All acute medications used for migraine attacks, when used too frequently, increase the risk of medication overuse headache with progression to a chronic daily headache syndrome. Use of opioids, triptans, ergotamines, or combination analgesics of any kind on 10 days a month or more, and use of NSAIDs or acetaminophen on 15 days a month or more places patients at risk for medication overuse headache. Patients with migraine should be educated with regard to these risks.
Sources:
Becker WJ, et al. Medication overuse headache in Canada. Cephalalgia. 2008 Nov;28(11):1218-20. PMID: 18983589.
Cheung V, et al. Medication overuse headache. Curr Neurol Neurosci Rep. 2015 Jan;15(1):509. PMID: 25398377.
Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013 Jul;33(9):629-808. PMID: 23771276.
Related Resources:
Patient Pamphlet: Treating Frequent Headaches with Pain Relievers: Don’t take them too often