Don’t take painkillers for more than 15 days a month; limit combination painkillers to 10 days. Otherwise, headaches may actually be caused by the medication itself.

If you take painkillers frequently for recurrent headaches, the medication itself may eventually provoke more frequent headaches — a clinical condition known as medication-overuse headache. The clinical threshold is taking standard single-ingredient analgesics (such as acetaminophen, ibuprofen, or aspirin) for 15 or more days per month for at least three consecutive months. For combination analgesics containing multiple active ingredients or caffeine, the threshold drops to 10 or more days per month. Rotating between different painkillers does not reset this counter. Most patients experience substantial symptom relief after systematically tapering excess pain medication under medical guidance.

No direct cost. You’ll just need to keep track of how many days you’ve taken the medicine, and resist the urge to pop pills at every sign of a headache.

The third edition of the International Classification of Headache published by the International Headache Society outlines the diagnostic criteria for this condition. It applies to people who already have a history of headaches, experience headaches on 15 or more days each month, and have been regularly taking excessive amounts of headache medication for over 3 months. For standard non-opioid painkillers, the threshold for overuse is 15 days per month; for combination painkillers, it is 10 days per month. This classification is backed by robust epidemiological evidence, and most patients see positive results after reducing their medication intake.

Painkillers with “caffeine” in their name typically contain added caffeine, so they count toward the 10-day limit for combination painkillers. If you find that your headache days are increasing month on month, it’s best to consult a neurologist rather than simply taking more medication. This evidence grade is assigned because the classification criteria serve as a diagnostic benchmark rather than being derived from controlled clinical trials. The benefit level is rated “moderate” as it primarily reduces the frequency of headaches without preventing life-threatening outcomes.

Headache Classification Committee of the International Headache Society (2018). The International Classification of Headache Disorders, 3rd edition. Cephalalgia, 38(1):1-211. https://doi.org/10.1177/0333102417738202；ICHD-3 在线版 8.2 Medication-overuse headache（含 8.2.3、8.2.5）. https://ichd-3.org/8-headache-attributed-to-a-substance-or-its-withdrawal/8-2-medication-overuse-headache-moh/