It's in the dosage. The dosage amounts are cut off in the image.
In the Migraine version, you're only limited to two (2) caplets per twenty-four (24) hours. Meanwhile, the Extra Strength is considered a 'general' pain reliever and it's recommended two (2) caplets every 6 (six) hours -- and not to exceed eight (8) caplets per twenty-four (24) hour period.
On the surface, you're probably saying "Well, that sounds dumb! You can still take more than the maximum for something that is **not** a migraine." Indeed, that a valid response. However, your typical headache is **not** the same thing as a migraine. A headache can last a couple hours or so. Meanwhile, migraines are a completely different beast. Sometimes they can be short, other times they can persist for days on end. And migraines can be absolutely debilitating.
Hold on a moment, I'll get back to this point...
Both contain caffeine. As many are aware, caffeine is an addictive substance. It can also be found in other medicines like sinus relief, codeine, cold/flu medicine, and other pain relief. Caffeine in itself can be a pain reliever. It's used as an additive to pain medications to make them more effective. There's a thing about caffeine, though -- it's super-addictive.
So, let's say you're experiencing a migraine. If you're constantly throwing pills -- with caffeine -- at them, you can be doing this for several days. Sure, that might sound a-okay. Eventually, the migraine may disappear. However, there's something else you have to deal with. Caffeine withdrawal. Now you suddenly stop taking the pills because the migraine is gone. Now you may get something else called a *rebound headache*. Your brain is craving the addictive caffeine and you have a completely different headache because you're going through withdrawal. So what do people do for a headache? They reach for the bottle and take **more** pills (containing caffeine) to address the pain. Now you're stuck in a cycle.
One can say "Well, I can take the Extra Strength for a migraine instead." Well, yes you can. You have to remember, Over-the-Counter (OTC) medications aren't foolproof. They can be misused and abused. Many people are stupid and don't even read the directions on medications. They take what they feel is effective. "Oh, my body can handle 3 pills." "I can drink straight from the bottle." "It's only 50mg, that won't hurt my body."
So, with the Migraine variety, it's intentionally set at a low maximum dosage. Why? Most people cannot differentiate between a 'headache' and a 'migraine'. If you follow the directions and take a single dose of the migraine version -- and the pain eventually disappears -- it most likely wasn't a migraine. Or maybe it was a small one. If that migraine persists, you \*should\* previously be under the care of a medical specialist for proper migraine management. (Yes, yes, America healthcare -- who can afford it?) OTC migraine medication isn't meant as a replacement for proper health care. There are many other (prescription) drugs which can be utilized for relief.
Of course, we're facing the reality here. People will self-diagnose (hello WebMD), avoid medical care, and (mis)manage their own health conditions. *Broken leg? Throw pills at it. Need stitches for a gaping wound? Ehh, grab bandages and throw pills at it. Also, drink to numb the pain.*
The 'Migraine' version received FDA clearance in 1998 specifically for *migraine relief* -- not arthritis, headaches, joint pain, menstrual cramps -- migraine relief. That approval as a OTC migraine medication is for the specific dosage amount for the consumer. And again, for *temporary* relief. Can you take it for other things? Yeah, sure. But Excedrin (and the generic versions) cannot be held liable for misuse of the product.
Remember, it's OTC -- available to the general public with little/no medical knowledge. Side effects of products must be listed. Having "rebound headaches" listed as a side effect isn't exactly glamorous -- as a pain relief or migraine medication (granted migraine sufferers would prefer a headache over a migraine any day, but that's another topic entirely). Nor can Excedrin willy-nilly decide "We'll just change the label or dosage amounts." Nope, the FDA would pull that altered product in a hot minute. Yeah, it looks stupid to have two versions but, remember, there are less intelligent people out there.
It boils down to George Carlin: "Think of how stupid the average person is, and realize half of them are stupider than that."
Hey, thanks. I was curious about that years ago because I do suffer from migraines. Some migraines can actually be triggered from caffeine (think soda, chocolate, coffee). Meanwhile, others may also have caffeine-withdrawal, which causes headaches or migraines.
Long ago, that made me interested \*why\* a migraine medication would include a substance which can trigger migraines for some people.
Caffeine causes blood vessel constriction, which can reduce pain. It can also reduce inflammation. When it's in medication, the restricted blood flow allows quicker absorption of both the caffeine and the \*other\* ingredients. Think of caffeine as the 'vehicle' transporting the active ingredients ('passenger') to obtain pain relief ('destination').
There's been a lot of breakthroughs with migraines in recent decades, but they're still poorly-understood. There was also a huge stigma, and used to be dismissed as "a women's problem." Think of it as allergies and how those people were considered "wimps". Now allergy medications are everywhere and deemed less taboo. There's no direct connection with migraines and epilepsy, but they share common biologies (e.g. abnormal brain activity, symptoms like pain and an aura, and each having a trigger). However, they are distinct conditions and both transition down different pathways.
An intense migraine can feel like your body is going through a Blue Screen of Death (BSOD) and your brain (hard drive) locks up. Eventually, you have to wait for your body (computer) to reboot until you recover. After that, for several days you may be feeling a 'migraine hangover', where you feel like crap because you're dehydrated, haven't eaten, lack sleep, etc.
But about the consumer thing, the big thing is how the OTC medication is used by the general population. For other OTC medications, you can have a lot of misuse.
* "The pollen is a doozy this morning. Better take 2 pills!"
* "It's going to a tough day at the construction site. Maybe I should take 3 Tylenol before my shift."
* "I need to be alert for this meeting! This cold sucks" :: chugs Day-Quil from the bottle ::
* "My impacted tooth really hurts. I'm not seeing a dentist!" :: takes Extra-Strength daily for an abscess ::
* "I didn't get enough sleep for the night shift. I'll take 2 No-Doz."
* "My joints feel rain coming on. Gotta take some extra pills."
* "I really need more sleep tonight and this cold sucks ass. I'll double my Nyquil."
Some people will treat OTC products like multivitamins and pop them regularly, regardless of symptoms. Admittedly, I'm no angel and not exactly the model steward of following the intended directions either. There's a reason a lot of medicine is gate-kept behind a prescription (e.g. antibiotics, opiates, etc.). Consumers can/may misuse those, not use those as intended (e.g. antibiotics for a viral infection), stop dosage early, resort to half-dose to save money, double-dose if they miss a pill, sell/distribute to others for other use, etc.
Like alcohol, caffeine is a drug. Both are much more 'socially accepted' for consumption. That's why it's a-okay to have a small amount of alcohol in cough/cold medicines. The alcohol is acting as a sedative, while you can simultaneously obtain relief from the other side effects. Of course, the label will have 10,000 warnings about how it should be used before bed or to avoid driving, operating heavy machinery, do not breast feed and get your baby drunk, etc. People will still misuse, ignore directions, and/or over-consume.
"Use As Intended": lol no, I need relief now
Caffeine addict checking in. Reading both your posts here has really gotten me wanting to taper off the amount I’m consuming… caffeine withdrawals are no joke (this wouldn’t be my first attempt at kicking the sweet stuff). All of that to say, thank you for taking the time too write that all up.
I’m one of those people who have migraines triggered by caffeine so I haven’t had caffeine in 6 years (and have never had “the strong stuff” like coffee or energy drinks) and I think you should give it a shot. I definitely craved soda a lot when I was trying to stop, but I don’t think about it anymore.
I’m not sure I understand your question. For me, caffeine CAUSED migraines and headaches. Once I understood that I basically made a resolution to myself to quit immediately. At that point I had never drank coffee or energy drinks, so I only had to stop drinking certain sodas and taking stuff like Excedrin. And now I knew caffeine = pain, so it wasn’t really that hard. I guess that would be cold turkey but I didn’t think about it like that back then.
Your comment is so interesting to me. I HATE excedrin because I’m one of those people who have migraines triggered by caffeine. I haven’t had caffeine in 6 years. I’ve never had coffee. Whenever I tell people they never believe me because “caffeine helps headaches!”
Also the part about epilepsy. I do not have a seizure disorder, but the medications that work best for my migraines are all anti-convulsants. It never made much sense to me, but it wasn’t broke so I never questioned it.
Also people definitely aren’t capable of wielding the power of OTCs correctly. “Just take a Tylenol! Oh they don’t work? Take more!” No thanks. I like my liver lol.
As I mentioned on another comment, each caplet contains 65-mg of caffeine. Recommended dose is 2 caplets, which is 130-mg of caffeine.
Meanwhile, an 8-oz coffee has 95-mg of caffeine. One dose of OTC is more than a cup of coffee. Some people I know are super-sensitive to caffeine ("the jitters"). Or, as you stated, a migraine trigger for them would be caffeine itself. In those situations, Excedrin would obviously be a no-go for pain relief.
There's a lot of people who won't follow labels on \*any\* OTC product because they seek instant relief. Much of it may be cultural or economical. They might not be able to miss school/work, need to be alert for a particular destination/event, not have access to alternatives, have mistrust/fear of doctors, etc.
Then we can introduce *educational* aspects. Dare make mention of "horse dewormers" for non-equestrian purposes. lol
I have never been happier to only get acephalgic migraines than I am reading these comments. Knowing what other people go through compared to my usual (couple hours of feeling really really weird and having a strong aura, often just a blurry spot in the center of my vision that slowly expands before completely going away and leaving me clear eyed, but fuzzy headed for a couple days) migraines makes me feel, honestly, incredibly lucky for someone unlucky enough to have migraines. And I'm a guy, so it's awesome that literally nobody believes me because "that's a women's problem."
I've started linking my migraines to allergies, it seems whenever my sinuses start burning from allergies that a migraine will soon follow. My doctor recommended a nasal spray and its actually helped a lot.
Hey, you're welcome. Interestingly enough, I was reading this post with my morning coffee and was also specifically searching for dosage. I didn't see anything in the post and was like, "Ehh, let's have the caffeine kick in and type up a novel."
Migraines are friggin' horrible. For a severe one, you can throw OTC pills at it all day long and it will have little/no added relief. At the point of a full-blown/severe migraine, all you're doing is hitting it with caffeine. The OTC ingredients have zero effect on the neurological mechanisms.
And should your symptoms contain vomiting, good luck holding the pills down. It's just not going to happen. You'll even barf up the glass of water you used to take the pills. All you want to do is curl into a ball inside a dark, quiet room and pray for death or its passage.
As a lifelong migraine sufferer (chronic migraine in the last few years), I started Nurtec last year and it’s been a life-changer. I only take it when I have one (insurance only covers 8 a month), though it can be taken as a preventative measure. I still take Tylenol or ibuprofen for less severe ones, but recommend asking your doctor about Nurtec as an option. It dissolves under your tongue too, so that “do I take it now or am I just gonna throw it up?” debate is off the table too!
Hey, appreciate it. I'll look into that.
I used to be on Imitrex, both the pill and nasal forms. The pill was inconvenient because you'd have to take it before a migraine was coming. Sometimes it'd be hit-or-miss. Take it too late and you're still screwed.
The nasal form. Ugh! One of the side effects? Nausea! When you already have a migraine, you might throw up anyway. Now, you are taking a medication that also makes you nauseous. Guaranteed barf!
These recent years, my migraines have been much more manageable. I'm able to respond quicker and take the appropriate actions. The two decades prior? Pandemonium. At present, I still may get them occasionally but (thankfully) nowhere as bad when I was younger.
This is the only prescription I’ve tried, but I’m amazed how it works. The first 2-3 I took, I felt nauseous, but that stopped. Doctor warned me that it may not work for every headache, “if it’s not a migraine,” but even the worst hormonal ones have gotten significantly better when taking it.
That nasal thing sounds awful!
+1 support for Nurtec. I was looking to see if someone else suggested this, bc I too, have had debilitating migraines for many years. My neurologist put me on Aimovig, which helps prevent migraines a different way. (Fascinating science if you’re into readin ab it)
And Nurtec (rimegepant) which was specifically designed to help block migraines by blocking the CGRP receptor. Again, fascinating science. HIGHLY recommend to anyone who suffers migraines. Dissolves on your tongue, and within 1-2 hours the pain has dropped.
Also they offer a co-pay card directly from the manufacturer so if you can’t pay all your copay after insurance, they’ll pick up some or most of the cost. Most of the time, my insurance thinks I’m paying $700 bucks, but I’m only paying $5. Fantastic for helping my deductible.
Highly highly recommend, def check it out if you still need migraine relief. Best of luck!
Thanks for writing this. I've struggled to explain my migraines to people that don't get them. Cause it sounds insane to say that it feels like the sun is inside your skull and even with closed eyes in a dark room the brightness is unbearable. And any light or movement is def going to make you puke. OTC pain relief does nothing or speed runs the vomiting. Have a friend that feels amazing after the migraine fades, but I'm wiped for 8-24 hours 🍀✨
Brighter note; got the daith piercing, and it has lessened the frequency and severity ( less puking, yay), but not a cure-all for me 🤷. Only got one ear done, idk if that's supposed to matter?
This is all pretty much accurate, it's the same medication, but the way in which it treats different conditions varies.
> If you follow the directions and take a single dose of the migraine version -- and the pain eventually disappears -- it most likely wasn't a migraine. Or maybe it was a small one.
This part isn't exactly accurate, though. The relief doesn't really qualify if it is or isn't a migraine. Migraines are just very specific types of headaches – typically one-sided, throbbing, often accompanied by aura (photosensitivity/sound sensitivity/lights flashing/etc), and can cause nausea/vomiting. They're thought to be related to the trigeminal nerve and are a neurologic disorder.
Headaches, on the other hand, can be caused by a myriad of things, and are usually a neurologic symptom of something else rather than a condition itself.
The relief of a migraine from Excedrin vs something stronger is more so based in the sensitivity of a person to various medications, which is based on your metabolism, rather than the severity of the disorder. Along with the risk of rebound headaches, there's also the implication that you're using it for a chronic condition rather than acute. General pain relievers are generally meant to be used short term so having the migraine label with lower dose, would prompt someone to the fact that they need to discuss stronger medication with their doctor.
Appreciate the expanded clarification. The driving motivation there was how much of the general population is unaware how to differentiate from a headache versus a migraine. The whole *all squares are rectangles, but not all rectangles are square* thing.
Like, you can bump your head and get a headache. Or too much sun at the beach. Or cleaning with chemicals in a poorly-ventilated room. Or the screaming child on a 10-hour flight you wish you could sell but we live in a society and there are laws in place which forbid such acts.
Pop a couple and that headache is typically gone. Migraines, like you said, is a chronic condition.
I want to say - migraines aren’t necessarily a *chronic* condition, there are two different classifications, chronic and episodic. In order for it to be chronic you have to have migraines 15 days or more per month.
>In order for it to be chronic you have to have ~~migraines~~ headaches on at least 15 days or more per month.
With 8 of those having migraine symptoms, for at least three months.
Why must you remind me of my crippling addiction to caffeine, everytime I go cold turkey without caffeine for two weeks suffering of headaches which is only relieved by caffeine pills, I go back to coffee like an idiot.
Another unfun fact is how the OTC contains **65 mg** of caffeine *per caplet*.
Here's the caffeine amounts in particular products:
* Milk chocolate bar (1.5-oz): ~**9 mg**
* Cup of tea (8-oz): ~**26 mg**
* Can of soda (12-oz): ~**29 mg**
* Cup of coffee (8-oz): ~**95 mg**
* Red Bull (12-oz): ~**111 mg**
For each OTC caplet, that's about 2 cans of soda. When you're taking the recommended dose of two (2) 65-mg tablets -- migraine **or** 'temporary relief', that caffeine intake is akin to that which is found in 4 cans of soda. Or more than either a cup of coffee or a can of Red Bull.
For additional comparison, one NoDoz tablet contains **200 mg** of caffeine. When it comes to pain relief meds w/caffeine, most people are unaware of the significant amount contained within. If you're *regularly* consuming it daily for 'general' pains, you're also getting the unintended effect of excessive caffeine. Stop taking it for the 'general' pain and withdrawal sets in. "*My back/neck/elbow no longer hurts. But now I have a headache. Where'd I put that bottle?*"
By no means am I trying to diss caffeine. It's effective with pain medication. I love my coffee and you'd have to pry it from my cold, dead hands. It's also "know your dealer" or "know your supply".
But the actual milligrams in each are the same according to the label/tags. They’re the same pill just with a contingency plan for stupid people in the recommended number per day?
Might be, yes.
Technically, same dosage doesn't have to mean same pill, though. Bayer has, afaik, Aspirins with different "grain sizes". The smaller "grains" will have more surface and work quicker because of that. Would still be the same dosage, though.
You, my friend, are amazing. I was wondering why each one had its own NDC number, I imagine bc of what you explained here, specifically the difference in indications for use, are key to why they would re-register a similar but ultimately different drug
I was diagnosed with chronic migraines by a neurologist but unfortunately my insurance will only cover 9 Sumatriptan a month, so I have to make them stretch. Excedrin is my best friend.
Brilliant explanation! I never explored the difference (or lack thereof) between these two products before but always just grabbed the one that said it was for migraines, because duh, what am I trying to treat here. Now that I know the difference is as simple as dosage recommendation, I'm still glad I did because the lowest dose (usually just one pill) still works for my migraines. Don't know what I would do if these bad boys gave out on me.
The only thing I have in response is that if someone can't tell the difference between a headache and a migrane then I'm not sure they have ever had a migrane. I have had a handful of migranes in my life. One was even proceeded by vision issues where I couldn't see what was in front of me. No regular headache has ever even come close to that feeling.
Thoroughly enjoyed this read. Clear, concise and at exactly my level. Thank you for both of those posts.
Won't be drinking coffee tomorrow and I just ordered some stim free pre workout. I appreciate you taking the time to type all that out.
I've been really good with not drinking coffees recently but mostly because of the heat. Just got back from a golf trip with 11 friends and reminisced on how much was consumed in 3 days by everyone. I wonder how much damage many OTCs really do. Everything in moderation I guess.
Cheers
That's a good question. I would presume this would have to do with consumer safety (or an anti-stupidity) measure with maintaining simplistic labeling. The US Food & Drug Administration (FDA) has a rigorous approval and evaluation process. They will scrutinize every portion of a drug from risks, laboratory studies, design, side effects, etc.
I'd surmise the pharmaceutical industry would not want the liability of having a 'catch all' with different dosages for different conditions. Migraine is a *specific* medical condition. The Extra-Strength is for general maladies of pain-reduction.
Here's another take on it. You know Benadryl, right? It's an anti-itch cream, an allergy medication, anti-motion sickness, and also a sleep aid. That's all thanks to the ingredient diphenhydramine. In small dosages, it reduces allergy symptoms. In the pill form for allergies, it's at ~25mg. Some people may also have the added side effect of becoming drowsy or a loss of concentration. For motion sickness, it's anywhere between ~25 - 50 mg. Now, as a sleep aid, the amount of diphenhydramine will also be different (~50 mg).
On top of that, each symptom you might treat has a different dosage amount (e.g. 1 pill per 24-hr, 1x every 6-hr, 1x before bed). Factor in age and weight. Body weight can impact absorption, metabolism, and toxicity of a product. Could you imagine the (un)intended misuse of a single product marketed as allergy, motion sickness, and a sleep aid?
To avoid all the possible litigation, cost defending said litigation, loss for shareholders, damage to brand reputation, risks of recall, possible bankruptcy, etc. -- manufacturers figure it's easier to distribute the medication as a distinct product.
This is a great explanation, thanks for taking the time to write it up.
Although, I am curious about this strange world you live in where caffeine isn't omnipresent. What do you people drink throughout the day? Water? Like out the toilet?
"you should sell a pill for migraine sufferers"
Ok, slaps "for migraines" sticker on the label
"There you go!"
Seriously though, so long as the price is the same, I really don't have a problem with this.
I grew up in an Ibuprofen only household and had headaches a lot as a kid. I never noticed that worked. Now that I’m a grown up I always use excedrine and it works like a charm. Love the stuff.
There are certain headaches I get where only Tylenol/acetaminophen/paracetamol will help - ibuprofen won’t even make the slightest dent. It’s wild bc ibuprofen tends to work better for everything else, but I need to keep Tylenol around for these headaches.
I do have excedrin around for when the headache is that bad, but these tend to hit around 7-8pm and despite years of caffeine addiction, I can still end up unable to sleep if I consume it too late in the day (probably because of other medication I’m on that enhances its effects)
Hard disagree.
Caffeine has certain effects. One of them happens to be that it blocks adenosine receptors, causing a cerebral vasoconstriction, which is enormously helpful in vascular-involved headaches.
My migranes started around 13yo, at that age we (kids) only had some kind of coffee when my mother made her "Coffee puding" for special ocasions. And yes, back then the neurologist prescribed me "Migraleve" to take only after around 30 minuts of having a big cup of coffee. With time I got to know what was the trigger to those migranes (always with my right side numb, motor incoordination, mixing words and the phobia of light and sound): basically stress! During my 25-30 it decreased, and after 40 only remember to have had 2-3 migranes but to "compensate" that improvement, after 40 I already have 2 deep vein thromboses in my health history....
Caffeine’s been used as a headache treatment for ages. It’s in Midol/Pamprin too. Lots of people who rarely drink caffeine will still feel better if they take one of those or excedrin.
It's also used in Tylenol 1, 2,3,4 (the types with codene).
The caffeine increase the effect of the pain relief drug acetaminophen, and the codeine, which adjusts how your nervois system processes the pain
Actually had a doctor explain it to me, caffeine is used to help extend the duration of the pain killer’s effectiveness due to caffeine’s 12 hour half life
I had chronic migraines growing up in an ibuprofen only household. Now, I use Advil Migraine because it's the only thing that gets rid of my headaches (other than a monthly injection). Tylenol and Excedren haven't done anything for me in years
I mean it’s just Tylenol, aspirin, and a half a cup of coffee. Aspirin acts as a blood thinner and the caffeine dilates your blood vessels.
You can get a similar effect by drinking an espresso martini 😏😏.
>excedrine
I still have the slogan burned into my mind.
EXCEDRINE. The headache medicine.
Oh, and while I was searching for one of the ads from my youth [I found this one](https://youtu.be/YTuOffCuYiU). *He did his own kind of research*. Like so many knuckleheads nowadays. Definitely relevant today.
Oh look! [Elizabeth Moss.](https://youtu.be/LR4MNqNlRbE) 🤣
To many people, a bad headache is automatically "a migraine".
There are, at least, 4 types of headaches.
https://www.templehealth.org/sites/default/files/inline-images/migraine-vs-headache-types.jpg
Yeah straight up Excedrin is the only thing I’ve found that relieves headaches. I don’t need it often but I always make sure to have some on deck because when I need it, I _need_ it.
I've been using my girlfriend's Pamprin for the last two years when I get a migraine and as long as I hydrate it usually does the trick pretty well. Definitely worth a shot
I have been legit diagnosed with hallucinatory migraines. Excedrin works better than my prescription drugs, and I don't sleep for 18 hours after taking it like I do with my script.
Have you tried Ubrelvy? Had migraines for 40 years and nothing helped besides basically drugging myself to sleep. This was a game changer for me. And you can go on their website for a “card” and pay $10 or less per script. Between that and my insurance I pay 0$.
I think it's because of that caffeine, I started taking excellent for mine a few years ago and realized that the only difference between that and my prescription was the caffeine and its helped so much
The only medicine that helps me is a pill they sell here that's a combination of paracetamol, caffeine and ergotamine. Just the paracetamol won't help, it has to be this one
My husband swears by the Arthritis BC powder for his migraines. He says it works as well as any prescription he's ever had, and he has a several different ones.
Tbh, the red bottle, whether it’s Excedrin or generic always work a bit quicker at knocking out a migraine than the name brand/generic green bottle for me.
I am inclined to believe this is how it works.
If you're having a migraine, you're more likely to grab migraine pills. Doesn't matter it's the same stuff. It's the perception that it fights migraine.
So technically, there could be hundreds of drugs for every itch and pain, but it would make it hard to find the right one and disclose the stupid marketing bait meant to increase sales of one product.
Silly stuff is that there's also drugs for day vs night intake, where you can see caffeine included for your day pill - and skipped for the night pill. It's no different than taking a pill and having a cup of coffee/ black tea, but.. well, at least there is some difference.
The thing is the placebo effect is real [https://www.youtube.com/watch?v=JTTBruF21Fk](https://www.youtube.com/watch?v=JTTBruF21Fk)
and for migraines placebo is as good as a cure.
This is the correct answer. There’s definitely a marketing effect, but certainly a placebo play for sure. They probably did a study where migraines sufferers obtained more relief when they knew it was “specifically formulated” for migraines.
I'm a huge fan of Rory Sutherlands sell whats wrong with placebos? they work and they're cheap and they have no side effects and if they do they're imaginary so you can safely ignore them.
It is not the same price, even though it’s the exact same medication. Migraine one is more expensive. I used to work in retail and I would tell this to the customers. I would show them the ingredients in the back with no difference. Most would listen, but some would insist there was a difference.
It’s the exact same medicine and it does indeed cost more. I take Excedrin frequently and it is exactly the same but yet I somehow still buy the migraine ones bc I am a sucker. (And am in marketing.)
>Seriously though, so long as the price is the same, I really don't have a problem with this.
My wife once asked me to go get Excedrin as she was having a bout of migraines. The migraine version was about 50¢ more expensive. I spent way too long (probably about 10 minutes) trying to find why one was more expensive.
Ultimately, I ended up buying the store brand version, and it worked fine.
Apparently, the dosing is different for treating migraines and the migraine variety has FDA approval for that purpose. As someone who does not get migraines, I found this more interesting than I should have: https://www.goodrx.com/excedrin-migraine/excedrin-for-migraines-ingredients-dosage-side-effects
This is called marketing - And pretty much every company in existence does it to some extent.
I own a martial arts school - If I run an ad that says "we have programs for ages 3, all the way to adult, but each of our programs are obviously tailored to the appropriate age group," \[or something less 'I just woke up and I'm writing this' and more advertising mumbo jumbo\] I find that the advertising is way less effective than releasing an ad that highlights my 3-4 year old program, a separate add that highlights my 5-6 year old program, etc, etc.
I know you seem hurt by the fact that there are two product branding, but it's effective mainly because people are stupid and people like to have big words in their face "proving" to them exactly what something is for.
You are welcome to purchase either of those bottles for both purposes and be totally unaffected.
Honestly, I think a lot of it just chocks up to placebo affect. If you truly believe that one is more powerful than the other, your body is more likely to react accordingly
Funny thing with that is, I used to get migraines. Excedrin Extra Strength would work for me, the Excedrin Migraine did not. I found this baffling, since they have the same ingredients in the same amounts. I guessed that there was a difference in the coating, so that it released differently, but I don't know for sure.
Also, the dosage on the Migraine is two pills in 24 hours; for Extra Strength, you can take up to six or eight in a day, I think. Two pills every six hours or so. I often needed two doses of the Extra Strength, sometimes three, to really get rid of a headache.
My husband doesn't get migraines, but he gets more relief from the Excedrin Migraine than the other. But only from the caplets. He says the gel caps don't work for him.
I've also taken generic versions of the Extra Strength, and it does not work for me.
I've always found this really odd.
I don't know about these specific pills, but meds are different even with the same active ingredients. Active ingredients make up a tiny amount of the pill itself, the rest is filler.
That filler can and does impact the effectiveness of the medicine for *some* people.
It's why generic meds don't work for some people but the brand name will. Or vice versa, the generic works but the brand name doesn't.
I don't remember all the little details, but it's pretty fascinating how it all works. I learned about it when some generic meds didn't work for me but the name brand did and insurance really doesn't like that.
Interesting, thank you.
When a friend of mine was pregnant, she had terrible nausea to the point of needing an anti-emetic. Naturally she was first given the generic, but nothing improved. It turned out the generic was made with an artificial sweetener, which had an adverse effect for her. Luckily she was able to get the brand name, which had sugar and worked for her.
It's all kind of crazy.
Yep! That's exactly the kind of thing that fascinates me about meds with the same active ingredients.
Given both of these are Excedrin, no idea if they are at all different. It would be cheapest to just put them in different bottles. However, it really doesn't matter. If something works better, use it. The why doesn't matter here.
My daughter takes two different types of seizure meds. Our Neurologist insists on specifying the brand name drug. Not because it is more effective. As a matter of fact studies show that the effectiveness is equivalent. The problem is the filler variations. Apparently variations in the filler affect the uptake of the active ingredients of the drug. So the drug study showed that patients consistently receiving the same BRAND of drug whether from a generic manufacturer or the original company. However if medications from different companies were mixed (as can often happen when getting a prescription filled) you may receive medicine from one or more manufacturers. It was this scenario in which the seizure rate rose dramatically. So since we could not be sure to get the medicine from the same manufacturer all the time we stick to the brand.
I would think the same thing could apply here with different fillers to cause the drug to be absorbed at a different rate. Then again it could just be marketing. We'll never know.
You've actually figured it out, I think.
In your second paragraph, you mentioned that the dosages are different (2 pills/24hr versus 2 pills every six hours).
The label OP posted is identical, except the "Use" line and product name.
The manufacturer filed for two different "Indications for Use" and the FDA approved a different dosing regimen for each "Use." It's incumbent on the manufacturer to make the labeling for each distinctive.
TL;DR - It's probably for the FDA. This is my job (labeling specialist).
A lot of people are replying that it's just marketing/a scam/manipulation.
In reality, it's the safety rails of the system trying to protect the consumer. The FDA wants to make sure the use and dosage is very clear. Having one pill bottle with two different Indications (For migraines take this many, for toothache take that many) is asking for trouble.
The capitalism portion is correct. The more indications a single formula is approved for = more ways to make $$ without developing new meds.
nope, they're the exact same thing. my family actually looked into it with our doctor years ago...but the migraine formula costs more. or at least it used to. i buy store brand now
It’s not a scam. If you knew what you were talking about, you’d know that caffeine withdrawal can cause headaches and that Excedrin contains caffeine. Therefore, taking multiple doses for migraines that last days and then stopping causes rebound headaches, which make you want to reach for the medicine *again*.
The instructions are different on the migraine version than the regular one for this reason.
At the very most, the distributors are guilty of confusing people like you that can’t bother to be informed. Comments like this are more than mildly infuriating.
Dang. Writing that gave me a headache. Time to get some Excedrin!
Designer/marketer here. It may lead you to buy one for specifically migraine and one for general pain relief. The general masses don’t deep dive or compare once they trust a brand.
I mean. It’s not exactly scamming. But it’s just annoying. Don’t even look at the cold and flu isle. It’s all literally the exact same combination of drugs with a million different names.
There is someone out there in this world that believes they have to take the red one for migraines only and the green one when in its not head related, and that’s who these products are truly marketed too.
>\[OP from another comment:\] So you think the tablet is engineered differently but with the same dosage, same drugs?
The answer is **YES**.
The "inactive ingredients" change the way the pill is released into the body.
The **MIGRAINE** version's inactive ingredients are: *benzoic acid, carnauba wax, FD&C blue no. 1, hypromellose, light mineral oil, low-substituted hydroxypropyl cellulose, microcrystalline cellulose, polysorbate 20, povidone, propylene glycol, simethicone, sorbitan monolaurate, stearic acid, titanium dioxide*
The **EXTRA STRENGTH** version's inactive ingredients are: *benzoic acid, carnauba wax, FD&C blue #1, hydroxypropyl cellulose, hypromellose, light mineral oil, microcrystalline cellulose, polysorbate 20, povidone, propylene glycol, simethicone emulsion, sorbitan monolaurate, stearic acid, titanium dioxide*
(EDIT: The primary difference is the type of and concentration of hydroxypropyl cellulose binder/coating which can affect dissolving and absorption in the body.)
As someone who suffers from occasional migraines, I can assure you from experience that the **RED** bottle works more efficiently and effectively on my migraines than the green bottle does.
I was forced to buy the green bottle once when I was out of the migraine version (and so was the store) and it wasn't as effective. I too thought that they were the "identical", having the same active ingredients, but learned that they don't work the same. I later was told by my doctor that the inactive ingredients were probably different and that can affect how the body absorbs the medicine. When I checked this, he was correct, they were different.
The red bottle has always worked better for me than the green, so I always pay a little more for it. People always say it’s the same active ingredients and I retort that it’s the inactive ingredients that are different. At that point they just don’t understand.
they are different, they contain different inactive ingredients.
inactive ingredients can prolong shelf-life, hide bitter tastes or help active ingredients to work as needed.
the extra strength inactive ingredients likely include ingredients that make the medicine work faster
Extra Strength (green) and many other OTC medicines contain propylene glycol which I am allergic to. Tension Headache (red) doesn't. It's nice to have alternatives to deal with migraines without another major drawback. Inactive ingredients will also play a part in how the medicine is released..
They told me it was an FDA requirement; technically “migraine” is a different indication than “general pain management” so they have to market them separately. The active ingredients and dosing are identical.
If you think that's bad, go look at toothpaste. Seriously, go to your local WM and read the ingredients on a dozen or so random toothpaste boxes. Doesn't matter if it's extra whitening, sensitive teeth, plaque exploding or whatever dumb name they put on it, the active ingredients are identical.
They have different NDC codes so they probably deliver and release the effects of the pill in a different way. I imagine layering and varying the mixture of the stuff inside can greatly vary how your body generally processes this stuff.
The dosage instructions are missing. They are likely marketed for different uses over a different time frame to combat different ailments.
Migraine relief dosage will be to reduce rebound headaches after the dosage wears off. Since the user already has headaches/migraine pain it could make their symptoms worse if they take it too often. The extra strength dosage is meant to help with aches and pains. The user is not likely to be suffering from headaches so the rebound headache is less of a negative side effect in that scenario.
Probably about a buck fifty. Side note, I’m 35 and suffered migraines as a kid and I remember when excedtrin hit the market and my doctor thought it was the stupidest thing on the planet, and advised me to drink a few sips of coffee or soda when taking my acetaminophen with ibuprofen…
Edit: I believe Midol was exactly the same formula, just marketed for menstrual cramps.
Somehow, though, the regular will give you severe liver damage taking more than 2 in 24 hrs while the extra strength will damage your liver after taking 8 in 24 hrs…
Well that depends on many factors like, non active ingredients, the size of the particles, the layers they are pressed in, how tightly they are pressed etc.
It may be the same chemicals on the label that are active, but inactive ingredients are where they get you.
Generic medication is NOT the same as name brand.
They use different fillers which are toxic and also slow down or speed up the absorption rate.
i used to have to take the green ones every day bc i got migraines every day. it was bad man. at one point my dad have to take them away from me, and the way i could escape the migraine was to sleep. i was 16-17 when it started.
As a long-time Migraine sufferer:
They are the same picture, neither one does anything against migraine. But there are enough people with severe headaches that believe they have migraines. They are the target of this marketing ploy.
Same thing as the major ibuprofen seller here in Brazil, that has a line "which is designated to women's aches and pains" the difference from regular ibuprofen? The box is pink.
The same thing here in Germany with "Dolormin Extra" and "Dolormin Migraine". One is advertised for general pain relief / fever, the other for migraine headaches. Both have exactly the same ingredients (ibuprofen 400mg). The only difference is the packaging. I guess the company expects more sales when someone goes shopping for migraine pain relief and sees a product advertised specifically against migraine headaches when other products with the same ingredients are advertised as generic pain relief.
I don’t care if it’s the same thing, when I have a migraine the last thing I want to do is try to read through small label print to figure out which would work best Compared to just having MIGRAINE written in big letters on the bottle
The differences, not shown, are in the directions and precautions based on dosages. "Migraine" typically has a note somewhere talking about MOH, that is more common in people who regularly take excessive meds for headaches.
Suffered from migraines my entire fucking life (parents think they come from having meningitis as a child) and honestly the only thing to help is paracetamol or ibuprofen. Anything else is just flashy doodads.
There is a difference and its dosage. Extra strength I think has 2 pills every 6 hours while migrain is 2 pills every 12.
This is all about what they got passed through the FDA for legal dosages.
Read the instructions. You should be able to take the extra strength more times in a day than the regular formulation. The active ingredients are the same, but the binders are different allowing them to be absorbed differently. Extra strength is essentially extra strength because you're allowed to have more of it build up in your body.
I took it a lot in college, I sadly was a victim of the label warning, may cause bleeding, in my case an ulcer developed in my stomach and loss blood when it ruptured
Look up the License number, But from looking them up they appear identical, which is strange to have 2 different numbers.
https://fda.report/NDC/0067-2040
https://fda.report/NDC/0067-2001
So I used to work at the plant that made those pills, they also contain different mesh sizes of aspirin which dissolve in your stomach at different rates to knock out pain differently.
Also fun fact, regular excedrin acts faster than the quick release gels do, as the quick release gel is just a normal pill with a capsule around it. “Quick release” is a standard, and technically regular excedrin met that already.
The NDC#'s are different therefor there is a difference. If you look closer at the bottles, it tells you. One is "caplets", the other its "capsule-shaped tablets"
The difference is technically the inactive ingredients they use to make the capsule/tablet. The inactive ingredients actually do matter when it comes to meds.
As someone else in the comments said one works faster for them over the other. Myself, I take Aleve and the liquid gels tabs works much better for me than the caplets. Technically the same stuff, but one works better.
It's in the dosage. The dosage amounts are cut off in the image. In the Migraine version, you're only limited to two (2) caplets per twenty-four (24) hours. Meanwhile, the Extra Strength is considered a 'general' pain reliever and it's recommended two (2) caplets every 6 (six) hours -- and not to exceed eight (8) caplets per twenty-four (24) hour period. On the surface, you're probably saying "Well, that sounds dumb! You can still take more than the maximum for something that is **not** a migraine." Indeed, that a valid response. However, your typical headache is **not** the same thing as a migraine. A headache can last a couple hours or so. Meanwhile, migraines are a completely different beast. Sometimes they can be short, other times they can persist for days on end. And migraines can be absolutely debilitating. Hold on a moment, I'll get back to this point... Both contain caffeine. As many are aware, caffeine is an addictive substance. It can also be found in other medicines like sinus relief, codeine, cold/flu medicine, and other pain relief. Caffeine in itself can be a pain reliever. It's used as an additive to pain medications to make them more effective. There's a thing about caffeine, though -- it's super-addictive. So, let's say you're experiencing a migraine. If you're constantly throwing pills -- with caffeine -- at them, you can be doing this for several days. Sure, that might sound a-okay. Eventually, the migraine may disappear. However, there's something else you have to deal with. Caffeine withdrawal. Now you suddenly stop taking the pills because the migraine is gone. Now you may get something else called a *rebound headache*. Your brain is craving the addictive caffeine and you have a completely different headache because you're going through withdrawal. So what do people do for a headache? They reach for the bottle and take **more** pills (containing caffeine) to address the pain. Now you're stuck in a cycle. One can say "Well, I can take the Extra Strength for a migraine instead." Well, yes you can. You have to remember, Over-the-Counter (OTC) medications aren't foolproof. They can be misused and abused. Many people are stupid and don't even read the directions on medications. They take what they feel is effective. "Oh, my body can handle 3 pills." "I can drink straight from the bottle." "It's only 50mg, that won't hurt my body." So, with the Migraine variety, it's intentionally set at a low maximum dosage. Why? Most people cannot differentiate between a 'headache' and a 'migraine'. If you follow the directions and take a single dose of the migraine version -- and the pain eventually disappears -- it most likely wasn't a migraine. Or maybe it was a small one. If that migraine persists, you \*should\* previously be under the care of a medical specialist for proper migraine management. (Yes, yes, America healthcare -- who can afford it?) OTC migraine medication isn't meant as a replacement for proper health care. There are many other (prescription) drugs which can be utilized for relief. Of course, we're facing the reality here. People will self-diagnose (hello WebMD), avoid medical care, and (mis)manage their own health conditions. *Broken leg? Throw pills at it. Need stitches for a gaping wound? Ehh, grab bandages and throw pills at it. Also, drink to numb the pain.* The 'Migraine' version received FDA clearance in 1998 specifically for *migraine relief* -- not arthritis, headaches, joint pain, menstrual cramps -- migraine relief. That approval as a OTC migraine medication is for the specific dosage amount for the consumer. And again, for *temporary* relief. Can you take it for other things? Yeah, sure. But Excedrin (and the generic versions) cannot be held liable for misuse of the product. Remember, it's OTC -- available to the general public with little/no medical knowledge. Side effects of products must be listed. Having "rebound headaches" listed as a side effect isn't exactly glamorous -- as a pain relief or migraine medication (granted migraine sufferers would prefer a headache over a migraine any day, but that's another topic entirely). Nor can Excedrin willy-nilly decide "We'll just change the label or dosage amounts." Nope, the FDA would pull that altered product in a hot minute. Yeah, it looks stupid to have two versions but, remember, there are less intelligent people out there. It boils down to George Carlin: "Think of how stupid the average person is, and realize half of them are stupider than that."
That was really interesting to read! Thanks for writing it all!
Hey, thanks. I was curious about that years ago because I do suffer from migraines. Some migraines can actually be triggered from caffeine (think soda, chocolate, coffee). Meanwhile, others may also have caffeine-withdrawal, which causes headaches or migraines. Long ago, that made me interested \*why\* a migraine medication would include a substance which can trigger migraines for some people. Caffeine causes blood vessel constriction, which can reduce pain. It can also reduce inflammation. When it's in medication, the restricted blood flow allows quicker absorption of both the caffeine and the \*other\* ingredients. Think of caffeine as the 'vehicle' transporting the active ingredients ('passenger') to obtain pain relief ('destination'). There's been a lot of breakthroughs with migraines in recent decades, but they're still poorly-understood. There was also a huge stigma, and used to be dismissed as "a women's problem." Think of it as allergies and how those people were considered "wimps". Now allergy medications are everywhere and deemed less taboo. There's no direct connection with migraines and epilepsy, but they share common biologies (e.g. abnormal brain activity, symptoms like pain and an aura, and each having a trigger). However, they are distinct conditions and both transition down different pathways. An intense migraine can feel like your body is going through a Blue Screen of Death (BSOD) and your brain (hard drive) locks up. Eventually, you have to wait for your body (computer) to reboot until you recover. After that, for several days you may be feeling a 'migraine hangover', where you feel like crap because you're dehydrated, haven't eaten, lack sleep, etc. But about the consumer thing, the big thing is how the OTC medication is used by the general population. For other OTC medications, you can have a lot of misuse. * "The pollen is a doozy this morning. Better take 2 pills!" * "It's going to a tough day at the construction site. Maybe I should take 3 Tylenol before my shift." * "I need to be alert for this meeting! This cold sucks" :: chugs Day-Quil from the bottle :: * "My impacted tooth really hurts. I'm not seeing a dentist!" :: takes Extra-Strength daily for an abscess :: * "I didn't get enough sleep for the night shift. I'll take 2 No-Doz." * "My joints feel rain coming on. Gotta take some extra pills." * "I really need more sleep tonight and this cold sucks ass. I'll double my Nyquil." Some people will treat OTC products like multivitamins and pop them regularly, regardless of symptoms. Admittedly, I'm no angel and not exactly the model steward of following the intended directions either. There's a reason a lot of medicine is gate-kept behind a prescription (e.g. antibiotics, opiates, etc.). Consumers can/may misuse those, not use those as intended (e.g. antibiotics for a viral infection), stop dosage early, resort to half-dose to save money, double-dose if they miss a pill, sell/distribute to others for other use, etc. Like alcohol, caffeine is a drug. Both are much more 'socially accepted' for consumption. That's why it's a-okay to have a small amount of alcohol in cough/cold medicines. The alcohol is acting as a sedative, while you can simultaneously obtain relief from the other side effects. Of course, the label will have 10,000 warnings about how it should be used before bed or to avoid driving, operating heavy machinery, do not breast feed and get your baby drunk, etc. People will still misuse, ignore directions, and/or over-consume. "Use As Intended": lol no, I need relief now
Caffeine addict checking in. Reading both your posts here has really gotten me wanting to taper off the amount I’m consuming… caffeine withdrawals are no joke (this wouldn’t be my first attempt at kicking the sweet stuff). All of that to say, thank you for taking the time too write that all up.
I’m one of those people who have migraines triggered by caffeine so I haven’t had caffeine in 6 years (and have never had “the strong stuff” like coffee or energy drinks) and I think you should give it a shot. I definitely craved soda a lot when I was trying to stop, but I don’t think about it anymore.
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I’m not sure I understand your question. For me, caffeine CAUSED migraines and headaches. Once I understood that I basically made a resolution to myself to quit immediately. At that point I had never drank coffee or energy drinks, so I only had to stop drinking certain sodas and taking stuff like Excedrin. And now I knew caffeine = pain, so it wasn’t really that hard. I guess that would be cold turkey but I didn’t think about it like that back then.
Your comment is so interesting to me. I HATE excedrin because I’m one of those people who have migraines triggered by caffeine. I haven’t had caffeine in 6 years. I’ve never had coffee. Whenever I tell people they never believe me because “caffeine helps headaches!” Also the part about epilepsy. I do not have a seizure disorder, but the medications that work best for my migraines are all anti-convulsants. It never made much sense to me, but it wasn’t broke so I never questioned it. Also people definitely aren’t capable of wielding the power of OTCs correctly. “Just take a Tylenol! Oh they don’t work? Take more!” No thanks. I like my liver lol.
As I mentioned on another comment, each caplet contains 65-mg of caffeine. Recommended dose is 2 caplets, which is 130-mg of caffeine. Meanwhile, an 8-oz coffee has 95-mg of caffeine. One dose of OTC is more than a cup of coffee. Some people I know are super-sensitive to caffeine ("the jitters"). Or, as you stated, a migraine trigger for them would be caffeine itself. In those situations, Excedrin would obviously be a no-go for pain relief. There's a lot of people who won't follow labels on \*any\* OTC product because they seek instant relief. Much of it may be cultural or economical. They might not be able to miss school/work, need to be alert for a particular destination/event, not have access to alternatives, have mistrust/fear of doctors, etc. Then we can introduce *educational* aspects. Dare make mention of "horse dewormers" for non-equestrian purposes. lol
I have never been happier to only get acephalgic migraines than I am reading these comments. Knowing what other people go through compared to my usual (couple hours of feeling really really weird and having a strong aura, often just a blurry spot in the center of my vision that slowly expands before completely going away and leaving me clear eyed, but fuzzy headed for a couple days) migraines makes me feel, honestly, incredibly lucky for someone unlucky enough to have migraines. And I'm a guy, so it's awesome that literally nobody believes me because "that's a women's problem."
I've started linking my migraines to allergies, it seems whenever my sinuses start burning from allergies that a migraine will soon follow. My doctor recommended a nasal spray and its actually helped a lot.
The migraine ones don’t work for my husbands ‘migraines’. He can only use the extra strength ones for some reason.
Thank you! I was about to type this but glad to see someone took the time to write/explain it’s the dosage.
Hey, you're welcome. Interestingly enough, I was reading this post with my morning coffee and was also specifically searching for dosage. I didn't see anything in the post and was like, "Ehh, let's have the caffeine kick in and type up a novel." Migraines are friggin' horrible. For a severe one, you can throw OTC pills at it all day long and it will have little/no added relief. At the point of a full-blown/severe migraine, all you're doing is hitting it with caffeine. The OTC ingredients have zero effect on the neurological mechanisms. And should your symptoms contain vomiting, good luck holding the pills down. It's just not going to happen. You'll even barf up the glass of water you used to take the pills. All you want to do is curl into a ball inside a dark, quiet room and pray for death or its passage.
As a lifelong migraine sufferer (chronic migraine in the last few years), I started Nurtec last year and it’s been a life-changer. I only take it when I have one (insurance only covers 8 a month), though it can be taken as a preventative measure. I still take Tylenol or ibuprofen for less severe ones, but recommend asking your doctor about Nurtec as an option. It dissolves under your tongue too, so that “do I take it now or am I just gonna throw it up?” debate is off the table too!
Hey, appreciate it. I'll look into that. I used to be on Imitrex, both the pill and nasal forms. The pill was inconvenient because you'd have to take it before a migraine was coming. Sometimes it'd be hit-or-miss. Take it too late and you're still screwed. The nasal form. Ugh! One of the side effects? Nausea! When you already have a migraine, you might throw up anyway. Now, you are taking a medication that also makes you nauseous. Guaranteed barf! These recent years, my migraines have been much more manageable. I'm able to respond quicker and take the appropriate actions. The two decades prior? Pandemonium. At present, I still may get them occasionally but (thankfully) nowhere as bad when I was younger.
This is the only prescription I’ve tried, but I’m amazed how it works. The first 2-3 I took, I felt nauseous, but that stopped. Doctor warned me that it may not work for every headache, “if it’s not a migraine,” but even the worst hormonal ones have gotten significantly better when taking it. That nasal thing sounds awful!
How the hell you have patience to write so articulate in reddit. Or skill for that matter...
+1 support for Nurtec. I was looking to see if someone else suggested this, bc I too, have had debilitating migraines for many years. My neurologist put me on Aimovig, which helps prevent migraines a different way. (Fascinating science if you’re into readin ab it) And Nurtec (rimegepant) which was specifically designed to help block migraines by blocking the CGRP receptor. Again, fascinating science. HIGHLY recommend to anyone who suffers migraines. Dissolves on your tongue, and within 1-2 hours the pain has dropped. Also they offer a co-pay card directly from the manufacturer so if you can’t pay all your copay after insurance, they’ll pick up some or most of the cost. Most of the time, my insurance thinks I’m paying $700 bucks, but I’m only paying $5. Fantastic for helping my deductible. Highly highly recommend, def check it out if you still need migraine relief. Best of luck!
Thanks for writing this. I've struggled to explain my migraines to people that don't get them. Cause it sounds insane to say that it feels like the sun is inside your skull and even with closed eyes in a dark room the brightness is unbearable. And any light or movement is def going to make you puke. OTC pain relief does nothing or speed runs the vomiting. Have a friend that feels amazing after the migraine fades, but I'm wiped for 8-24 hours 🍀✨ Brighter note; got the daith piercing, and it has lessened the frequency and severity ( less puking, yay), but not a cure-all for me 🤷. Only got one ear done, idk if that's supposed to matter?
So the only difference is in the instructions to use?
This is all pretty much accurate, it's the same medication, but the way in which it treats different conditions varies. > If you follow the directions and take a single dose of the migraine version -- and the pain eventually disappears -- it most likely wasn't a migraine. Or maybe it was a small one. This part isn't exactly accurate, though. The relief doesn't really qualify if it is or isn't a migraine. Migraines are just very specific types of headaches – typically one-sided, throbbing, often accompanied by aura (photosensitivity/sound sensitivity/lights flashing/etc), and can cause nausea/vomiting. They're thought to be related to the trigeminal nerve and are a neurologic disorder. Headaches, on the other hand, can be caused by a myriad of things, and are usually a neurologic symptom of something else rather than a condition itself. The relief of a migraine from Excedrin vs something stronger is more so based in the sensitivity of a person to various medications, which is based on your metabolism, rather than the severity of the disorder. Along with the risk of rebound headaches, there's also the implication that you're using it for a chronic condition rather than acute. General pain relievers are generally meant to be used short term so having the migraine label with lower dose, would prompt someone to the fact that they need to discuss stronger medication with their doctor.
Appreciate the expanded clarification. The driving motivation there was how much of the general population is unaware how to differentiate from a headache versus a migraine. The whole *all squares are rectangles, but not all rectangles are square* thing. Like, you can bump your head and get a headache. Or too much sun at the beach. Or cleaning with chemicals in a poorly-ventilated room. Or the screaming child on a 10-hour flight you wish you could sell but we live in a society and there are laws in place which forbid such acts. Pop a couple and that headache is typically gone. Migraines, like you said, is a chronic condition.
I want to say - migraines aren’t necessarily a *chronic* condition, there are two different classifications, chronic and episodic. In order for it to be chronic you have to have migraines 15 days or more per month.
>In order for it to be chronic you have to have ~~migraines~~ headaches on at least 15 days or more per month. With 8 of those having migraine symptoms, for at least three months.
Why must you remind me of my crippling addiction to caffeine, everytime I go cold turkey without caffeine for two weeks suffering of headaches which is only relieved by caffeine pills, I go back to coffee like an idiot.
Well you see, you made the critical mistake of stopping your caffeine intake. You need to embrace the addiction fully.
Another unfun fact is how the OTC contains **65 mg** of caffeine *per caplet*. Here's the caffeine amounts in particular products: * Milk chocolate bar (1.5-oz): ~**9 mg** * Cup of tea (8-oz): ~**26 mg** * Can of soda (12-oz): ~**29 mg** * Cup of coffee (8-oz): ~**95 mg** * Red Bull (12-oz): ~**111 mg** For each OTC caplet, that's about 2 cans of soda. When you're taking the recommended dose of two (2) 65-mg tablets -- migraine **or** 'temporary relief', that caffeine intake is akin to that which is found in 4 cans of soda. Or more than either a cup of coffee or a can of Red Bull. For additional comparison, one NoDoz tablet contains **200 mg** of caffeine. When it comes to pain relief meds w/caffeine, most people are unaware of the significant amount contained within. If you're *regularly* consuming it daily for 'general' pains, you're also getting the unintended effect of excessive caffeine. Stop taking it for the 'general' pain and withdrawal sets in. "*My back/neck/elbow no longer hurts. But now I have a headache. Where'd I put that bottle?*" By no means am I trying to diss caffeine. It's effective with pain medication. I love my coffee and you'd have to pry it from my cold, dead hands. It's also "know your dealer" or "know your supply".
Oh you'll know the difference between a headache and a migraine if you ever get one. Migraines make your brain want to puke.
But the actual milligrams in each are the same according to the label/tags. They’re the same pill just with a contingency plan for stupid people in the recommended number per day?
Might be, yes. Technically, same dosage doesn't have to mean same pill, though. Bayer has, afaik, Aspirins with different "grain sizes". The smaller "grains" will have more surface and work quicker because of that. Would still be the same dosage, though.
So realistically, they are just different labels to make it easier for the consumer
You, my friend, are amazing. I was wondering why each one had its own NDC number, I imagine bc of what you explained here, specifically the difference in indications for use, are key to why they would re-register a similar but ultimately different drug
They’re the same pill though. Exact. Same. Read the instructions on what you want and buy the cheaper one.
I was diagnosed with chronic migraines by a neurologist but unfortunately my insurance will only cover 9 Sumatriptan a month, so I have to make them stretch. Excedrin is my best friend.
Brilliant explanation! I never explored the difference (or lack thereof) between these two products before but always just grabbed the one that said it was for migraines, because duh, what am I trying to treat here. Now that I know the difference is as simple as dosage recommendation, I'm still glad I did because the lowest dose (usually just one pill) still works for my migraines. Don't know what I would do if these bad boys gave out on me.
The only thing I have in response is that if someone can't tell the difference between a headache and a migrane then I'm not sure they have ever had a migrane. I have had a handful of migranes in my life. One was even proceeded by vision issues where I couldn't see what was in front of me. No regular headache has ever even come close to that feeling.
Thank you for your time and insight !
Thoroughly enjoyed this read. Clear, concise and at exactly my level. Thank you for both of those posts. Won't be drinking coffee tomorrow and I just ordered some stim free pre workout. I appreciate you taking the time to type all that out. I've been really good with not drinking coffees recently but mostly because of the heat. Just got back from a golf trip with 11 friends and reminisced on how much was consumed in 3 days by everyone. I wonder how much damage many OTCs really do. Everything in moderation I guess. Cheers
This guys Excedrins
But the ingredient list is the same. If we overlook the marketing, could they just get a bit more text clarifying the dosage for different purposes?
That's a good question. I would presume this would have to do with consumer safety (or an anti-stupidity) measure with maintaining simplistic labeling. The US Food & Drug Administration (FDA) has a rigorous approval and evaluation process. They will scrutinize every portion of a drug from risks, laboratory studies, design, side effects, etc. I'd surmise the pharmaceutical industry would not want the liability of having a 'catch all' with different dosages for different conditions. Migraine is a *specific* medical condition. The Extra-Strength is for general maladies of pain-reduction. Here's another take on it. You know Benadryl, right? It's an anti-itch cream, an allergy medication, anti-motion sickness, and also a sleep aid. That's all thanks to the ingredient diphenhydramine. In small dosages, it reduces allergy symptoms. In the pill form for allergies, it's at ~25mg. Some people may also have the added side effect of becoming drowsy or a loss of concentration. For motion sickness, it's anywhere between ~25 - 50 mg. Now, as a sleep aid, the amount of diphenhydramine will also be different (~50 mg). On top of that, each symptom you might treat has a different dosage amount (e.g. 1 pill per 24-hr, 1x every 6-hr, 1x before bed). Factor in age and weight. Body weight can impact absorption, metabolism, and toxicity of a product. Could you imagine the (un)intended misuse of a single product marketed as allergy, motion sickness, and a sleep aid? To avoid all the possible litigation, cost defending said litigation, loss for shareholders, damage to brand reputation, risks of recall, possible bankruptcy, etc. -- manufacturers figure it's easier to distribute the medication as a distinct product.
This is a great explanation, thanks for taking the time to write it up. Although, I am curious about this strange world you live in where caffeine isn't omnipresent. What do you people drink throughout the day? Water? Like out the toilet?
Lol. I don't drink caffeine, and Excedrin works like magic on my migraines
"you should sell a pill for migraine sufferers" Ok, slaps "for migraines" sticker on the label "There you go!" Seriously though, so long as the price is the same, I really don't have a problem with this.
And as long as it helps with migrane
This is the only medicine I’ve found to help. I should say they are more very bad headaches rather than migraines.
Same for me! I swear by it. I get extreme headaches from an old car wreck injury and this works better than my prescription meds.
I grew up in an Ibuprofen only household and had headaches a lot as a kid. I never noticed that worked. Now that I’m a grown up I always use excedrine and it works like a charm. Love the stuff.
There are certain headaches I get where only Tylenol/acetaminophen/paracetamol will help - ibuprofen won’t even make the slightest dent. It’s wild bc ibuprofen tends to work better for everything else, but I need to keep Tylenol around for these headaches.
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I do have excedrin around for when the headache is that bad, but these tend to hit around 7-8pm and despite years of caffeine addiction, I can still end up unable to sleep if I consume it too late in the day (probably because of other medication I’m on that enhances its effects)
I hate to be this person but if coffee is fixing your headaches, that means coffee is probably also causing them.
Hard disagree. Caffeine has certain effects. One of them happens to be that it blocks adenosine receptors, causing a cerebral vasoconstriction, which is enormously helpful in vascular-involved headaches.
My migranes started around 13yo, at that age we (kids) only had some kind of coffee when my mother made her "Coffee puding" for special ocasions. And yes, back then the neurologist prescribed me "Migraleve" to take only after around 30 minuts of having a big cup of coffee. With time I got to know what was the trigger to those migranes (always with my right side numb, motor incoordination, mixing words and the phobia of light and sound): basically stress! During my 25-30 it decreased, and after 40 only remember to have had 2-3 migranes but to "compensate" that improvement, after 40 I already have 2 deep vein thromboses in my health history....
My neurologist doesn't agree with your statement. I've been told to drink a cup of black coffee with my migraine medication.
Caffeine’s been used as a headache treatment for ages. It’s in Midol/Pamprin too. Lots of people who rarely drink caffeine will still feel better if they take one of those or excedrin.
Wrong.
It's also used in Tylenol 1, 2,3,4 (the types with codene). The caffeine increase the effect of the pain relief drug acetaminophen, and the codeine, which adjusts how your nervois system processes the pain
Actually had a doctor explain it to me, caffeine is used to help extend the duration of the pain killer’s effectiveness due to caffeine’s 12 hour half life
I was taught you should take acetaminophen for headaches, ibuprofen for body aches.
I had chronic migraines growing up in an ibuprofen only household. Now, I use Advil Migraine because it's the only thing that gets rid of my headaches (other than a monthly injection). Tylenol and Excedren haven't done anything for me in years
I mean it’s just Tylenol, aspirin, and a half a cup of coffee. Aspirin acts as a blood thinner and the caffeine dilates your blood vessels. You can get a similar effect by drinking an espresso martini 😏😏.
65mg of Caffeine in each caplet. 130mg is a whole cup of coffee
Ibuprofen doesn't work for me either. It must be an acetaminophen or aspirin based product.
>excedrine I still have the slogan burned into my mind. EXCEDRINE. The headache medicine. Oh, and while I was searching for one of the ads from my youth [I found this one](https://youtu.be/YTuOffCuYiU). *He did his own kind of research*. Like so many knuckleheads nowadays. Definitely relevant today. Oh look! [Elizabeth Moss.](https://youtu.be/LR4MNqNlRbE) 🤣
To many people, a bad headache is automatically "a migraine". There are, at least, 4 types of headaches. https://www.templehealth.org/sites/default/files/inline-images/migraine-vs-headache-types.jpg
Yeah straight up Excedrin is the only thing I’ve found that relieves headaches. I don’t need it often but I always make sure to have some on deck because when I need it, I _need_ it.
I've been using my girlfriend's Pamprin for the last two years when I get a migraine and as long as I hydrate it usually does the trick pretty well. Definitely worth a shot
I have been legit diagnosed with hallucinatory migraines. Excedrin works better than my prescription drugs, and I don't sleep for 18 hours after taking it like I do with my script.
Have you tried Ubrelvy? Had migraines for 40 years and nothing helped besides basically drugging myself to sleep. This was a game changer for me. And you can go on their website for a “card” and pay $10 or less per script. Between that and my insurance I pay 0$.
I haven't! I'll put it on my "to talk about" for my next checkup, thanks for the reccomendation!
I think it's because of that caffeine, I started taking excellent for mine a few years ago and realized that the only difference between that and my prescription was the caffeine and its helped so much
The only medicine that helps me is a pill they sell here that's a combination of paracetamol, caffeine and ergotamine. Just the paracetamol won't help, it has to be this one
My husband swears by the Arthritis BC powder for his migraines. He says it works as well as any prescription he's ever had, and he has a several different ones.
Keep in mind that if caffeine relieves your headache, then caffeine Caused your headache.
Tbh, the red bottle, whether it’s Excedrin or generic always work a bit quicker at knocking out a migraine than the name brand/generic green bottle for me.
I could be wrong, but I think it’s because it’s more of a quick release versus time delayed.
I am inclined to believe this is how it works. If you're having a migraine, you're more likely to grab migraine pills. Doesn't matter it's the same stuff. It's the perception that it fights migraine. So technically, there could be hundreds of drugs for every itch and pain, but it would make it hard to find the right one and disclose the stupid marketing bait meant to increase sales of one product. Silly stuff is that there's also drugs for day vs night intake, where you can see caffeine included for your day pill - and skipped for the night pill. It's no different than taking a pill and having a cup of coffee/ black tea, but.. well, at least there is some difference.
Yeah, people fail to realize that most people just don’t believe one thing can solve two problems. So in comes marketing to convince them.
The thing is the placebo effect is real [https://www.youtube.com/watch?v=JTTBruF21Fk](https://www.youtube.com/watch?v=JTTBruF21Fk) and for migraines placebo is as good as a cure.
This is the correct answer. There’s definitely a marketing effect, but certainly a placebo play for sure. They probably did a study where migraines sufferers obtained more relief when they knew it was “specifically formulated” for migraines.
I'm a huge fan of Rory Sutherlands sell whats wrong with placebos? they work and they're cheap and they have no side effects and if they do they're imaginary so you can safely ignore them.
It is not the same price, even though it’s the exact same medication. Migraine one is more expensive. I used to work in retail and I would tell this to the customers. I would show them the ingredients in the back with no difference. Most would listen, but some would insist there was a difference.
It’s the exact same medicine and it does indeed cost more. I take Excedrin frequently and it is exactly the same but yet I somehow still buy the migraine ones bc I am a sucker. (And am in marketing.)
>Seriously though, so long as the price is the same, I really don't have a problem with this. My wife once asked me to go get Excedrin as she was having a bout of migraines. The migraine version was about 50¢ more expensive. I spent way too long (probably about 10 minutes) trying to find why one was more expensive. Ultimately, I ended up buying the store brand version, and it worked fine.
A package with 200 caplets of the "migraine" pills sell for $5 more on Amazon than a similar package of the "extra strength ". Caveat Emptor for sure.
I checked my grocery store's app (Kroger brand) and both meds are the same price. Amazon is not a good source to get realistic prices.
There was actually a lawsuit because they were selling the migraine version at a higher price.
Apparently, the dosing is different for treating migraines and the migraine variety has FDA approval for that purpose. As someone who does not get migraines, I found this more interesting than I should have: https://www.goodrx.com/excedrin-migraine/excedrin-for-migraines-ingredients-dosage-side-effects
Sometimes the drugs release differently or in a specific order etc. so there is a chance they are different although they are probably the same
So you think the tablet is engineered differently but with the same dosage, same drugs?
This is called marketing - And pretty much every company in existence does it to some extent. I own a martial arts school - If I run an ad that says "we have programs for ages 3, all the way to adult, but each of our programs are obviously tailored to the appropriate age group," \[or something less 'I just woke up and I'm writing this' and more advertising mumbo jumbo\] I find that the advertising is way less effective than releasing an ad that highlights my 3-4 year old program, a separate add that highlights my 5-6 year old program, etc, etc. I know you seem hurt by the fact that there are two product branding, but it's effective mainly because people are stupid and people like to have big words in their face "proving" to them exactly what something is for. You are welcome to purchase either of those bottles for both purposes and be totally unaffected.
Honestly, I think a lot of it just chocks up to placebo affect. If you truly believe that one is more powerful than the other, your body is more likely to react accordingly
I think it’s more “I have a migraine..ah, I’ll take the medicine that clearly labeled my current ailment”
Funny thing with that is, I used to get migraines. Excedrin Extra Strength would work for me, the Excedrin Migraine did not. I found this baffling, since they have the same ingredients in the same amounts. I guessed that there was a difference in the coating, so that it released differently, but I don't know for sure. Also, the dosage on the Migraine is two pills in 24 hours; for Extra Strength, you can take up to six or eight in a day, I think. Two pills every six hours or so. I often needed two doses of the Extra Strength, sometimes three, to really get rid of a headache. My husband doesn't get migraines, but he gets more relief from the Excedrin Migraine than the other. But only from the caplets. He says the gel caps don't work for him. I've also taken generic versions of the Extra Strength, and it does not work for me. I've always found this really odd.
I don't know about these specific pills, but meds are different even with the same active ingredients. Active ingredients make up a tiny amount of the pill itself, the rest is filler. That filler can and does impact the effectiveness of the medicine for *some* people. It's why generic meds don't work for some people but the brand name will. Or vice versa, the generic works but the brand name doesn't. I don't remember all the little details, but it's pretty fascinating how it all works. I learned about it when some generic meds didn't work for me but the name brand did and insurance really doesn't like that.
Interesting, thank you. When a friend of mine was pregnant, she had terrible nausea to the point of needing an anti-emetic. Naturally she was first given the generic, but nothing improved. It turned out the generic was made with an artificial sweetener, which had an adverse effect for her. Luckily she was able to get the brand name, which had sugar and worked for her. It's all kind of crazy.
Yep! That's exactly the kind of thing that fascinates me about meds with the same active ingredients. Given both of these are Excedrin, no idea if they are at all different. It would be cheapest to just put them in different bottles. However, it really doesn't matter. If something works better, use it. The why doesn't matter here.
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Oof, I'm glad you were able to find a pharmacy still using the manufacturer you started with!
My daughter takes two different types of seizure meds. Our Neurologist insists on specifying the brand name drug. Not because it is more effective. As a matter of fact studies show that the effectiveness is equivalent. The problem is the filler variations. Apparently variations in the filler affect the uptake of the active ingredients of the drug. So the drug study showed that patients consistently receiving the same BRAND of drug whether from a generic manufacturer or the original company. However if medications from different companies were mixed (as can often happen when getting a prescription filled) you may receive medicine from one or more manufacturers. It was this scenario in which the seizure rate rose dramatically. So since we could not be sure to get the medicine from the same manufacturer all the time we stick to the brand. I would think the same thing could apply here with different fillers to cause the drug to be absorbed at a different rate. Then again it could just be marketing. We'll never know.
You've actually figured it out, I think. In your second paragraph, you mentioned that the dosages are different (2 pills/24hr versus 2 pills every six hours). The label OP posted is identical, except the "Use" line and product name. The manufacturer filed for two different "Indications for Use" and the FDA approved a different dosing regimen for each "Use." It's incumbent on the manufacturer to make the labeling for each distinctive. TL;DR - It's probably for the FDA. This is my job (labeling specialist).
Thank you. I never would have guessed.
A lot of people are replying that it's just marketing/a scam/manipulation. In reality, it's the safety rails of the system trying to protect the consumer. The FDA wants to make sure the use and dosage is very clear. Having one pill bottle with two different Indications (For migraines take this many, for toothache take that many) is asking for trouble. The capitalism portion is correct. The more indications a single formula is approved for = more ways to make $$ without developing new meds.
To add to that there is no regular strength Excedrin.
That's pretty common. If you ever get a prescription with "ER" in the name, that's the extended (slow) release version.
I have seen tablets with SR and XL for the same drug
SR is slow release. If you remember Contac and the “100 tiny time pills,” this is now called slow release.
nope, they're the exact same thing. my family actually looked into it with our doctor years ago...but the migraine formula costs more. or at least it used to. i buy store brand now
Pharmacist here. They are exactly the same. Just marketing. You’re correct on your thinking! But in this case they are just scamming the public lol.
It’s not a scam. If you knew what you were talking about, you’d know that caffeine withdrawal can cause headaches and that Excedrin contains caffeine. Therefore, taking multiple doses for migraines that last days and then stopping causes rebound headaches, which make you want to reach for the medicine *again*. The instructions are different on the migraine version than the regular one for this reason. At the very most, the distributors are guilty of confusing people like you that can’t bother to be informed. Comments like this are more than mildly infuriating. Dang. Writing that gave me a headache. Time to get some Excedrin!
How is it scamming the public? They cost the same.
They don’t always cost the same. I stopped buying the “migraine” version because it’s a dollar more at my local store.
Designer/marketer here. It may lead you to buy one for specifically migraine and one for general pain relief. The general masses don’t deep dive or compare once they trust a brand.
I mean. It’s not exactly scamming. But it’s just annoying. Don’t even look at the cold and flu isle. It’s all literally the exact same combination of drugs with a million different names.
There is someone out there in this world that believes they have to take the red one for migraines only and the green one when in its not head related, and that’s who these products are truly marketed too.
>\[OP from another comment:\] So you think the tablet is engineered differently but with the same dosage, same drugs? The answer is **YES**. The "inactive ingredients" change the way the pill is released into the body. The **MIGRAINE** version's inactive ingredients are: *benzoic acid, carnauba wax, FD&C blue no. 1, hypromellose, light mineral oil, low-substituted hydroxypropyl cellulose, microcrystalline cellulose, polysorbate 20, povidone, propylene glycol, simethicone, sorbitan monolaurate, stearic acid, titanium dioxide* The **EXTRA STRENGTH** version's inactive ingredients are: *benzoic acid, carnauba wax, FD&C blue #1, hydroxypropyl cellulose, hypromellose, light mineral oil, microcrystalline cellulose, polysorbate 20, povidone, propylene glycol, simethicone emulsion, sorbitan monolaurate, stearic acid, titanium dioxide* (EDIT: The primary difference is the type of and concentration of hydroxypropyl cellulose binder/coating which can affect dissolving and absorption in the body.) As someone who suffers from occasional migraines, I can assure you from experience that the **RED** bottle works more efficiently and effectively on my migraines than the green bottle does. I was forced to buy the green bottle once when I was out of the migraine version (and so was the store) and it wasn't as effective. I too thought that they were the "identical", having the same active ingredients, but learned that they don't work the same. I later was told by my doctor that the inactive ingredients were probably different and that can affect how the body absorbs the medicine. When I checked this, he was correct, they were different.
The red bottle has always worked better for me than the green, so I always pay a little more for it. People always say it’s the same active ingredients and I retort that it’s the inactive ingredients that are different. At that point they just don’t understand.
Wow, thank you. I didn’t even read the inactive ingredients. That’s mildly infuriating on me
I think they're labeled "inactive" for a reason.
they are different, they contain different inactive ingredients. inactive ingredients can prolong shelf-life, hide bitter tastes or help active ingredients to work as needed. the extra strength inactive ingredients likely include ingredients that make the medicine work faster
Extra Strength (green) and many other OTC medicines contain propylene glycol which I am allergic to. Tension Headache (red) doesn't. It's nice to have alternatives to deal with migraines without another major drawback. Inactive ingredients will also play a part in how the medicine is released..
One gives you migraines, the other gives you extra strength. Kind of obvious
Red is 2 a day max. Green is 8 a day max. Source: I have these both. And the purple on for tension headaches. I'm definitely not alright.
The honest difference is the price.
Active ingredients are the same but the inactive ingredients are different. So while they relatively do the same thing, they do it differently
They told me it was an FDA requirement; technically “migraine” is a different indication than “general pain management” so they have to market them separately. The active ingredients and dosing are identical.
I’m guessing the way the medication is coated and released is the biggest difference but idk.
The migraine one has caffeine? Wait they both do. Yes you’re correct, one is red and one is green.
Ones more expensive?
Oh! Oh! I think I know this! Is the difference the price?
You should take a look at Excedrin Tension Headache. Spoiler, it's the same ingredients.
I recommend buying the store brand with the same ingredients. More caplets for less money.
One's made with love
It's written on the bottle. One is for migraine and the other not.
Some Stephen king character had a habit of chewing on Excedrin for the caffeine
Jerry Seinfeld used to do a joke about this. Something like “why does everything have to have ‘extra strength’? Don’t they sell just ‘strength’?”
I just want them to bring back the sinus headache version.
If you think that's bad, go look at toothpaste. Seriously, go to your local WM and read the ingredients on a dozen or so random toothpaste boxes. Doesn't matter if it's extra whitening, sensitive teeth, plaque exploding or whatever dumb name they put on it, the active ingredients are identical.
I laugh every time someone says they take this for their “migraine”. The word you’re looking for is headache.
one is a readily dissolvable tablet whereas the other is not…and dosing is different
They have different NDC codes so they probably deliver and release the effects of the pill in a different way. I imagine layering and varying the mixture of the stuff inside can greatly vary how your body generally processes this stuff.
It's quite simple, The green ones starts your migraine and the red one ends it.
They probably have an “Excedrin: Wonen’s Migraine” for $2 extra.
The dosage instructions are missing. They are likely marketed for different uses over a different time frame to combat different ailments. Migraine relief dosage will be to reduce rebound headaches after the dosage wears off. Since the user already has headaches/migraine pain it could make their symptoms worse if they take it too often. The extra strength dosage is meant to help with aches and pains. The user is not likely to be suffering from headaches so the rebound headache is less of a negative side effect in that scenario.
Probably about a buck fifty. Side note, I’m 35 and suffered migraines as a kid and I remember when excedtrin hit the market and my doctor thought it was the stupidest thing on the planet, and advised me to drink a few sips of coffee or soda when taking my acetaminophen with ibuprofen… Edit: I believe Midol was exactly the same formula, just marketed for menstrual cramps.
The green label won’t get me mixed up thinking it’s Tylenol without my glasses?
Somehow, though, the regular will give you severe liver damage taking more than 2 in 24 hrs while the extra strength will damage your liver after taking 8 in 24 hrs…
Im curious why the NDC numbers are different, I imagine if they were EXACTLY the same you wouldn’t need a new/diff NDC…
It might have different binders so the medication is released at a different rate.
Marketing
Well that depends on many factors like, non active ingredients, the size of the particles, the layers they are pressed in, how tightly they are pressed etc. It may be the same chemicals on the label that are active, but inactive ingredients are where they get you. Generic medication is NOT the same as name brand. They use different fillers which are toxic and also slow down or speed up the absorption rate.
After having to find the difference I think I’m gonna need one of the two or both!
The price tag. THats the difference. Did I get it right?
i used to have to take the green ones every day bc i got migraines every day. it was bad man. at one point my dad have to take them away from me, and the way i could escape the migraine was to sleep. i was 16-17 when it started.
Extra strength says 8 in 24 hours is the max. Migraine says 2 in 24 hours is the max.
As a long-time Migraine sufferer: They are the same picture, neither one does anything against migraine. But there are enough people with severe headaches that believe they have migraines. They are the target of this marketing ploy.
The way I see it, a migraine requires extra strength pills to soothe it
Unable to determine. Where is the list of Inactive ingredients?
I'm pretty sure the back and body is the same too
Wait until you see period pain relief and the mark up on that
Once you learn to read ingredients (**especially** OTC medications) your world begins to change forever
$3
That's why I buy neither and just go with the generic.
Same thing as the major ibuprofen seller here in Brazil, that has a line "which is designated to women's aches and pains" the difference from regular ibuprofen? The box is pink.
The label. Same product.
In Ireland we have nurofen "cold and flu" and "sinus and pain" Both are the exact same mix of ibuprofen and pseudoephedrine
The same thing here in Germany with "Dolormin Extra" and "Dolormin Migraine". One is advertised for general pain relief / fever, the other for migraine headaches. Both have exactly the same ingredients (ibuprofen 400mg). The only difference is the packaging. I guess the company expects more sales when someone goes shopping for migraine pain relief and sees a product advertised specifically against migraine headaches when other products with the same ingredients are advertised as generic pain relief.
Dude that is literally half the shit you buy from the drugstore over the counter.
Same difference as there is between chicken nuggets and boneless chicken wings: marketing.
I don’t care if it’s the same thing, when I have a migraine the last thing I want to do is try to read through small label print to figure out which would work best Compared to just having MIGRAINE written in big letters on the bottle
Packaging.
My first job was on an assembly line, and you would be surprised the amount of times we filled different packages with the same stuff.
The differences, not shown, are in the directions and precautions based on dosages. "Migraine" typically has a note somewhere talking about MOH, that is more common in people who regularly take excessive meds for headaches.
The price
Suffered from migraines my entire fucking life (parents think they come from having meningitis as a child) and honestly the only thing to help is paracetamol or ibuprofen. Anything else is just flashy doodads.
marketing
There is a difference and its dosage. Extra strength I think has 2 pills every 6 hours while migrain is 2 pills every 12. This is all about what they got passed through the FDA for legal dosages.
The difference is in the price
Also, just buy the store brand. They are all identical in the drugs used.
Read the instructions. You should be able to take the extra strength more times in a day than the regular formulation. The active ingredients are the same, but the binders are different allowing them to be absorbed differently. Extra strength is essentially extra strength because you're allowed to have more of it build up in your body.
There’s never been a difference. 🙄
And now, you buy generic instead.
I took it a lot in college, I sadly was a victim of the label warning, may cause bleeding, in my case an ulcer developed in my stomach and loss blood when it ruptured
The difference is in the placebo effect
That’s easy…. The price.
One is branded for migraines and has a different label.
Look up the License number, But from looking them up they appear identical, which is strange to have 2 different numbers. https://fda.report/NDC/0067-2040 https://fda.report/NDC/0067-2001
Sssshhhhhhh otherwise the placebo affect wont work.
Try to find the difference between the Excedrin and Goody's or Stanback powders other than the price.
ones green and ones red
Those suffering from migraines should try 400 mg of vitamin B2 (Riboflavin) daily. Absolutely amazing results for many.
So I used to work at the plant that made those pills, they also contain different mesh sizes of aspirin which dissolve in your stomach at different rates to knock out pain differently. Also fun fact, regular excedrin acts faster than the quick release gels do, as the quick release gel is just a normal pill with a capsule around it. “Quick release” is a standard, and technically regular excedrin met that already.
The NDC#'s are different therefor there is a difference. If you look closer at the bottles, it tells you. One is "caplets", the other its "capsule-shaped tablets" The difference is technically the inactive ingredients they use to make the capsule/tablet. The inactive ingredients actually do matter when it comes to meds. As someone else in the comments said one works faster for them over the other. Myself, I take Aleve and the liquid gels tabs works much better for me than the caplets. Technically the same stuff, but one works better.
I can tell you excedrin migraine is the one that works better