I’ll go plain old paracetamol which works for me most of the time. If that fails then ibuprofen would be my next choice.

It depends on the cause, and your own biology.

Aspirin reduces pain signals but also reduces blood clotting, If your headache is from vasculature issues in and around your brain it’s extra insurance.

Acetaminophen just reduces pain signals in the nervous system. It doesn’t have any secondary advantageous effects but it is easier on your stomach.

Ibuprofen reduces pain signals and also as an anti-inflammatory. So if your headache is caused from minor swelling in the head it’s the obvious choice.

I feel like at least in the US most people tend to overtake ibuprofen when they’d probably be better suited with Tylenol or aspirin.

Ibuprofen if I’m at work, but at home I usually take a short nap and have some coffee after, which works better for me.

I prefer paracetamol since ibuprofen can create secondary effects in the gastric system.

I’m in too much chronic spinal pain to register a headache. I don’t know why, but the question made me realize I haven’t had a headache in a decade since my broken neck and back. I get to a point where I can’t focus on anything. The anti inflammatory Tylenol Arthritis formula is the most effective by a considerable margin. I don’t have arthritis and am 40. I’ve been on most available pain meds over the last decade, and honestly this one beats most others for me. I used to have headaches, my issues are different but my family basically switched to the same thing too after trying it.

Whichever is closest.

Acetaminophen kills your liver. Ibuprofen melts the glue holding your guts together.

What matters right now is your headache.

Somewhat in order of action:

• check if I am clenching jaw/grinding my teeth, relax shoulders and neck, center my thoughts, lower blood pressure and pulse

• thoroughly flush sinuses (like spend 20 minutes or more at least)

• drink lots of water/electrolytes and caffeine

• reduce sensory input: dark quiet room with comfortable seating

• double dose of Sudafed and Diclofenac sodium

• jump into traffic

Motrin(Ibuprofen) because it works better for me, assuming the migraine doesn’t cause me to puke it up right after.

Aspirin has never been of value to me and I would only take it if I had a heart attack.

If I can’t avoid it or if I’m in a hurry, I will take Paracetamol 500mg. If there is no change within an hour, I’ll take Ibuprofen 600mg. But if I have time, I will get some rest (avoid bright light, close eyes and listen to podcasts).

As other comments have said, deal with the origin of the pain first, THEN…

If it’s bad enough to take meds but not too bad, then one 500mg paracetamol and 200mg ibuprofen (my go to for pain). The paracetamol will generally be one with some caffeine in it.

If it’s a BAD headache, then 900mg aspirin.

I do have a headache hat which is kept in the fridge.

Ibuprofen, but hardly ever because near 100% of my occasional headaches are migraine so I use sumatriptan (which is prescription here). Because no painkiller works for those, but 6mg of intramuscular sumatriptan knocks them out 99% of the time.

Never Tylenol/paracetamol because it has never worked for me at all for any pain. Not headache not any other pain. Like zero effect, I just feel vaguely poisoned.

Never naproxen because I puke it up - I tried it first for a migraine and assumed I’d just vomited because migraine. But later tried it for a knee injury and nope, puked it right out again.

So for the rare not migraine headache that doesn’t just go away by itself, ibuprofen because it does work.

I default to ibuprofen. Feels a little more effective to me than acetaminaphen. I’ve never taken aspirin for pain.

Used to be ibuprofen but I gained an allergy to it so now it’s acetaminophen (Tylenol)

Aspirin because I used to run ultras where they sometimes ban NSAIDs because it can cause acute kidney injury in those kinds of scenarios (rhabdomyolysis) but ibuprofin is the worst of the two.

And I don’t fuck around with tylenol ever because the effective dose is pretty damn close to a toxic dose and if you drink alcohol forget about it altogether.

But NSAIDs also inhibit bone remodeling so I tend to just avoid them altogether, running and all. Some cells in/on your bones (osteoblasts) rely on inflammation as a cue to shit out new bone, so reducing inflammation kinda messes with that

Well, I’m not in a situation where I can go otc for headaches. I’m already using acetaminophen (paracetamol for the brits) non stop for chronic pain, and I have to save ibuprofen for stuff that never responds to other pain control methods because I’m an old fuck and I’m not supposed to take it at all, and it causes problems when I ignore that and take it anyway.

Luckily, my headaches almost always stem from stress and/or muscle tension in my neck, so it’s very rare they don’t respond to non chemical methods, and I happen to have prescription meds that are prn for those things if I want/need.

But, for headaches, I used to find caffeine more effective than analgesics, nsaid or otherwise. Even when I wasn’t drinking caffeine regularly (which means I know that it wasn’t just caffeine withdrawal causing the headache to begin with), a cup of coffee usually got rise of a headache faster and more thoroughly than NSAIDs.

But it was usually acetaminophen that would be my first pick when I went the OTC pill route. Less likely to irritate my already irritating bowel syndrome issues.

Tbh though, none of the OTC analgesics are great at getting rid of a headache. Some of the older studies and double blind tests I saw put them about the same as placebo for headaches, though that’s been years since I looked up anything about it.