Medication Overuse Headache (MOH): Are You at Risk?

What is medication overuse headache?

Medication overuse headache (MOH), sometimes called rebound headache, is a chronic headache caused by taking acute pain or migraine medication too often. It is a paradox that catches many people: the drugs that stop a single attack, used too frequently, start to cause near-daily headache of their own.

MOH is one of the most common causes of chronic daily headache worldwide, and it is almost entirely preventable — but only if you are counting your medication days. Most people are not.

The day-count thresholds that signal risk

The risk is defined by how many days per month you take acute medication, not how many pills. The widely used thresholds are:

• Triptans, ergots, opioids, or combination painkillers: 10 or more days per month
• Simple painkillers (paracetamol/acetaminophen, ibuprofen, aspirin): 15 or more days per month

If you cross these limits for three months or more, you are in the MOH risk zone. The trap is that the medication still works on each individual attack, so the overuse feels justified right up until the background headache becomes constant.

Why you cannot judge this from memory

Almost nobody accurately remembers how many days last month they reached for a triptan or a painkiller. Attacks cluster, “just one” days are forgotten, and over-the-counter tablets taken for a “normal” headache are rarely counted. This is exactly why a structured tracker matters: a single medication-day count per month turns a vague worry into a number you and your doctor can act on.

To track it properly, record for every day:

1. Which medication you took (acute vs preventive — only acute counts toward MOH)
2. Whether you took it at all that day (the day is the unit, not the dose)
3. The running monthly total against the 10- and 15-day lines

How to get out of the MOH zone

The only definitive treatment is to reduce or withdraw the overused medication, which often causes a temporary worsening before the headaches improve over 2–8 weeks. This should be planned with a doctor, who may bridge the withdrawal with a preventive. Tracking is central to the process: it shows whether you are genuinely under the threshold afterwards, and whether a preventive is working.

This article is general information, not medical advice. Do not stop prescribed medication without talking to your doctor.

How Trackwell tracks medication days

The Trackwell migraine tracker includes a built-in MOH risk bar: each acute-medication day fills the bar, and it visibly warns as you approach the 10-day line. The one-page doctor summary reports your medication days per month so your neurologist can see the risk at a glance.

If you want to try the structure first, download the free 1-month sample →. No payment, no account.