Medicines to avoid in tension-type headache

Morphine-related pain relievers such as codeine and dihydrocodeine are not recommended for the treatment of tension-type headache.

Many pharmacy-only pain relievers commonly promoted for the relief of strong pain are unlikely to be any more effective for tension-type headache than simple pain relievers and could increase the risk of side effects and medication overuse headache. Examples of medicines containing paracetamol, aspirin or ibuprofen in combination with low doses of codeine include Codapane, Panadeine Extra, Codis, Dispirin Forte, Rafen Plus, Nurofen Plus, Aspalgin Soluble). Other products that contain paracetamol and codeine in combination with doxylamine, an antihistamine with sedative effects (e.g. Panalgesic, Mersyndol), are also not recommended .  

Although the triptans (e.g. Relpax, Naramig, Maxalt, Imigran, Sumatab, Zomig) are a mainstay in the treatment of migraine, they are not effective in the treatment of simple tension-type headache.

  • British Association for the Study of Headache. Guidelines for all health professionals in the diagnosis and management of migraine, tension-type-type headache, cluster headache and medication overuse headache. Hull: BASH, 2010. (accessed 13 December 2011)
  • Neurology Writing Group. Therapeutic Guidelines: Neurology, Version 4 Updated November 2011 [eTG complete CD-ROM]. Melbourne: Therapeutic Guidelines Ltd, 2011.
  • Loder E, Rizzoli P. Tension-type headache. BMJ 2008;336:88–92
  • Bendtsen L, Evers S, Linde M, et al. EFNS guideline on the treatment of tension-type headache - report of an EFNS task force. European Journal of Neurology 2010;17:1318-25.
  • Murnion BP. Combination analgesics in adults. Australian Prescriber 2010; 33:113–115