Tension, migraine, sinus or cluster — identify your headache type and find the best OTC relief available at Australian pharmacies, plus the red flags that mean see a GP.

To help relieve a headache, rest in a quiet, dark room and drink water — dehydration is a common trigger. A cold compress on the forehead or a warm compress on the neck can ease tension. For most tension headaches, paracetamol (e.g. Panadol) or ibuprofen (e.g. Nurofen) may help relieve symptoms — ask your pharmacist which suits you. Migraines often also need rest and sleep in a dark, quiet space. Seek urgent medical care if a headache is sudden and severe, or comes with fever, a stiff neck, vision changes, confusion, or weakness.
Headaches are one of the most common health complaints in Australia, affecting around 87% of Australians at some point. But 'headache' is not a single condition — it is an umbrella term covering many different types, each with different causes, symptoms, and treatments. Taking the wrong approach can mean the treatment does not work, or in some cases, makes things worse. This guide covers the five most common headache types and the best way to treat each one using products available over the counter in Australian pharmacies.
Tension-type headaches are the most common headache, accounting for roughly 70% of all headaches. They feel like a dull, constant pressure or tightness on both sides of the head — often described as a band squeezing around the forehead. The pain is mild to moderate and does not usually stop you from carrying on with daily activities.
Tension headaches can feel similar to a mild migraine, so if you are unsure which one you have, see our full migraine vs tension headache comparison guide for a detailed breakdown of how to tell them apart.
Simple analgesics are the first-line treatment. Paracetamol (500mg to 1000mg) is the gentlest option and works well for most tension headaches. Ibuprofen (200mg to 400mg) is an alternative, particularly if there is any muscle or neck tenderness contributing to the pain. Take at the first sign of the headache — do not wait for it to become severe.
Migraines are much more than a bad headache. They are a neurological condition causing moderate to severe throbbing pain, usually on one side of the head. Migraines often come with nausea, vomiting, and extreme sensitivity to light and sound. Some people experience an 'aura' before the pain starts — visual disturbances such as flashing lights, zigzag lines, or temporary blind spots. Migraines affect around 12% of Australians and are more common in women.
Migraines are often confused with severe tension headaches or sinus headaches. For a detailed, side-by-side breakdown of the symptoms that tell them apart, see our full migraine vs tension headache comparison guide.
Timing is critical with migraines. Take your OTC pain reliever as early as possible — ideally at the first sign of symptoms or during the aura phase. Delaying treatment significantly reduces effectiveness because migraine slows down stomach emptying, meaning tablets are absorbed more slowly as the attack progresses.
Ibuprofen (400mg) is one of the most effective OTC options for migraines and is supported by good clinical evidence. Soluble aspirin (900mg) is another evidence-based choice — the soluble form is preferred because it is absorbed faster than standard tablets. Paracetamol combined with caffeine (such as Panadol Extra) can also be effective; the caffeine improves absorption and has a mild pain-relieving effect of its own.
True sinus headaches come from inflammation or infection of the sinuses (sinusitis), producing a deep, constant ache in the cheekbones, forehead, or bridge of the nose that usually worsens on bending forward, alongside a genuinely blocked nose and thick, discoloured mucus. Important note: research suggests around 90% of self-diagnosed 'sinus headaches' are actually migraines — if yours comes with nausea, light sensitivity, or throbbing pain and your nose is not truly congested, treat it as a migraine instead. For the full comparison, the OTC treatment ladder (saline, steam, decongestants, pain relief), and when antibiotics are actually needed, see our dedicated guide: Sinus Headache Treatment and How to Tell It From a Migraine.
Cluster headaches are rare but extremely painful — often described as one of the most severe pain conditions known. They produce intense, burning or piercing pain behind or around one eye. Unlike migraines, cluster headaches tend to be short (15 minutes to 3 hours) but can occur multiple times a day, often at the same time each day, in 'clusters' lasting weeks or months. They are more common in men.
Standard OTC painkillers are generally not effective for cluster headaches because the attacks are too severe and peak too quickly for oral medicines to take effect in time. If you suspect you are having cluster headaches, see your GP as soon as possible. Effective treatments exist — including high-flow oxygen therapy and fast-acting triptans — but these require a prescription or specialist referral.
This is a common but often overlooked problem. If you take headache medicines regularly — 15 or more days a month for simple painkillers, or 10 or more for codeine, triptans and caffeine combinations — the medicines themselves can start causing headaches, sometimes called 'rebound headache'. The only effective treatment is to reduce or stop the overused medicine, best done with your GP's guidance, and it is fully reversible. For the day thresholds by medicine type, what withdrawal involves, and how to prevent it, see our dedicated guide: Medication-Overuse Headache: Causes and How to Break the Cycle.
| Feature | Tension | Migraine | Sinus | Cluster | Medication-Overuse |
|---|---|---|---|---|---|
| Pain type | Dull, pressing, band-like | Throbbing, pulsing | Deep, constant pressure | Sharp, burning, piercing | Dull, persistent |
| Location | Both sides, forehead, temples | Usually one side | Forehead, cheeks, nose bridge | Behind or around one eye | Varies (often widespread) |
| Severity | Mild to moderate | Moderate to severe | Moderate | Severe to excruciating | Mild to moderate |
| Nausea | No | Yes, often with vomiting | Uncommon | Uncommon | Sometimes |
| Light/sound sensitivity | Mild or none | Yes, significant | No | Possible light sensitivity | Mild |
| Duration | 30 min to several days | 4 to 72 hours | Days (while congested) | 15 min to 3 hours per attack | Near-daily, ongoing |
| Best OTC treatment | Paracetamol or ibuprofen | Ibuprofen, aspirin, paracetamol + caffeine | Decongestant + paracetamol or ibuprofen | See GP (OTC usually ineffective) | Stop overused medication (with GP guidance) |
This is one of the most common questions Australians have about headache treatment. Both are effective, safe, and widely available — but they work differently and suit different situations.
| Paracetamol | Ibuprofen | |
|---|---|---|
| How it works | Reduces pain signals in the brain (exact mechanism not fully understood) | Blocks prostaglandins that cause pain and inflammation (an NSAID) |
| Best for | Tension headaches, mild to moderate pain, when you cannot take NSAIDs | Migraines, headaches with muscle tension or inflammation, moderate to severe pain |
| Onset | About 30 to 60 minutes | About 20 to 30 minutes |
| Take with food? | No (can be taken on an empty stomach) | Yes (take with food or milk to protect the stomach) |
| Stomach friendly? | Yes — gentle on the stomach | Can irritate the stomach, especially with regular use |
| Safe in pregnancy? | Yes (all trimesters, at recommended doses) | Avoid in the third trimester; use only with medical advice earlier in pregnancy |
| Key cautions | Do not exceed 4g per day. Check all other medicines for hidden paracetamol (common in cold and flu products) | Avoid if you have stomach ulcers, kidney problems, or are taking blood thinners. Not suitable for everyone with asthma |
Bottom line: for a standard tension headache, either will work well — choose paracetamol if you want the gentlest option, or ibuprofen if you want faster relief or there is any inflammatory component (such as neck stiffness). For migraines, ibuprofen has stronger evidence of effectiveness. You can also alternate between paracetamol and ibuprofen if one alone is not providing enough relief — they work by different mechanisms, so this is safe for short-term use. Ask your pharmacist for guidance on timing.
Prevention is always better than treatment. While you cannot avoid every headache, these evidence-based strategies can significantly reduce how often they occur:
Most headaches are not dangerous. However, in rare cases a headache can be a sign of a serious medical condition. Call 000 or go to your nearest emergency department immediately if you experience any of the following:
You should also make a non-urgent appointment with your GP if your headaches are becoming more frequent, are not responding to OTC treatments, or are affecting your work or quality of life.
For a typical tension headache, the fastest combination is usually rest in a quiet, dark room, a glass or two of water, and a simple pain reliever such as paracetamol (e.g. Panadol) or ibuprofen (e.g. Nurofen) taken at the first sign of pain. A cold compress on the forehead or a warm compress on the neck can ease the pressure within minutes. Faster-absorbing forms — such as soluble or liquid-capsule products — may help relieve symptoms a little sooner than standard tablets. Always read the label and ask your pharmacist which option suits you.
The most common everyday triggers are dehydration, stress and muscle tension, poor or irregular sleep, skipped meals and low blood sugar, eye strain from screens, poor posture, and caffeine or alcohol. Hormonal changes, weather shifts, and certain foods can also trigger migraines in susceptible people. Keeping a simple headache diary — noting what you ate, how you slept, and your stress levels — is one of the best ways to identify your personal triggers so you can avoid them.
Yes — dehydration is one of the most common and easily avoided headache triggers. When you do not drink enough fluid, the body loses water and electrolytes, which can trigger a dull, all-over headache that often worsens when you move your head. It is more likely in hot Australian weather, after exercise, or after drinking alcohol. Rehydrating with water and resting often helps relieve a dehydration headache within a few hours. Aim for around 2 litres of fluid a day, and more when it is hot or you have been active.
Look at where the pain is, what it feels like, and what comes with it. A tension headache feels like a dull, pressing band across both sides of the head, with no nausea. A migraine is usually a throbbing, one-sided pain with nausea and sensitivity to light or sound. A sinus headache causes deep pressure in the cheeks, forehead, or nose bridge alongside a blocked nose. A cluster headache is severe, burning pain behind one eye with a watering or red eye. Use the 'Headache Types at a Glance' table above to compare your symptoms side by side — and see your pharmacist or GP if you are unsure.
A medication-overuse headache (also called a rebound headache) is a headache caused by taking pain-relief medicines too often. If you use simple painkillers like paracetamol or ibuprofen on 15 or more days a month — or combination or stronger products on 10 or more days a month — for three months or longer, the medicines themselves can start triggering headaches. The pain often returns as each dose wears off, prompting another dose and creating a cycle. The only effective treatment is to stop the overused medicine, which is best done with guidance from your GP.
Yes, for short-term use in adults, you can take paracetamol and ibuprofen together or alternate between them. They work by different mechanisms, so combining them can provide better relief than either alone. However, do not do this regularly without speaking to your pharmacist or GP. Follow the recommended dose for each medicine individually — taking both does not mean you should exceed the maximum dose of either.
For occasional headaches, take paracetamol or ibuprofen as directed on the pack (paracetamol every 4 to 6 hours, up to 4g daily; ibuprofen every 6 to 8 hours, up to 1200mg daily for OTC use). The key rule is to avoid regular use on more than 15 days per month for simple analgesics or more than 10 days per month for combination products, as this can lead to medication-overuse headaches.
Aspirin is an effective headache treatment, particularly for migraines. Soluble aspirin (such as Aspro Clear) is absorbed quickly and has good evidence for migraine relief at a dose of 900mg. However, aspirin is not suitable for everyone: avoid it if you have a stomach ulcer, bleeding disorder, or aspirin-sensitive asthma. Aspirin must not be given to children or teenagers under 16 due to the risk of Reye's syndrome. Always read the label.
Caffeine withdrawal is one of the most common headache triggers. If your body is used to regular caffeine, skipping it causes blood vessels in the brain to widen, which can trigger a headache. This usually starts 12 to 24 hours after your last caffeine intake and can last one to two days. To avoid caffeine withdrawal headaches, reduce your intake gradually rather than stopping suddenly. Interestingly, small amounts of caffeine can also help treat headaches, which is why it is included in some headache products like Panadol Extra.
Yes. In Australia, all medicines — generic and branded — must meet the same TGA standards for quality, safety, and effectiveness. A 200mg ibuprofen tablet from a pharmacy-own brand contains exactly the same active ingredient at the same dose as a branded Nurofen tablet. The main differences are in the inactive ingredients (binders, coatings) and the formulation (for example, liquid capsules may be absorbed slightly faster than standard tablets). For most headaches, a generic paracetamol or ibuprofen tablet will work just as well at a significantly lower cost.
See your GP if your headaches are occurring on more than two days a week, are getting worse over time, are not adequately controlled by OTC medicines, are new and different from your usual headaches, or are affecting your ability to work or enjoy daily activities. You should also see a doctor if you need to take headache medicine more than two to three days per week to function normally.
This information is general in nature and isn’t a substitute for professional medical advice. Always read the label and follow the directions for use. Talk to your pharmacist or doctor about what’s right for you.

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