Migraine medication diary: what to record each time you take something and how to count medication days

You take something when a migraine attack starts, and at the next appointment you are asked how often. That is hard to answer from memory. You can keep a record on paper or in Sam, where the medication list sits next to your migraine diary. This post covers the medication column only: what to write down each time, how to count medication days and what your doctor does with the numbers.

Why does your doctor ask about your migraine medication?

Part of the answer is in the guidelines. A German guideline on treating migraine attacks and preventing migraine, issued by the AWMF, says people should keep a headache diary to record attack frequency and whether each attack medication worked. The Migraine Trust diary states a similar purpose: to assess whether your acute or preventive medication is working.

A second reason is medication-overuse headache, a topic in the classification ICHD-3. The classification says that when someone often takes several medicines and cannot give an account of their names or amounts, a diary is almost always needed.

For you, that means your notes give the doctor a number and an order of events instead of an impression. You do not have to judge anything.

What do you record each time you take something?

Four details cover most diaries:

• Date and time. The National Migraine Centre in the UK asks for the times you take medication, including every repeat dose.
• Name of the medicine, ideally the active ingredient and the name on the pack. The Migraine Trust diary has a column for acute or rescue medication.
• How many you took. A German patient form from IQWiG asks which medicines you took and how many.
• How well it worked, in your own view. The German DMKG calendar uses three steps: good, medium, poor. That is your impression, not a measurement.

A note field is useful for side effects you noticed. The other attack fields, from strength to aura, are in our post on migraine symptoms and aura and what to note. Here we stay with medication.

How do you count medication days?

Count days, not tablets. A medication day is a calendar day on which you took at least one acute medicine for the headache. Two doses on the same day are one day. ICHD-3 counts in days a month, and the German guideline in intake days a month.

Some habits make the count reliable:

• Write it down the same day, not at the end of the month. After a few weeks you will not know whether Tuesday was a medication day.
• Note the medicine every time, not just a tick. The sources group medicines by type, and your doctor needs to see which type it was.
• Record days without medication too. On paper a dash is enough. Otherwise an empty box looks the same as a forgotten entry.
• At the end of the month, add up the medication days in total and, if you take more than one medicine, also for each type.

How to count headache days and migraine days is in Chronic migraine: how many days count?. It uses the same counting rule for medication days.

What do the sources say about 10 and 15 days a month?

They do not agree on one number. This is what each source says:

• ICHD-3 (the International Headache Society's classification): 10 or more days a month for ergotamine, triptans, opioids and combination analgesics, and 15 or more days a month for non-opioid analgesics such as paracetamol and NSAIDs, each for more than three months. When medicines from several types are taken, ICHD-3 adds the days together, from 10 days in total. ICHD-3 itself states that these numbers are based on expert opinion rather than on formal evidence.
• AWMF guideline on migraine attack treatment (revised August 2025, in German): a threshold of at least 10 intake days a month for triptans and combination analgesics and at least 15 for single-ingredient analgesics.
• The Migraine Trust: 15 or more days a month for paracetamol and NSAIDs, and 10 or more days a month for ergotamine, triptans, opioids and combination painkillers. It adds that doctors may diagnose when the pattern continues for at least three months.
• NHS Scotland (clinician guidance): 15 or more days a month for simple analgesics, and 10 or more for triptans, opioids and combination analgesics.
• The NHS migraine page: a weekly figure instead. It advises trying not to take painkillers for more than 2 days a week.

So the figures differ by source and by type of medicine. None of them is a diagnosis. In ICHD-3, medication-overuse headache also requires headache on at least 15 days a month in someone who already has a headache disorder, and regular overuse for more than three months. Your doctor assesses that, not a number in your diary.

These numbers are also not a measure for planning your own medication. If you wonder what your count means, take it to your appointment as a question.

Paper diary or app: what changes?

A paper diary or the app from the German DMKG gives you columns for medicine, dose and effect. That works if you keep it up every day. The DMKG app, according to its own page, asks on headache days about strength, duration, other symptoms and medication taken.

Compared with paper, Sam adds a list. Your medicines are entered once in a medication list that belongs to you. During an attack you pick from that list instead of typing the name each time.

How do you log migraine medication in Sam?

First you add the medicine to the medication list. You search by name or active ingredient, or type in a name of your own. More about the list is on the medication page.

For a medicine you take only when needed, you choose "As needed". When you have taken it, you log it from the Medications chip on the Today tab. An undo message appears briefly afterwards. That puts the dose in your medication list. It reaches the migraine program's doctor report when you add it in the attack entry.

In the migraine program, a diary with a doctor report and a monthly questionnaire, the list is linked to the attack entry. There you pick the as-needed medicine you took, or a type of medicine. You can write how well it worked in the note of the attack. The program starts after you confirm a doctor's diagnosis. Without it you can still use the list.

The program's doctor report shows the days on which you marked acute medication in an attack entry, also month by month.

What do you bring to the appointment?

• A list of your acute medicines, with names as printed on the pack.
• For each month, your medication days in total and by type of medicine, and your migraine days.
• Your impression of how each medicine worked, in one sentence.
• The diary itself, printed or on your phone.

Two questions help: "How do you classify my medication days?" and "What should I record until the next appointment?" More on preparing is in Migraine diagnosis: what now?.

Log migraine medication in Sam and take it to your appointment

You record each dose on the day you take it, and you arrive with a list instead of a recollection.

• Instead of a note on a slip or in a notes app: in the attack entry you pick your as-needed medicine from your medication list.
• Instead of recalling it later: the dose sits next to the start, strength and duration of the attack in your migraine diary.
• Instead of searching at the appointment: the migraine program summarizes the diary in a doctor report as a PDF and shows the days with acute medication, also per month.

Sam shows what you entered. What the number means for you is for your doctor to judge.

Try Sam Health

Sam is a wellness companion, not a medical device. The app does not diagnose, treat, cure or prevent any condition or health state. Always consult qualified professionals for medical decisions.

Related reading

• Chronic migraine: how many days count?
• Migraine diagnosis: what now? Your first weeks
• Migraine Symptoms and Aura: Phases and What to Note
• As-needed medication log: what to record each time
• Medication list for your doctor: what to include

Sources

Updated: October 2026

• International Headache Society: ICHD-3, 8.2 Medication-overuse headache
• AWMF: S1 guideline 030/057, Therapie der Migraeneattacke und Prophylaxe der Migraene (DGN, DMKG), version 7.1, August 2025, in German
• The Migraine Trust: Medication overuse headache and headache diary (PDF)
• NHS Scotland, Right Decisions: Medication overuse guidance, headache pathway
• NHS: Migraine
• National Migraine Centre: Headache diary
• Deutsche Migraene- und Kopfschmerzgesellschaft (DMKG): Kopfschmerzkalender (PDF) and DMKG app
• IQWiG, gesundheitsinformation.de: Migraine diary form (PDF, in German)