Headache Medication Day Counter
Medication-overuse headache is defined as headache on 15 or more days a month together with overuse of acute headache medication, and the overuse limit depends on the type of medicine: 15 or more days a month for simple painkillers, but 10 or more days a month for combination painkillers, triptans, opioids and ergotamine.2,3 This counter lets you enter your medication days for one month and shows how they compare with those limits.
Check with your doctor about frequent headaches and painkiller use. This is a counting aid, not a diagnosis. Medication-overuse headache can only be diagnosed by a doctor, who also rules out other causes. A sudden, severe or new kind of headache, or a headache with the warning signs listed in this red flag section, needs prompt medical assessment.
Count days, not tablets: a day with two doses counts as one day. Leave a field at 0 if you did not use that class. If you are unsure which class a product belongs to, ask your pharmacist or doctor.
How long has this pattern lasted?Where the limits come from
The limits in this counter follow the medication thresholds of the International Classification of Headache Disorders (ICHD-3) as summarised in a 2024 review: 15 or more days a month for simple (non-opioid) painkillers such as paracetamol and anti-inflammatory painkillers, and 10 or more days a month for combination painkillers, triptans, opioids and ergotamine, in each case for more than 3 months.2 A combined limit of 10 or more days a month applies to combined use of ergotamine, triptans, non-opioid painkillers and/or opioids when no single class reaches its own limit.5 In ICHD-3, a combination painkiller means a product combining drugs of two or more classes, each with a painkilling effect (for example, paracetamol and codeine) or acting as an adjuvant (for example, caffeine).4 Medication-overuse headache may affect 1–2% of the population.2,3
Simple painkillers have evidence-based effectiveness and are widely regarded as first-line acute treatment for tension-type headache.1 In a pooled analysis discussed in my Tension Headache Relief article, a combination of acetylsalicylic acid, paracetamol and caffeine left more headache episodes pain free at 2 hours than paracetamol alone,3 and combination painkillers have the stricter 10-day overuse limit.2 Counting medication days per month can therefore be a useful habit for anyone with frequent headaches.3
How to read the result
The counter compares numbers with published limits. It does not know your headache type, your medicines in detail or your medical history, so it cannot tell whether your headaches are caused by medication. The definition of medication-overuse headache also requires a pre-existing headache disorder and headache on 15 or more days a month for at least three months.2 Bring your counts to your doctor if you are worried.
References
- Ashina et al. 2021. Tension-type headache. Nat Rev Dis Primers.
- Gosalia, Moreno-Ajona, Goadsby 2024. Medication-overuse headache: a narrative review. J Headache Pain.
- Dr. Antti Rintanen: Tension Headache Relief
- Headache Classification Committee of the International Headache Society. ICHD-3, 8.2.5 Combination-analgesic-overuse headache.
- Headache Classification Committee of the International Headache Society. ICHD-3, 8.2.6 Medication-overuse headache attributed to multiple drug classes not individually overused.
This tool is for general education. It does not diagnose, give personal recommendations or replace an assessment by your doctor.
