NDPH
Free tool
Medication-overuse checker.
Taking acute headache medicine too often can itself make headaches more frequent. Enter roughly how many days a month you take each kind of medicine, and see how that compares with the published limits.1
In a typical month, on how many days do you take…
Count days, not tablets: two doses on the same day count as one day. Leave a box empty if you don’t take it.
The limits, explained
The International Classification of Headache Disorders counts medication overuse as taking acute headache medicine regularly for more than three months on at least:1
- 10 days a month for triptans, ergots, opioids or combination painkillers;
- 15 days a month for simple painkillers — paracetamol, aspirin and other anti-inflammatories;
- 10 days a month in total when several of these are mixed, even if no single one goes over its own limit.
Medication-overuse headache itself also needs a headache on 15 or more days a month in someone who already had a headache disorder. It affects an estimated 1–2% of people, and it is one of the few causes of daily headache that can improve substantially once the overuse is addressed.31
What to do with the result
Bring it to your doctor rather than acting on it alone. Treatment usually starts with advice to cut down, sometimes a planned withdrawal of the overused medicine, and often a preventive treatment alongside.31 Some medicines must not be stopped suddenly — opioids, butalbital-containing tablets and anything with a sedative in it need a supervised plan.
If you live with NDPH and the daily headache began before you started taking painkillers this often, say so plainly: the order matters to the diagnosis. The printable calendar has a tick box for medication days, so you can bring an exact count instead of an estimate.
References
Numbers in the text link to these sources. Where the evidence comes from migraine rather than NDPH, the text says so.
- Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018;38(1):1-211. doi.org/10.1177/0333102417738202
- Diener HC, Dodick D, Evers S, et al. Pathophysiology, prevention, and treatment of medication overuse headache. Lancet Neurol 2019;18:891-902. doi.org/10.1016/S1474-4422(19)30146-2