Fioricet Provides Quick Relief for Migraines and Tension Headaches

If you suffer from chronic headaches, you are well aware of the disruption this can cause in your daily life. Trying to work or socialize while experiencing a headache can be quite difficult. Migraines can make these activities virtually impossible.

The majority of those suffering from chronic headaches report that they are unable to lead a normal life. Migraine and tension headaches disrupt their work, social, and family life.

A single debilitating headache can steal many valuable hours away from a day. After unsuccessfully trying several of the headache medications available, some chronic sufferers may simply give up. Before doing this, they might want to try Fioricet. It may just be the answer they have been seeking.

Fioricet can easily be bought online or at your local pharmacy, but you will need to obtain a prescription from a physician first. Most doctors are aware of the benefits of Fioricet and will readily provide a prescription for those suffering from migraines and tension headaches.

This combination medication is used to treat tension headaches. Acetaminophen helps to decrease the pain from the headache. Caffeine helps increase the effects of acetaminophen. Butalbital is a sedative that helps to decrease anxiety and cause sleepiness and relaxation.

The three active ingredients in Fioricet work together to relieve migraines and tension headaches. Fioricet is unique in that it includes acetaminophen, butalbital, and caffeine. While acetaminophen may be found in over the counter medicines, its combination with the other two ingredients is what makes Fioricet truly effective.

Butalbital is a barbiturate, which creates a sense of relaxation in the body. Caffeine further alleviates tension headaches by reducing the flow of blood to the brain. The combination of these three ingredients have provided immense relief to many chronic headache sufferers.

Fioricet comes in capsule and tablet form and is usually taken every four hours as needed. It is advised not to take more than six capsules in a day. Be sure to follow your doctor’s instructions carefully. If you feel that you are in need of a larger dose, consult your doctor first.

The butalbital in Fioricet tends to make people drowsy. It is important to stay away from driving or using heavy machinery after a dose. As with any medication, take care when using Fioricet. With the assistance of your physician, Fioricet can be taken safely, often with excellent results.

If you are interested in learning more about Fioricet, your doctor or pharmacist will be able to answer any questions or concerns you may have. Your physician will determine if Fioricet is a viable solution for your chronic headaches.

How to use Fioricet

Take this medication by mouth with or without food as directed by your doctor, usually every 4 hours as needed.

If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

The dosage is based on your medical condition, age, and response to treatment. This medication works best if it is used as the first signs of a headache occur. If you wait until the headache has worsened, the medication may not work as well.

If you suddenly stop using this medication, you may have withdrawal symptoms (such as nausea/vomiting, mental/mood changes, seizures). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used this medication for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.

Though it helps many people, this medication may sometimes cause addiction. This risk may be higher if you have a substance use disorder (such as overuse of or addiction to drugs/alcohol). Take this medication exactly as prescribed to lower the risk of addiction. Ask your doctor or pharmacist for more details.

Tell your doctor if you notice increased use of this medication, a worsening of headaches, an increase in the number of headaches, the medication not working as well, or use of this medication for more than 2 headache episodes a week. Do not take more than recommended. Your doctor may need to change your medication and/or add a separate medication to prevent the headaches.

What is cyclobenzaprine and What is Cyclobenzaprine side effects ?

What is cyclobenzaprine?

Cyclobenzaprine oral tablet is a prescription drug that’s available as the brand-name drug Fexmid.

It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in all strengths or forms as the brand-name drug.

Cyclobenzaprine also comes as an oral extended-release capsule.

Brand Name: Flexeril, Amrix and Fexmid

Generic Name: Cyclobenzaprine

Drug Class: Skeletal Muscle Relaxants

 

WHAT IS CYCLOBENZAPRINE AND HOW DOES IT WORK?

Cyclobenzaprine is a prescription drug used short-term to treat muscle spasms. It is usually used along with rest and physical therapy. It works by helping to relax the muscles.

Cyclobenzaprine is available under the following different brand names: Flexeril, Amrix and Fexmid.

Dosages of Cyclobenzaprine:

Tablet (adult and pediatric)

      • 5 mg
      • 7.5 mg
      • 10 mg

Capsule, extended-release (adult only)

      • 15 mg
      • 30 mg

Dosage Considerations – Should be Given as Follows:

Take this medication by mouth with or without food as directed by your doctor, usually once daily. Swallow the capsules whole. Do not crush or chew the capsules. Doing so can release all of the drug at once, increasing the risk of side effects.

This medication is not recommended for use in older adults because they may be at greater risk for side effects while using this drug.

This medication should only be used short-term (for 3 weeks or less) unless directed by your doctor. Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.

Muscle Spasm

Immediate-release tablet

  • Adult: 5 mg orally every 8 hours, may increase dose to 7.5-10 mg orally every 8 hours as needed
  • Under 15 years of age: Safety and efficacy not established
  • Over 15 years of age: 5 mg orally every 8 hours, may increase dose to 7.5 mg orally every 8 hours as needed
  • Geriatric: Immediate-release tablet: 5 mg/day orally initially; dose slowly upward and consider less frequent dosing

Extended-release capsule

  • Adult 15 mg orally once per day; some patients may require up to 30 mg orally once per day
  • Under 18 years of age: Safety and efficacy not established
  • Geriatric: Extended-release capsule not recommended in elderly, because of increased plasma levels (40%) and prolonged half-life (56%) compared with young adults
  • Dosing Modifications
  • Hepatic impairment
  • Immediate-release tablet: 5 mg/day orally initially; dose slowly and consider less frequent dosing
  • Extended-release capsule: Not recommended in mild-to-severe hepatic impairment

Why it’s used

Cyclobenzaprine oral tablet is used to help relax muscles. It helps relieve pain, stiffness, or discomfort caused by strains or injuries to your muscles. It’s used along with rest and physical therapy. It should only be used for two to three weeks at a time.

Cyclobenzaprine may be used as part of a combination therapy. This means you may need to take it with other medications.

How it works

Cyclobenzaprine belongs to a class of drugs called muscle relaxants. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

It isn’t known exactly how this drug works to relax your muscles. It may decrease the signals from your brain that tell your muscles to spasm.

The primary adverse effects of cyclobenzaprine

The primary adverse effects of cyclobenzaprine include dizziness, xerostomia, drowsiness, fatigue, headache, nervousness, and confusion. Like other cyclical antidepressants, cyclobenzaprine antagonizes the muscarinic receptors, which may produce undesired side effects such as xerostomia, ileus, tachycardia, mydriasis, confusion, and hallucinations. Additionally, like other cyclical antidepressants, cyclobenzaprine antagonizes the alpha1 adrenergic receptor, causing a vasodilatory effect, and may contribute further to reflex tachycardia. The most common adverse effects seen with cyclobenzaprine are somnolence, dry mucous membranes, dizziness, and confusion

Cyclobenzaprine side effects

Cyclobenzaprine oral tablet may cause drowsiness and dizziness. This is more likely to happen in the few hours after you take it. It can also have other side effects.

More common side effects

The more common side effects of cyclobenzaprine can include:

      • dry mouth
      • dizziness
      • fatigue
      • constipation
      • drowsiness
      • nausea
      • heartburn

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

    • Heart problems. Symptoms can include:
      • fainting
      • heart palpitations (fast or irregular heartbeat)
      • confusion
      • trouble speaking or understanding
      • loss of control or numbness in your face, arms, or legs
      • trouble seeing in one or both eyes
    • Serotonin syndrome. Symptoms can include:
      • agitation (a feeling of aggravation or restlessness)
      • hallucinations (hearing or seeing something that isn’t there)
      • seizures
      • nausea

You can not take Prescription for a long time, you need find a way to treat your pain without prescription. Exercising is the best way to relieve your pain. because exercising can enhance your immune system and increase your muscle strength and make your nerve strong.

You can also take some natural nutritions to increase your immune system too.

Some anti-aging products can also increase your immune ability. You can try USANA Products to make you strong. I take USANA Essentials every day and I find my health get better and better.

Flexeril Effects and Abuse

Taking Flexeril can improve sleep, motor skills, and energy levels in consumers that are experiencing severe muscle pain. In addition to these benefits, the medication can produce a variety of negative and potentially harmful effects as well. These side effects can range from mild to severe and include any of the following:

      • Drowsiness
      • Dry mouth
      • Fatigue
      • Headaches
      • Dizziness
      • Nausea
      • Constipation
      • Blurred vision
      • Confusion
      • Acid reflux
      • Abdominal pain
      • Fever
      • Nervousness
      • Urination problems

Another potential side effect of Flexeril is overdose if an individual takes too much of the drug. Although Flexeril doesn’t produce a euphoric high like many other drugs, people still misuse it due to its relaxing effects, and many will increase dosages to amplify those effects.

A Flexeril overdose can cause severe health problems such as cardiac arrest, dangerously low blood pressure, and seizures. In extreme cases, central nervous system depression, seizures, heart attack and even death can occur. Signs of overdose include chest pain, hallucinations, vomiting, rapid heartbeat, slurred speech, difficulty breathing, and extreme drowsiness. The risk of overdose is significantly increased when Flexeril is combined with other drugs, particularly central nervous system depressants such as alcohol or benzodiazepines.

This combination can cause extreme drowsiness and respiratory depression, but many people that abuse Flexeril will mix them anyway simply to increase the intoxication experienced.

Signs of a Flexeril Addiction

Professionals generally consider Flexeril to be non-addictive; however, there is evidence that Flexeril addiction is possible. Flexeril depresses the central nervous system, and some people find these effects to be desirable, which can lead to misuse. An individual might abuse Flexeril in order to feel relaxed, mildly euphoric, or sedated.

In high doses, Flexeril produces a variety of anticholinergic effects, altering the activity of brain neurotransmitters. Chronic use of the drug can then cause physical dependence; a person that was simply taking a higher dose of Flexeril due to pain can become accustomed to the presence of the drug in the system and develop an addiction as a result.

Additionally, Flexeril users may experience mild withdrawal symptoms if the drug is used chronically in high doses.

Signs that indicate someone may have a Flexeril addiction include:

    • Taking Flexeril after it’s no longer needed or longer then prescribed
    • Needing more and more of the drug to elicit the same effects
    • Spending the majority of the day thinking about Flexeril: how to get more, the effects it produces, and when to use it
    • Constantly using Flexeril and being unable to stop
    • Faking symptoms to get Flexeril prescriptions
    • Sudden changes in physical appearance, hygiene, and behavior

Another tall-tell sign of Flexeril addiction is abusing the medication in combination with another substance to produce a greater sense of euphoria. Alcohol is commonly abused alongside muscle relaxers like Flexeril because it heightens the side effects of both, causing the individual to experience a more intense sedation or high. People might also use Flexeril as a way to come down from stimulant drugs, such as cocaine or Adderall. When someone that is addicted to the drug attempts to stop taking it or reduce doses, he or she will start to experience withdrawal symptoms although they are typically not severe. Flexeril withdrawal symptoms can include headache, nausea, fatigue, and cravings for the drug.

Index Terms

  • Cyclobenzaprine HCl
  • Cyclobenzaprine Hydrochloride
  • Flexeril

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Capsule Extended Release 24 Hour, Oral, as hydrochloride:

Amrix: 15 mg [contains fd&c red #40, fd&c yellow #10 (quinoline yellow)]

Amrix: 30 mg [contains brilliant blue fcf (fd&c blue #1), fd&c blue #2 (indigotine), fd&c red #40, fd&c yellow #6 (sunset yellow)]

Generic: 15 mg, 30 mg

Tablet, Oral, as hydrochloride:

Fexmid: 7.5 mg

Generic: 5 mg, 7.5 mg, 10 mg

Brand Names: U.S.

  • Amrix
  • Fexmid

Pharmacologic Category

  • Skeletal Muscle Relaxant

Pharmacology

Centrally-acting skeletal muscle relaxant pharmacologically related to tricyclic antidepressants; reduces tonic somatic motor activity influencing both alpha and gamma motor neurons

Metabolism

Hepatic via CYP3A4, 1A2, and 2D6; may undergo enterohepatic recirculation

Excretion

Urine (primarily as glucuronide metabolites); feces (as unchanged drug; Hucker, 1978); Clearance: 0.7 L/minute

Onset of Action

Immediate release: Within 1 hour

Immediate release: ~4 hours (Winchell 2002); Extended release: 7 to 8 hours

Duration of Action

Immediate release: 12 to 24 hours

Half-Life Elimination

Normal hepatic function: Range: 8 to 37 hours; Immediate release: 18 hours; Extended release: 32 hours; Impaired hepatic function: 46.2 hours (range: 22.4 to 188 hours) (Winchell 2002)

Special Populations: Hepatic Function Impairment

In mild-to-moderate hepatic impairment, AUC and Cmax increased approximately twofold with immediate-release cyclobenzaprine.

Special Populations: Elderly

AUC increased ~2.4-fold in elderly males and ~1.2-fold in elderly females with immediate-release cyclobenzaprine. AUC increased 40% and the plasma half-life is prolonged (50 hours) in elderly subjects with extended-release cyclobenzaprine.

Use: Labeled Indications

Muscle spasm: As an adjunct to rest and physical therapy for short-term (2 to 3 weeks) relief of muscle spasm associated with acute, painful musculoskeletal conditions.

Off Label Uses

Fibromyalgia

Data from multiple double-blind, placebo-controlled trials [Bennett 1988][Quimby 1989] support the use of cyclobenzaprine in the treatment of fibromyalgia.

Based on the European League Against Rheumatism revised recommendations for the management of fibromyalgia, cyclobenzaprine is recommended as an alternative agent in the management of this condition [EULAR [Macfarlane 2017]].

Temporomandibular disorder, acute

Data from 2 randomized, double-blind, placebo-controlled trials of patients experiencing myofascial jaw pain upon awakening suggest that cyclobenzaprine at bedtime may have some benefit for the treatment of acute jaw pain due to temporomandibular disorder [Alencar 2014][Herman 2002]. Of note, 1 study demonstrated significant improvement in pain scores with treatment; however, no significant differences were seen compared to placebo [Alencar 2014].

Contraindications

Hypersensitivity to cyclobenzaprine or any component of the formulation; during or within 14 days of MAO inhibitors; hyperthyroidism; heart failure; arrhythmias; heart block or conduction disturbances; acute recovery phase of MI

Dosing: Adult

Note: Patients more sensitive to sedating and other CNS adverse effects (eg, those who are older, debilitated patients, those with organ impairment) may better tolerate a reduced dose, less frequent administration, and/or more gradual titration (Chou 2019).

Fibromyalgia (alternative agent) (off-label use):

Note: For mild to moderate symptoms, particularly with sleep disturbance (EULAR [Macfarlane 2017]; Goldenberg 2020; Tofferi 2004).

Oral: Immediate release: Initial: 5 to 10 mg once daily before bedtime; may gradually titrate as needed and tolerated up to 10 to 40 mg daily in 1 to 3 divided doses (Calandre 2015; EULAR [Macfarlane 2017]; Goldenberg 2020; Tofferi 2004). If excessive sedation occurs, may divide dose so larger portion is taken at bedtime (eg, 5 mg in morning and 10 or 15 mg at bedtime) (Goldenberg 2020; Tofferi 2004).

Muscle spasm and/or musculoskeletal pain (adjunctive therapy):

Note: For skeletal muscle spasm and/or pain (eg, low back pain, neck pain) with muscle spasm, usually in combination with a nonsteroidal anti-inflammatory drug (NSAID) and/or acetaminophen (ACP [Chou 2017]; Borenstein 2003; van Tulder 2003). In general, muscle relaxants should be used temporarily (eg, for a few days or intermittently for a few days when needed) (APS 2016).

Oral: Immediate release: Initial: 5 mg 3 times daily scheduled or as needed with one of the doses administered at bedtime (Chou 2019). May increase dose based on response and tolerability up to 10 mg 3 times daily as needed. Once-daily use at bedtime (with daytime NSAID and/or acetaminophen) may be better tolerated (Knight 2020).

Oral: Extended release: Usual: 15 mg once daily; some patients may require up to 30 mg once daily.

Temporomandibular disorder, acute (adjunctive therapy) (off-label use):

Note: Adjunct to an NSAID in select patients with pain on palpation of the lower jaw muscle (Alencar 2014; Herman 2002; Mehta 2019).

Oral: Immediate release: Usual: 10 mg once daily at bedtime for 10 to 14 days (Alencar 2014; Herman 2002; Mehta 2019).

Dosing: Geriatric

Avoid use (Beers Criteria [AGS 2019]).

Dosing: Pediatric

Muscle spasm, treatment: Adolescents ?15 years: Oral: Immediate release tablet: Initial: 5 mg 3 times daily; may increase up to 10 mg 3 times daily if needed. Do not use longer than 2 to 3 weeks.

Administration

Oral: Extended release: Swallow whole and administer at the same time each day. Alternatively, the contents of the capsule may be sprinkled onto a tablespoon of applesauce and consume immediately without chewing; rinse mouth to ensure all contents have been swallowed; discard any unused portion of capsule.

Storage

Capsules: Store at 25°C (77°F); excursions are permitted to 15°C to 30°C (59°F to 86°F).

Tablets: Store between 20°C and 25°C (68°F and 77°F).

Drug Interactions

Acetylcholinesterase Inhibitors: May diminish the therapeutic effect of Anticholinergic Agents. Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors. Monitor therapy

Aclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination

Alcohol (Ethyl): CNS Depressants may enhance the CNS depressant effect of Alcohol (Ethyl). Monitor therapy

Alizapride: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Amantadine: May enhance the anticholinergic effect of Anticholinergic Agents. Monitor therapy

Anticholinergic Agents: May enhance the adverse/toxic effect of other Anticholinergic Agents. Monitor therapy

Azelastine (Nasal): CNS Depressants may enhance the CNS depressant effect of Azelastine (Nasal). Avoid combination

Blonanserin: CNS Depressants may enhance the CNS depressant effect of Blonanserin. Management: Use caution if coadministering blonanserin and CNS depressants; dose reduction of the other CNS depressant may be required. Strong CNS depressants should not be coadministered with blonanserin. Consider therapy modification

Botulinum Toxin-Containing Products: May enhance the anticholinergic effect of Anticholinergic Agents. Monitor therapy

Botulinum Toxin-Containing Products: Muscle Relaxants (Centrally Acting) may enhance the adverse/toxic effect of Botulinum Toxin-Containing Products. Specifically, the risk for increased muscle weakness may be enhanced. Monitor therapy

Brexanolone: CNS Depressants may enhance the CNS depressant effect of Brexanolone. Monitor therapy

Brimonidine (Topical): May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Bromopride: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Bromperidol: May enhance the CNS depressant effect of CNS Depressants. Avoid combination

Buprenorphine: CNS Depressants may enhance the CNS depressant effect of Buprenorphine. Management: Consider reduced doses of other CNS depressants, and avoiding such drugs in patients at high risk of buprenorphine overuse/self-injection. Initiate buprenorphine at lower doses in patients already receiving CNS depressants. Consider therapy modification

Cannabidiol: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Cannabis: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Chloral Betaine: May enhance the adverse/toxic effect of Anticholinergic Agents. Monitor therapy

Chlormethiazole: May enhance the CNS depressant effect of CNS Depressants. Management: Monitor closely for evidence of excessive CNS depression. The chlormethiazole labeling states that an appropriately reduced dose should be used if such a combination must be used. Consider therapy modification

Chlorphenesin Carbamate: May enhance the adverse/toxic effect of CNS Depressants. Monitor therapy

Cimetropium: Anticholinergic Agents may enhance the anticholinergic effect of Cimetropium. Avoid combination

CloZAPine: Anticholinergic Agents may enhance the constipating effect of CloZAPine. Management: Consider alternatives to this combination whenever possible. If combined, monitor closely for signs and symptoms of gastrointestinal hypomotility and consider prophylactic laxative treatment. Consider therapy modification

CNS Depressants: May enhance the adverse/toxic effect of other CNS Depressants. Monitor therapy

Dimethindene (Topical): May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Doxylamine: May enhance the CNS depressant effect of CNS Depressants. Management: The manufacturer of Diclegis (doxylamine/pyridoxine), intended for use in pregnancy, specifically states that use with other CNS depressants is not recommended. Monitor therapy

Dronabinol: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Droperidol: May enhance the CNS depressant effect of CNS Depressants. Management: Consider dose reductions of droperidol or of other CNS agents (eg, opioids, barbiturates) with concomitant use. Exceptions to this monograph are discussed in further detail in separate drug interaction monographs. Consider therapy modification

Eluxadoline: Anticholinergic Agents may enhance the constipating effect of Eluxadoline. Avoid combination

Esketamine: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Flunitrazepam: CNS Depressants may enhance the CNS depressant effect of Flunitrazepam. Consider therapy modification

Gastrointestinal Agents (Prokinetic): Anticholinergic Agents may diminish the therapeutic effect of Gastrointestinal Agents (Prokinetic). Monitor therapy

Glucagon: Anticholinergic Agents may enhance the adverse/toxic effect of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased. Monitor therapy

Glycopyrrolate (Oral Inhalation): Anticholinergic Agents may enhance the anticholinergic effect of Glycopyrrolate (Oral Inhalation). Avoid combination

Glycopyrronium (Topical): May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination

HydrOXYzine: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Ipratropium (Oral Inhalation): May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination

Itopride: Anticholinergic Agents may diminish the therapeutic effect of Itopride. Monitor therapy

Kava Kava: May enhance the adverse/toxic effect of CNS Depressants. Monitor therapy

Lemborexant: May enhance the CNS depressant effect of CNS Depressants. Management: Dosage adjustments of lemborexant and of concomitant CNS depressants may be necessary when administered together because of potentially additive CNS depressant effects. Close monitoring for CNS depressant effects is necessary. Consider therapy modification

Levosulpiride: Anticholinergic Agents may diminish the therapeutic effect of Levosulpiride. Avoid combination

Lisuride: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Lofexidine: May enhance the CNS depressant effect of CNS Depressants. Management: Drugs listed as exceptions to this monograph are discussed in further detail in separate drug interaction monographs. Monitor therapy

Magnesium Sulfate: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Methotrimeprazine: CNS Depressants may enhance the CNS depressant effect of Methotrimeprazine. Methotrimeprazine may enhance the CNS depressant effect of CNS Depressants. Management: Reduce the usual dose of CNS depressants by 50% if starting methotrimeprazine until the dose of methotrimeprazine is stable. Monitor patient closely for evidence of CNS depression. Consider therapy modification

Metoclopramide: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

MetyroSINE: CNS Depressants may enhance the sedative effect of MetyroSINE. Monitor therapy

Mianserin: May enhance the anticholinergic effect of Anticholinergic Agents. Monitor therapy

Minocycline (Systemic): May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Mirabegron: Anticholinergic Agents may enhance the adverse/toxic effect of Mirabegron. Monitor therapy

Monoamine Oxidase Inhibitors: Cyclobenzaprine may enhance the serotonergic effect of Monoamine Oxidase Inhibitors. This could result in serotonin syndrome. Avoid combination

Nabilone: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Nitroglycerin: Anticholinergic Agents may decrease the absorption of Nitroglycerin. Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption. Monitor therapy

Ombitasvir, Paritaprevir, and Ritonavir: May decrease the serum concentration of Cyclobenzaprine. Monitor therapy

Ombitasvir, Paritaprevir, Ritonavir, and Dasabuvir: May decrease the serum concentration of Cyclobenzaprine. Monitor therapy

Opioid Agonists: CNS Depressants may enhance the CNS depressant effect of Opioid Agonists. Management: Avoid concomitant use of opioid agonists and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Consider therapy modification

Orphenadrine: CNS Depressants may enhance the CNS depressant effect of Orphenadrine. Avoid combination

Oxatomide: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination

Oxomemazine: May enhance the CNS depressant effect of CNS Depressants. Avoid combination

OxyCODONE: CNS Depressants may enhance the CNS depressant effect of OxyCODONE. Management: Avoid concomitant use of oxycodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Consider therapy modification

Paraldehyde: CNS Depressants may enhance the CNS depressant effect of Paraldehyde. Avoid combination

Perampanel: May enhance the CNS depressant effect of CNS Depressants. Management: Patients taking perampanel with any other drug that has CNS depressant activities should avoid complex and high-risk activities, particularly those such as driving that require alertness and coordination, until they have experience using the combination. Consider therapy modification

Piribedil: CNS Depressants may enhance the CNS depressant effect of Piribedil. Monitor therapy

Potassium Chloride: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Avoid combination

Potassium Citrate: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Citrate. Avoid combination

Pramipexole: CNS Depressants may enhance the sedative effect of Pramipexole. Monitor therapy

Pramlintide: May enhance the anticholinergic effect of Anticholinergic Agents. These effects are specific to the GI tract. Avoid combination

Ramosetron: Anticholinergic Agents may enhance the constipating effect of Ramosetron. Monitor therapy

Revefenacin: Anticholinergic Agents may enhance the anticholinergic effect of Revefenacin. Avoid combination

ROPINIRole: CNS Depressants may enhance the sedative effect of ROPINIRole. Monitor therapy

Rotigotine: CNS Depressants may enhance the sedative effect of Rotigotine. Monitor therapy

Rufinamide: May enhance the adverse/toxic effect of CNS Depressants. Specifically, sleepiness and dizziness may be enhanced. Monitor therapy

Secretin: Anticholinergic Agents may diminish the therapeutic effect of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin. Consider therapy modification

Serotonergic Agents (High Risk): Cyclobenzaprine may enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when these agents are combined. Exceptions: Isocarboxazid; Linezolid; Methylene Blue; Moclobemide; Phenelzine; Tranylcypromine. Monitor therapy

Sodium Oxybate: May enhance the CNS depressant effect of CNS Depressants. Management: Consider alternatives to combined use. When combined use is needed, consider minimizing doses of one or more drugs. Use of sodium oxybate with alcohol or sedative hypnotics is contraindicated. Consider therapy modification

Suvorexant: CNS Depressants may enhance the CNS depressant effect of Suvorexant. Management: Dose reduction of suvorexant and/or any other CNS depressant may be necessary. Use of suvorexant with alcohol is not recommended, and the use of suvorexant with any other drug to treat insomnia is not recommended. Consider therapy modification

Tetrahydrocannabinol: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Tetrahydrocannabinol and Cannabidiol: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Thalidomide: CNS Depressants may enhance the CNS depressant effect of Thalidomide. Avoid combination

Thiazide and Thiazide-Like Diuretics: Anticholinergic Agents may increase the serum concentration of Thiazide and Thiazide-Like Diuretics. Monitor therapy

Tiotropium: Anticholinergic Agents may enhance the anticholinergic effect of Tiotropium. Avoid combination

Tolperisone: May enhance the adverse/toxic effect of Muscle Relaxants (Centrally Acting). Management: Monitor for increased sedation or CNS effects if tolperisone is combined with other centrally acting muscle relaxants. Consider decreasing the tolperisone dose if these agents are combined. Consider therapy modification

Topiramate: Anticholinergic Agents may enhance the adverse/toxic effect of Topiramate. Monitor therapy

Trimeprazine: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Umeclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination

Zolpidem: CNS Depressants may enhance the CNS depressant effect of Zolpidem. Management: Reduce the Intermezzo brand sublingual zolpidem adult dose to 1.75 mg for men who are also receiving other CNS depressants. No such dose change is recommended for women. Avoid use with other CNS depressants at bedtime; avoid use with alcohol. Consider therapy modification

Test Interactions

May cause false-positive serum TCA screen (Wong, 1995)

Adverse Reactions

>10%:

Central nervous system: Drowsiness (1% to 39%), dizziness (1% to 11%)

Gastrointestinal: Xerostomia (6% to 32%)

1% to 10%:

Central nervous system: Fatigue (1% to 6%), headache (1% to 5%), confusion (1% to 3%), decreased mental acuity (1% to 3%), irritability (1% to 3%), nervousness (1% to 3%)

Gastrointestinal: Dyspepsia (?4%), abdominal pain (1% to 3%), acid regurgitation (1% to 3%), constipation (1% to 3%), diarrhea (1% to 3%), nausea (1% to 3%), unpleasant taste (1% to 3%)

Neuromuscular & skeletal: Weakness (1% to 3%)

Ophthalmic: Blurred vision (1% to 3%)

Respiratory: Pharyngitis (1% to 3%), upper respiratory tract infection (1% to 3%)

<1%, postmarketing, and/or case reports: Abnormal dreams, abnormal hepatic function tests, abnormality in thinking, ageusia, agitation, anaphylaxis, angioedema, anorexia, anxiety, ataxia, cardiac arrhythmia, cholestasis, convulsions, depression, diaphoresis, diplopia, disorientation, dysarthria, excitement (paradoxical, children), facial edema, flatulence, gastritis, gastrointestinal pain, hallucination, hepatitis (rare), hypertonia, hypotension, increased thirst, insomnia, jaundice, malaise, muscle twitching, palpitations, paresthesia, pruritus, psychosis, seizure, serotonin syndrome, skin rash, syncope, tachycardia, tinnitus, tongue edema, tremor, urinary frequency, urinary retention, urticaria, vasodilation, vertigo, vomiting

Warnings/Precautions

Concerns related to adverse effects:

• Anticholinergic effects: Use with caution in patients with angle-closure glaucoma, increased intraocular pressure, or urinary frequency/hesitancy.

• CNS depression: May cause CNS depression, which may impair physical or mental abilities; ethanol and/or other CNS depressants may enhance these effects. Patients must be cautioned about performing tasks which require mental alertness (eg, operating machinery or driving).

• Serotonin syndrome: Potentially life-threatening serotonin syndrome has occurred with cyclobenzaprine when used in combination with other serotonergic agents (eg, SSRIs, SNRIs, TCAs, buspirone, meperidine, tramadol, MAO inhibitors), bupropion, and verapamil. Monitor patients closely especially during initiation/dose titration for signs/symptoms of serotonin syndrome such as mental status changes (eg, agitation, hallucinations); autonomic instability (eg, tachycardia, labile blood pressure, diaphoresis); neuromuscular changes (eg, tremor, rigidity, myoclonus); GI symptoms (eg, nausea, vomiting, diarrhea); and/or seizures. Discontinue cyclobenzaprine and any concomitant serotonergic agent immediately if signs/symptoms arise. Concomitant use or use within 14 days of discontinuing an MAO inhibitor is contraindicated.

• Toxicity: Cyclobenzaprine shares the toxic potentials of the tricyclic antidepressants, including prolongation of conduction time, arrhythmias, and tachycardia; the usual precautions of tricyclic antidepressant therapy should be observed.

Disease-related concerns:

• Hepatic impairment: Use with caution in patients with mild hepatic impairment; plasma concentrations increased twofold in presence of mild impairment. Not recommended in moderate-to-severe hepatic impairment. Extended release capsules not recommended in patients with hepatic impairment of any severity (mild, moderate, or severe).

Concurrent drug therapy issues:

• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.

Special populations:

• Elderly: Extended release capsules not recommended for use in elderly.

Other warnings/precautions:

• Appropriate use: Limit therapy to 2-3 weeks; efficacy has not been established for longer periods of use.

Pregnancy Considerations

Published information related to cyclobenzaprine use in pregnancy is limited (Flannery 1989; Moreira 2014).

Patient Education

What is this drug used for?

• It is used to relax muscles.

Frequently reported side effects of this drug

• Fatigue

• Dizziness

• Loss of strength and energy

• Dry mouth

• Constipation

• Nausea

Other side effects of this drug: Talk with your doctor right away if you have any of these signs of:

• Fast heartbeat

• Abnormal heartbeat

• Serotonin syndrome like dizziness, severe headache, agitation, sensing things that seem real but are not, fast heartbeat, abnormal heartbeat, flushing, tremors, sweating a lot, change in balance, severe nausea, or severe diarrhea.

• Signs of a significant reaction like wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat.

Are there any negative side effects of the pain killer Fioricet?

Are there any negative side effects of the pain killer Fioricet?

My doctor prescribed Fioricet to me for my migraines.

My Rx says that I can take 2 pills – 4 times a day.

Are there any known long term side effects from using this drug? I take them pretty regularly.

Side effects requiring immediate medical attention

Along with its needed effects, acetaminophen/butalbital/caffeine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking acetaminophen / butalbital / caffeine:

More common

  • Lightheadedness
  • shortness of breath

Incidence not known

  • Abdominal or stomach pain
  • black, tarry stools
  • bleeding gums
  • blistering, peeling, or loosening of the skin
  • blood in the urine or stools
  • blurred vision
  • change in the frequency of urination or amount of urine
  • chills
  • cough
  • diarrhea
  • difficulty with breathing
  • difficulty with swallowing
  • dizziness
  • drowsiness
  • dry mouth
  • fainting
  • fast, pounding, or irregular heartbeat or pulse
  • flushed or dry skin
  • fruit-like breath odor
  • hives, itching, or skin rash
  • increased hunger
  • increased thirst
  • increased urination
  • joint or muscle pain
  • loss of appetite
  • nausea or vomiting
  • pinpoint red spots on the skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • seizures
  • shakiness in the legs, arms, hands, or feet
  • sore throat
  • sores, ulcers, or white spots in the mouth or on the lips
  • sweating
  • swelling of the feet or lower legs
  • tightness in the chest
  • trembling or shaking of the hands or feet
  • troubled breathing
  • unexplained weight loss
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • weakness

Symptoms of overdose

  • Confusion as to time, place, or person
  • dark urine
  • difficult or painful urination
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • fever
  • general feeling of discomfort or illness
  • hallucinations
  • headache
  • holding false beliefs that cannot be changed by fact
  • increased sweating
  • irregular, fast or slow, or shallow breathing
  • light-colored stools
  • loss of appetite
  • pale or blue lips, fingernails, or skin
  • restlessness
  • sudden decrease in the amount of urine
  • sweating
  • trouble sleeping
  • unpleasant breath odor
  • unusual excitement, nervousness, or restlessness
  • vomiting of blood
  • yellow eyes or skin

Side effects not requiring immediate medical attention

Some side effects of acetaminophen / butalbital / caffeine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Relaxed and calm
  • sleepiness

Incidence not known

  • Anxiety
  • bloated
  • constipation
  • continuing ringing or buzzing or other unexplained noise in the ears
  • depression
  • earache
  • excess air or gas in the stomach or intestines
  • false or unusual sense of well-being
  • full feeling
  • hearing loss
  • heartburn
  • heavy eyelids
  • high energy
  • hot spells
  • hyperventilation
  • irritability
  • numbness
  • pain in the leg
  • passing gas
  • sluggishness
  • stuffy nose
  • tingling sensation

You can not take Prescription for a long time, you need find a way to treat your pain without prescription. Exercising is the best way to relieve your pain. because exercising can enhance your immune system and increase your muscle strength and make your nerve strong.

You can also take some natural nutritions to increase your immune system too. Some anti-aging products can also increase your immune ability. You can try USANA Products ro make you strong. I take USANA Essentials every day and I find my health get better and better.

We do not suggest you to take Fioricet or Gabapentin for a long time, you need go to your local health professional to treat your pain without prescription. We think exercising is the best way to relieve your pain. Exercising is a very good methods. Exercising can enhance your immune system and increase your muscle strength and make your nerve strong.
You can also take some nutrition from food. But We really think the best health is to become an USANA Health Sciences Independent Distributor and take nutritions and it will make you much more health than before.

Make you-self beauty by whitening your teeth. It will be make you much happier and relieve your pain. You can also try to become a usana distributor or associate and eat health organic food to get rid of your headache or nerve pain.

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8 Triggers of Migraines and 6 Ways to Kiss Your Headache Goodbye

“A migraine is like a tornado; it attacks fast without any warning and wreaks havoc. ”

Migraines usually start during the teenage years or early in adult life, affecting more women than men with a ratio of three to one. Migraines are caused from constricted (tightening) arteries that supply blood flow to the brain. When the arteries constrict, blood flow to the brain is reduced as well as the brains oxygen supply. The brain reacts by dilating (enlarging) arteries to meet the brain’s need for energy. The dilation spreads to the arteries in the neck and scalp and is the culprit of the pain in migraines.

If you live with migraines, make sure to have your Doctor rule out an underlying illness or other medical conditions that mimic migraines with the appropriate tests: for example , x-rays determining sinus infection, EEG for seizure activity or a CAT scan to detect blood clots or a brain tumor. Your Dr . may determine a drug to help ease your pain.

Eight Migraine Triggers

1 . Cerviogentic Headache:

Some people who have a tender neck and suffer from sore bone and joint problems are diagnosed with this type

2 . Temporomandibular Migraine:

Triggered by teeth grinding

3. Sinus Migraine:

Triggered by allergies and caused by excessive mucous and often accompanied by a fever. If you have this type of migraine, you may experience pain around both eyes and also may feel nauseated and sensitive to light.

4. Genetic Migraines:

Studies have lined a gene to people affected with migraines. Often when the gene for migraines is passed on to the next generation, the recipient will also experience headaches around the same age as the person who passed on the migraine.

5. Stress Migraine:

Stress can be a major contributing factor to the onset of a migraine. Type A personalities are more likely to experience migraines. Type A is ambitious, bright, perfectionist, emotionally repressed, cautious and has a decreased ability to manage stress. However , this is the easiest type of migraine to treat because a type A personality can acquire the skills necessary to manage stress.

6. Hormonal Migraine:

Fluctuating hormones in women are often the cause of migraines and can happen during menstrual cycles.

7. Cigarette Migraine

An equal opportunity source of migraines is because the nicotine alters blood vessels. High carbon monoxide levels in a person who smokes or even inhales second hand smoke can lead to a migraine.

8. Food Migraines

Food allergies are another factor that leads to migraines. However , migraine sufferers are able to eat chocolate without falling prey to a migraine. Some patients actually report relief from eating chocolate.

Foods that Can Cause Migraines

1 . Aged cheese such as Roquefort, Stilton and Sharp Cheddar
2 . Fermented Dairy such as Sour Cream, Buttermilk and Yogurt
3. Citrus: Oranges or Grapefruit, including juice
4. Nuts: Peanuts, Walnuts or Pecans
5. Legumes: Peas, Beans and Soy product 6. Onions and Garlic
7. Bananas
8. Pickled foods: picked herring is the most common instigator
9. MSG found in Chinese food
10. Alcohol

Now that you know the common triggers, also note that skipping meals also causes migraines. Skipping meals causes your blood sugar to drop, which in turn causes a migraine.

Six Ways to Kiss Your Migraine Goodbye

1 . Medicine

Medicines have been used for centuries to treat migraines. Today Dr’s prescribe Beta Blockers to treat migraines by maintaining adequate dilation of blood vessels. Antidepressants: The brain chemical ‘serotonin’ plays a role in migraine attacks because the levels of serotonin may cause or relieve migraine and that’s why Drs sometimes prescribe antidepressants for migraines. Antidepressants reduce migraine frequency by regulating serotonin levels in the brain. Other drugs are triptans available as an injection or nasal spray. This type of drug shuts down the inflammation and transmission of migraine pain.

Fioricet is the best medicine for the Migraine Treatment and make you get migraine go away.

2 . Surgical Treatment

Nerve stimulators have been used to control back and muscle pain and in 2003 a nerve stimulator was successfully used to treat chronic headaches. With nerve stimulation, one end of a wire is connected to a nerve that controls pain and the other is connected to a small battery powered generator. The patient controls the generator via a remote device. Once turned on, it disconnects the pain signal.

Not only do chronic migraine suffers face agonizing physical disabilities, they also have the psychological fear of not being able to earn a living or manage their home life because daily activities can suddenly become unbearable with the onset of a migraine.

3. Holistic Intervention

Rarely are people offered a non drug approach to treating migraines. Treating a migraine holistically not only can treat the migraine at onset but can also act as prevention.

Create a headache diary listing the 5 W’s.

A. Who were you with?
B. Where? Did someone irritate you? At work with glaring lights?
C. What? What medications were you on?
D. When? When did the headache start?
E. Why? Did some particular food or drink aggravate the situation? Did you get enough sleep?

4. Review your diary after 30 days and see if you can isolate the trigger.

5. Use heat to help dilate the blood vessels in the body. This must be done at direct onset of your migraine. Soak your hands in hot water for 20-30 minutes. As the migraine progresses and the blood vessels enlarge, apply ice to the back of the neck and forehead to help constrict capillaries that are pressing against the nerves.

6. Relaxation techniques

You can use relaxation techniques to manage stress. Research has found that people who consciously practice yoga daily for 30 – 45 minutes can learn to positively manipulate involuntary bodily responses like migraine pain. Studies have shown that relaxation practiced on a regular basis achieves a 45 to 80% reduction or elimination in both migraine severity and frequency. Yoga triggers a boost in the brain chemical serotonin, a neurotransmitter that is involved with your body’s anger, pain, sleep and migraine and can be a cure for headaches.

Frequent headaches are a sign that you are stressed out and it’s your body’s way of saying slow down and take care of me. Especially if you are a type A personality. My type A patients often say they can’t sit still and have a difficult time with the relaxation/mediation part of yoga. My reply? What’s more difficult to live with. Meditating daily or living with a migraine, a stroke or a heart attack? These are very real situations that afflict people with constricted arteries and that’s why it’s vital that you make time for your health.

Unfortunately for my patients, I often meet them after they’ve suffered from a condition of vascular abnormality. They are very motivated to participate because they have experienced what happens when blood flow to the heart or brain is compromised. Consequently they practice my techniques daily to reduce a recurrence.

Why not make time now? There are 1440 minutes in a day. 45 minutes a day practicing yoga is a wise investment in your health that offers a positive life style with increased energy without the use of toxic drugs polluting your liver and fewer Doctor visits which equals fewer co-payments. Yoga Chi for Energy DVD includes medically engineered relaxation techniques with an 11 minute meditation by a crackling fireplace.

What are the Causes of Headache and How to Treat Headache ?

When a bad headache strikes, you just want it to end. The aching, throbbing pain can be debilitating and result in missed appointments, work, or time with family and friends.

Your headache symptoms can help your doctor determine its cause and the appropriate treatment. Most headaches aren’t the result of a serious illness, but some may result from a life-threatening condition requiring emergency care.

Headaches are generally classified by cause:

Primary headaches

A primary headache is caused by overactivity of or problems with pain-sensitive structures in your head. A primary headache isn’t a symptom of an underlying disease.

Chemical activity in your brain, the nerves or blood vessels surrounding your skull, or the muscles of your head and neck (or some combination of these factors) can play a role in primary headaches. Some people may also carry genes that make them more likely to develop such headaches.

The most common primary headaches are:

  1. Cluster headache
  2. Migraine
  3. Migraine with aura
  4. Tension headache
  5. Trigeminal autonomic cephalalgia (TAC), such as cluster headache and paroxysmal hemicrania

A few headache patterns also are generally considered types of primary headache, but are less common. These headaches have distinct features, such as an unusual duration or pain associated with a certain activity.

Although generally considered primary, each could be a symptom of an underlying disease. They include:

  1. Chronic daily headaches (for example, chronic migraine, chronic tension-type headache, or hemicranias continua)
  2. Cough headaches
  3. Exercise headaches
  4. Sex headaches

Some primary headaches can be triggered by lifestyle factors, including:

  1. Alcohol, particularly red wine
  2. Certain foods, such as processed meats that contain nitrates
  3. Changes in sleep or lack of sleep
  4. Poor posture
  5. Skipped meals
  6. Stress

Secondary headaches

A secondary headache is a symptom of a disease that can activate the pain-sensitive nerves of the head. Any number of conditions — varying greatly in severity — may cause secondary headaches.

Possible causes of secondary headaches include:

  1. Acute sinusitis (nasal and sinus infection)
  2. Arterial tears (carotid or vertebral dissections)
  3. Blood clot (venous thrombosis) within the brain — separate from stroke
  4. Brain aneurysm (a bulge in an artery in your brain)
  5. Brain AVM (arteriovenous malformation) (arteriovenous malformation) — an abnormal formation of brain blood vessels
  6. Brain tumor
  7. Carbon monoxide poisoning
  8. Chiari malformation (structural problem at the base of your skull)
  9. Concussion
  10. Coronavirus disease 2019 (COVID-19)
  11. Dehydration
  12. Dental problems
  13. Ear infection (middle ear)
  14. Encephalitis (brain inflammation)
  15. Giant cell arteritis (inflammation of the lining of the arteries)
  16. Glaucoma (acute angle closure glaucoma)
  17. Hangovers
  18. High blood pressure (hypertension)
  19. Influenza (flu) and other febrile (fever) illnesses
  20. Intracranial hematoma
  21. Medications to treat other disorders
  22. Meningitis
  23. Monosodium glutamate (MSG)
  24. Overuse of pain medication
  25. Panic attacks and panic disorder
  26. Persistent post-concussive symptoms (Post-concussion syndrome)
  27. Pressure from tight headgear, such as a helmet or goggles
  28. Pseudotumor cerebri
  29. Stroke
  30. Toxoplasmosis
  31. Trigeminal neuralgia (as well as other neuralgias, all involving irritation of certain nerves connecting the face and brain)

Some types of secondary headaches include:

  1. External compression headaches (a result of pressure-causing headgear)
  2. Ice cream headaches (commonly called brain freeze)
  3. Medication overuse headaches (caused by overuse of pain medication)
  4. Sinus headaches (caused by inflammation and congestion in sinus cavities)
  5. Spinal headaches (caused by low pressure or volume of cerebrospinal fluid, possibly the result of spontaneous cerebrospinal fluid leak, spinal tap or spinal anesthesia)
  6. Thunderclap headaches (a group of disorders that involves sudden, severe headaches with multiple causes)

Regardless of whether you are prone to migraines, tension headaches, or cluster headaches (see “Is this your headache?”), you may be able to reduce their frequency by identifying what brings them on. Here’s a look at the most common triggers for each of these kinds of headaches.

1. Stress. Stress can cause tight muscles in the shoulders and neck, which often leads to tension headaches. “It’s believed to start in the muscles. When tension headaches become frequent, the pain in shoulder and neck muscles is felt by the brain as pain in the head,” says Dr. Sait Ashina, a neurologist who specializes in headache treatment at Harvard-affiliated Beth Israel Deaconess Medical Center. Stress is also a common trigger for migraines.

2. Diet. Hunger itself can trigger a migraine or tension headache. But eating certain foods may trigger migraines. It could be just one type of food — like beans or nuts — or many foods, such as avocados, bananas, cheese, chocolate, citrus, herring, dairy products, and onions. “Processed foods with nitrites, nitrates, yellow food dyes, or monosodium glutamate can be especially problematic,” Dr. Ashina notes.

3. Alcohol intake. Alcohol is a common cause of migraine and cluster headaches. For some people, a few ounces of red wine are all it takes to provoke a headache, although any kind of alcohol can be a trigger. It’s not clear if the alcohol itself is to blame or if another component in the drink causes the problem.

4. Environment. “Cluster headaches seem to be seasonal and often happen in the spring or fall,” Dr. Ashina says. “It’s something in the environment, but we can’t tell exactly what it is yet.” Environmental factors such as bright light, smoke, humidity, intense scents, or cold weather are associated with migraine headaches.

5. Hormones. Changes in estrogen levels are associated with migraines in women, and women suffer from migraines more often than men. Menstrual cycles may be tied to migraine in younger women. Varying estrogen levels during perimenopause can sometimes start migraines in women who never experienced them before. Estrogen therapy may also be a migraine trigger. Menopause does seem to end migraines in most women.

6. Caffeine withdrawal. If you normally consume caffeine in coffee or tea, stopping intake abruptly may trigger a migraine. This may be because caffeine causes blood vessels to constrict; without caffeine, the blood vessels widen and bulge out with each heartbeat — a chief reason for the pounding pain of migraines.

7. Lack of sleep. A lack of sleep is associated with migraines and tension headaches. “We don’t know why, but we do know there’s a correlation and that sleep can lead to pain relief. Sometimes people feel better after taking a nap,” Dr. Ashina says.

How to Treat Headaches ?

Your head hurts. Again. The first step in foiling your frequent headaches is determining what type of headache you have. Sometimes headaches are a symptom of another disease or condition; sometimes there’s no clear cause.

Take a close look at your headache signs and symptoms. Keeping a headache diary might help determine your headache type. Note when your headaches occur, your symptoms, and potential triggers, such as food, stress or changes in sleep.

There are many types and sub-types of headaches. Chronic daily headaches, which occur 15 days or more a month, are one sub-type. Tension-type headaches and migraines are also common sub-types of headaches. They can both be chronic, though they aren’t always. Other types of chronic daily headaches include:

  • Hemicrania continua, a one-sided headache that can feel like a migraine
  • Primary stabbing headaches, which last for a few seconds and can occur several times throughout the day
  • Primary exertional headaches, caused by exercise
  • Chronic paroxysmal hemicranias, sharp, one-sided headaches that can cause tearing or a congested nose
  • Medication overuse headaches, which occur from overusing pain medications for headaches for at least three months. These headaches occur at least 15 days out of the month.

Other headache types include:

  • Cluster headaches, which cause severe pain on one side of the head and occur off and on for weeks over the course of a few months. Cluster headaches are associated with one or more signs and symptoms, such as tearing, nasal congestion and nasal discharge. These occur on the same side as the pain.

Tension-type headaches

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Tension-type headaches, the most common variety of headaches:

    • Might be felt as a tight band of pain around your head, a dull ache or pressure
    • Might cause mild to moderate pain on both sides of the head
    • Vary widely in frequency
      • Can be occasional
      • May occur more than 15 days a month (chronic)
  • Last from 30 minutes to a week

Headache Treatment

Most occasional tension-type headaches are easily treated with over-the-counter medications, including:

  • Aspirin
  • Ibuprofen (Advil, Motrin IB, others)
  • Acetaminophen (Tylenol, others)
  • Fioricet

Daily prescription medications, including tricyclic antidepressants, might manage chronic tension-type headaches. Alternative therapies aimed at stress reduction might help. They include:

  • Cognitive behavioral therapy
  • Biofeedback
  • Massage therapy
  • Acupuncture

Migraines

Migraines are another common type of headache. They affect three times more women than men. Migraines typically:

  • Cause pain that is moderate to severe
  • Pulsate
  • Cause nausea, vomiting, or increased sensitivity to light or sound
  • Affect only one side of your head, but can affect both sides
  • Worsen with activity such as climbing steps
  • Last from four to 72 hours without treatment

Treatment

Migraine treatment is aimed at relieving symptoms and preventing additional attacks. If you know what triggers your migraines, avoiding those triggers and learning how to manage them can help prevent migraines or lessen the pain. Treatment might include:

  • Rest in a quiet, dark room
  • Hot or cold compresses to your head or neck
  • Massage and small amounts of caffeine
  • Over-the-counter medications such as ibuprofen (Advil, Motrin IB, others), acetaminophen (Tylenol, others) and aspirin
  • Prescription medications including triptans, such as sumatriptan (Imitrex) and zolmitriptan (Zomig)
  • Preventive medications such as metoprolol (Lopressor), propranolol (Innopran, Inderal, others), amitriptyline, divalproex (Depakote), topiramate (Qudexy XR, Trokendi XR ,Topamax) or erenumab-aooe (Aimovig)

Recognize emergency symptoms

Seek emergency care if you have:

  • A very severe, sudden headache
  • Headache after a head injury or fall
  • Fever, stiff neck, rash, confusion, seizure, double vision, weakness, numbness or difficulty speaking
  • Pain that worsens despite treatment

These symptoms suggest a more serious condition, so it’s important to get a prompt diagnosis and treatment.

Take control

Almost everyone gets headaches, and many are nothing to worry about. But if headaches are disrupting your activities, work or personal life, it’s time to see your doctor. Headaches can’t always be prevented, but your doctor can help you manage the symptoms.