Headache epidemiology:
• Most common form of ❌
• 1 in 10 people get ❌, more common in women.
• Migraines usually first occur between the ages of 10-30, and may get ❌ in middle age.
• Estimated that almost half of the adult population have had a headache at least once within the last year.
• Associated with pain, disability, damaged quality of life, and financial cost. Global Burden of Disease – 3rd and 6th

Types of headache:
• ❌ headache. Most common type
• Medication overuse headache. Also known as “❌”
• Sinus headache
• Migraine (with or without aura). 70-90% experience migraine ❌ aura
• ❌ migraine. Extremely disabling
• Others – including high altitude headache, menstrual migraine and
chronic migraine

Menstrual migraine
• Tend to be particularly ❌
• Self help tips:
1.Eat small, ❌ snacks to keep your blood sugar level up.
2.Have a ❌ sleep pattern.
3. Avoid ❌.

Location of pain:
Sinus - ❌
Tension - ❌
Migraine - ❌
Cluster - ❌

Medication overuse (rebound):
It may feel like a tension-type headache or migraine-like attack.
Headaches often improve within ❌ of withdrawal of the
overused medicine but can feel ❌ before improvement is seen.
• To avoid this, limit the use of pain relief medication:
- Paracetamol and NSAIDs should not be taken for headache on more than ❌ days per month
- Triptans for migraine should not be used for more than ❌ days per month

Cluster migraine
• A ❌ type of headache that affects about 1 to 2 people in every 1,000
• They can happen ❌ times a day for a period of time, then disappear for ❌ or years.
• Try to identify the triggers and avoid those things.

Pain relieving medicines (for immediate relief):
• Paracetamol (liquid or soluble)
• NSAIDs e.g. ibuprofen, diclofenac, naproxen
• Opioids – ❌ (pharmacist only)
• ❌ - rizatriptan, sumatriptan, zolmitriptan

Medicines for nausea/ vomiting:
❌

• Medicines to prevent migraines
• Beta blockers - ❌
• ❌ (TCAs)
• Sodium valproate, gabapentin, topiramate
• Verapamil, oxygen
• Botulinum toxin type A
• Pizotifen
• ❌ (TMS)
• Acupuncture

A pharmacist can sell ❌ OTC when sold in the ❌ pack, containing ❌ or less tablets (of ❌ or less per tablet) for ❌ relief of migraine ❌ aura.

Red flags
• A really severe headache that comes on ❌ and gets ❌ within minutes (especially if over ❌ years old)
• Changes in your ❌ or eye sight or changes in consciousness
• feeling sick (nausea), a stiff ❌, rash, fever, shakes or sensitivity to ❌
• ❌ eye, feeling sick (nausea) or being sick (vomiting)
• Headache following a ❌.