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Headaches in Children

Headache treatments for children

There are 3 types of medicines to treat headaches in children, called rescue medicines. Rescue medicines don’t stop your child from getting headaches, but they can make your child feel better. These medicines include:

  • pain relievers (analgesics)
  • anti-nausea medicines (anti-emetics)
  • antimigraine medicines (triptans and gepants)

Read and follow all the instructions on the medicine box or bottle carefully. Talk to a pharmacist or your child’s healthcare provider if you have any questions about treating your child’s headaches with medicine

Pain relievers

Pain relievers (analgesics) work well for migraine attacks and tension-type headaches. Your child needs to take them as soon as a headache starts (within the first hour).

Don’t give your child pain relievers more than 2 or 3 times a week. Pain relievers can cause more headaches if you take them regularly for weeks or months.

The main type of non-specific pain relievers for headaches in children are non-steroidal anti-inflammatory drugs (NSAIDs).

NSAIDs for headaches include:

  • Ibuprofen (such as Advil or Motrin). Ibuprofen is the most common over-the-counter NSAID for treating headaches in children. Ibuprofen doesn't usually cause side effects other than possible stomach upset (nausea) and usually only causes side effects if you take it regularly.
  • Naproxen (such as Aleve). Naproxen is an over-the-counter NSAID for migraine attacks. You can try naproxen if ibuprofen doesn't work. Naproxen can cause stomach problems if you use it regularly. Don’t give your child naproxen more than 3 times a week.
  • Ketorolac (Toradol). Ketorolac is a prescription NSAID for moderate to very bad pain. The most common side effect is abdominal (belly) pain if you use it regularly.
  • Diclofenac (Cambia) is a prescription NSAID for moderate to very bad pain and migraine attacks. The most common side effect is abdominal (belly) pain if you use it regularly.

Acetaminophen (Tylenol) is an anti-fever medicine that is often used to treat headaches, but for migraine attacks it has been shown to be less effective than ibuprofen. Acetaminophen usually doesn’t cause side effects unless it is used regularly. Talk to your child’s healthcare provider if you have questions about pain relievers for headaches.

Anti-nausea medicines

Some children may have nausea or vomiting along with a headache. Anti-nausea medicines (anti-emetics) help stop nausea and vomiting from happening. They can also help pain relievers work better. 

Anti-nausea medicines that are sometimes used with pain relievers to treat headaches include:

  • Metoclopramide (Maxeran; Metonia) to help pain relievers work faster. It also helps with nausea and vomiting. Side effects include feeling tired and muscle spasms.
  • Ondansetron (Zofran) to prevent nausea and vomiting. Side effects include diarrhea, constipation, feeling sleepy, and being itchy.

Antimigraine medicines

Antimigraine medicines (triptans or gepants) are prescription medicines that are sometimes used for migraine attacks when pain relievers don’t work. These medicines change chemicals in the brain that can cause headaches and pain. It’s important for your child to take an antimigraine medicine as soon as the migraine starts. Your child should not use triptan antimigraine medicines more than 2 times per week.

Almotriptan (Axert) is the only antimigraine medicine approved in Canada for migraine attacks in children between 12 and 17 years old. It is a triptan medicine. Side effects include tingling in the hands and feet, and feeling weak, tired, and tight in the chest.

The following triptan antimigraine medicines are considered safe, but they’re not officially approved for children because they haven’t been studied enough in this age group:

  • rizatriptan (Maxalt)
  • sumatriptan (Imitrex)
  • zolmitriptan (Zomig)

Your child shouldn’t take triptan medicines if they have:

  • high blood pressure
  • a history of stroke or heart attack
  • a history of peripheral vascular disease
  • hemiplegic migraine (a headache that makes 1 side of the body weak)
  • migraine with brainstem aura (a headache that can cause dizziness, vision changes, and trouble moving)

Gepants are new antimigraine medicines that don’t have any studies published on their use in children and teens yet, though studies are happening. These medicines have been shown to be effective to treat migraine attacks in adults:​

  • ubrogepant (Ubrelvy)
  • rimegepant (Nurtec)

Talk to your child's healthcare provider about whether these medicines are right for your child.

Other ways to treat headaches in children

Complementary medicine (healthcare some people use along with standard medical treatments and medicines) may help to treat and manage headaches in children.

Research is starting to look at how the following types of complementary medicine might help with children’s headaches:

  • biofeedback
  • acupuncture
  • guided imagery
  • relaxation therapy
  • herbs, minerals, and vitamins
  • physical therapy

Talk to a nurse, social worker, psychologist, or doctor about other ways to treat your child's headaches. They can help you and your child:

  • find out what could be causing the headaches
  • use cognitive behavioural therapy (counselling that helps change negative thoughts and behaviours) for headache
  • learn self-hypnosis to help manage pain

Current as of: November 12, 2024

Author: Pediatric Neurology, Alberta Health Services