stay healthy. Here are some trackers that have good reviews and come recommended by our readers: The Fitbit Zip costs about $50; the Fitbit Flex wristband monitors activity and sleep for about $130; and the Withings Pulse Wireless Activity and Sleep Tracker also monitors heart rate and more for about $250. 
Fighting Migraines With Progressive Relaxation

Stress is a major migraine trigger. If you can defuse that stress the moment you become aware of it affecting your body, you may be able to reduce the frequency and intensity of migraine attacks. Progressive relaxation is an easy technique for calming yourself and unclenching muscles. How do you do it? See our Guide to Progressive Relaxation. Click here.

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All-in-one, clinical strength supplement for correcting Magnesium, B2 and CoQ10 deficiencies associated with neurological discomfort.
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