A 32-year-old female presents to the pharmacy with persistent tension-type headaches occurring almost daily for the past month. She has tried acetaminophen and ibuprofen without consistent relief. She has no significant past medical history or allergies. What is the most appropriate recommendation for acute symptomatic relief in this patient?

Question: A 32-year-old female presents to the pharmacy with persistent tension-type headaches occurring almost daily for the past month. She has tried acetaminophen and ibuprofen without consistent relief. She has no significant past medical history or allergies. What is the most appropriate recommendation for acute symptomatic relief in this patient?

Answer options:

• Naproxen 500 mg twice daily for 7 days. ✅ A combination analgesic product containing caffeine.
• Amitriptyline 10 mg at bedtime for prophylaxis.
• Sumatriptan 50 mg at headache onset.

Correct answer: A combination analgesic product containing caffeine.

Explanation: For tension-type headaches that are not consistently relieved by single-agent analgesics, a combination analgesic product, especially one containing caffeine (e.g., ibuprofen/caffeine, acetaminophen/caffeine), can be more effective for acute relief. Naproxen 500 mg BID is a strong anti-inflammatory but might be stronger than needed acutely or for long-term daily use without other indications. Amitriptyline is for prophylaxis, not acute relief. Sumatriptan is for migraines.