Fact Checked

What is in Excedrin Migraine?

Approximately 50 million Americans suffer from migraine. Migraine is not your typical headache as it involves more complex reasons for their occurrence that are neurological in origin. Most people with migraine disease have one to two migraine attacks per month, but for people with chronic migraine, these attacks can be as frequent as up to 15 per month. The debilitating pain that is associated with migraine symptoms can interfere with daily activities like driving, working, reading and writing, seriously impacting the quality of life in people who face this medical condition. Most people who get migraine have a family history of their occurrence, indicating that genetics play a large role in their cause. Typical migraine symptoms include:

  • Throbbing pain in one or both sides of the head
  • Light and sound sensitivity
  • Nausea
  • Vomiting
  • Vision changes like the appearance of an aura 

Identifying triggers that can cause a migraine is also important, as avoiding these triggers can prevent the onset of a migraine attack. Typically, a migraine attack can last for several hours to days. The longer the duration of the migraine attack, it can make going about daily activities very hard for the affected individual. Common migraine triggers include:

  • Bright lights or sun glare
  • Strong scents
  • Hormonal changes that cause estrogen fluctuation in women 
  • Certain foods that contain substances like tyramine or monosodium glutamate (MSG)
  • Artificial sweeteners like aspartame
  • Weather changes
  • High altitude
  • Stress
  • Alcohol
  • Changes in sleep patterns

Treatment of Migraine 

Many people do not seek proper medical treatment for migraine even though there are many medications available for their prevention and treatment. These medications are either over-the-counter migraine medication, for which a prescription is not necessary for purchase, or prescription drugs that need a valid prescription from a doctor after you have been evaluated. Prescription medications are used when the frequency of migraine occurs more than just a few times a month and can be very helpful in preventing migraines from occurring if taken regularly. Most commonly, prescription drugs that are used to treat blood pressure like beta-blockers, anti-depressants, anti-seizure medications, or CPRG inhibitors are used to prevent the occurrence of a migraine. Recently, devices that release electrical stimulation to certain parts of the head have also been approved for the treatment of migraines. 

OTC drugs can help relieve the symptoms of a migraine and provide fast relief. There are several good options for OTC medications such as ibuprofen, naproxen, or acetaminophen. One of the best OTC options for treating migraine is Excedrin Migraine.

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What is Excedrin Migraine? 

Excedrin Migraine is an FDA-approved medication that contains a combination of three active ingredients: aspirin, acetaminophen, and caffeine. This combination is especially effective because each active ingredient targets the pain caused by migraine in different ways. Taking the medication as a single pill combines the unique action of each active ingredient for overall reduction of pain during the onset of a migraine attack. According to the manufacturer of Excedrin Migraine, the medication starts working as quickly as 30 minutes after it is taken in some people. Clinical trials showed that one dose of the medication could relieve pain in people with moderate or severe migraine. 

How does Excedrin migraine work?

The three main active ingredients of Excedrin Migraine have their own distinct functions that are described below. 

Aspirin 

Each tablet of Excedrin Migraine contains 250 mg of Aspirin. Aspirin is a non-steroid anti-inflammatory (NSAID) drug that has been used for more than 100 years. It reduces inflammation by blocking the production of a substance called prostaglandin in the peripheral nervous system. To do this, aspirin blocks the action of a protein named COX that is used to produce prostaglandins. By lowering prostaglandin levels, there is less pain caused by inflammation. The way aspirin works is similar to other NSAIDs like ibuprofen (Advil). 

Acetaminophen

Each tablet also contains 250 mg of Acetaminophen, also known as the brand name Tylenol. Acetaminophen is also a pain reliever, but it works in a different way compared to aspirin or the other NSAIDs. The exact way that acetaminophen works is unclear, but it also reduces the amount of pain-causing prostaglandins in the body. Unlike the NSAIDs, acetaminophen is though to alter chemical substances within the central nervous system that makes you aware of pain. By doing this, it increases your pain threshold and makes you feel like you are experiencing less pain overall.

Caffeine 

Caffeine is considered to be one of the triggers of migraine. But, each tablet of Excedrin migraine contains 65 mg of caffeine. This can seem confusing. How does this help relieve pain associated with migraine? Caffeine is actually beneficial in relieving headaches. During a migraine, there is inflammation or swelling of the blood vessels in the brain. This causes pressure that is felt as pain. Caffeine can constrict the widened blood vessels and thereby relieve the pressure that occurs during migraine. Additionally, caffeine can enhance the effects of aspirin and acetaminophen to make them up to 40 percent more effective. 

How to take Excedrin Migraine

The recommended dosage is two tablets with a glass of water for adults that are 18 years or older. No more than two tablets should be taken within 24 hours unless your doctor specifically instructs otherwise. Children under the age of 18 should consult a doctor before taking Excedrin Migraine. This is because the medication contains aspirin that can cause complications if taken by children. 

Side effects of Excedrin Migraine 

There are some side effects that can be caused by taking Excedrin Migraine. These are the side effects that you can experience from its three active ingredients. Additionally, a serious allergic reaction can also occur if taking Excedrin Migraine for the first time. Signs of an allergic reaction are trouble breathing, itchy rash, or blisters. Some of the common side effects caused by each active ingredient are listed here. 

Side effects of Aspirin

Since Aspirin is an NSAID, it can cause unpleasant side effects on the stomach. NSAIDs are generally rough on the stomach and can cause increased risk of stomach ulcers or stomach bleeding. If you have a history of stomach problems like peptic ulcer disease or inflammatory bowel disease, taking aspirin may not be right for you, as it can increase the chance of experiencing more side effects in the stomach. If you are also taking other blood thinner medications like warfarin, the chance of stomach bleeding from Excedrin Migraine will be higher. Symptoms of stomach bleeding are vomiting blood or black or bloody stools.

Side effects of Acetaminophen

Acetaminophen at the dosage included in Excedrin Migraine is safe to take. However, it should not be combined with other products containing acetaminophen because it can significantly increase the risk of liver damage. Drinking more than 3 alcoholic beverages a day while taking acetaminophen can further increase the risk of liver damage. 

Side effects of caffeine

Taking caffeine can cause trouble sleeping. If you take Excedrin Migraine regularly, you may also experience caffeine withdrawal symptoms that can cause a headache. 

Drug interactions 

The active ingredients of Excedrin Migraine can interact with other medications. It is important to check with your doctor or pharmacist before taking Excedrin Migraine to prevent an adverse drug reaction from occurring. Taking certain medications with Excedrin Migraine can also amplify the side effects that you may experience. Some of these drugs include:

  • Blood thinners such as warfarin, apixaban and rivaroxaban
  • Other NSAIDS such as ibuprofen, naproxen or celecoxib
  • Medications for gout such as probenecid, sulfinpyrazone 
  • Anti-seizure drugs (e.g., phenytoin, valproic acid) 
  • Corticosteroids such as prednisone
  • Dichlorphenamide
  • Ketoconazole
  • Methotrexate,
  • Acetazolamide
  • Cimetidine,

Very serious interactions can occur if you take the following drugs with Excedrin Migraine:

This is not an exhaustive list of drug interactions that may occur so be sure to check with your doctor if you are taking any other medications before you take Excedrin Migraine. 

Where to buy Excedrin Migraine 

Excedrin Migraine is available OTC at any pharmacy, drugstore or chain supermarkets. The manufacturer of Excedrin Migraine discontinued production earlier this year in January due to reported inconsistencies in the weight of components within the medication. Excedrin Migraine was temporarily unavailable in many stores due to this. However, as of July, this halt in production has ceased and there should no trouble in purchasing Excedrin Migraine anymore. 

A prescription is not necessary to purchase this medication, but if you have to take medication for migraine more than four times a month, consulting a doctor is highly recommended. Taking medication for migraine more frequently than is recommended can actually make the condition worse by causing a medication overuse headache (MOH). Your doctor should be able to tell you whether you need prescription medications to treat your migraine problem, or evaluate your symptoms to determine whether the underlying cause of migraine is something else. Prescription medications may work for you if you are still not able to find relief with OTC migraine medications like Excedrin Migraine. 

Published September 2nd, 2020 by Chris Riley
Fact Checked by Chris Riley

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