Pharmacists and other health professionals should warn patients that frequent use of asprin, paracetamol and triptans could cause "more pain than relief", according to health watchdog Nice.

The guidance, published today (September 16), said patients who regularly used painkillers for a period of more than three months could develop "medication overuse headache" and should stop taking the drugs immediately.

Patients who take triptans, opiods, ergots or combination analgesic medicines for 10 days a month over at least three months should be "alerted to the possibility" that the medication may be worsening their pain, Nice said. The advice should also be issued to patients who have taken paracetamol, aspirin, or NSAIDS, either alone or a combination, for 15 days a month or more.

One in 50 people are estimated to experience headaches caused by medication overuse	More on analgesics Pharmacists must overcome 'fear' of ibuprofen use Category Focus: Analgesics Counterpart Plus: Pain management
	The guidelines recommend that patients suffering from the effects of medication overuse should stop taking the drugs "abruptly rather than gradually" and avoid use for at least one month. But headache symptoms would be likely to "get worse in the short term", so healthcare professionals should offer "close follow-up and support" as patients experience potential withdrawal symptoms, Nice advised.

Estimates suggest that one in 50 people experience headaches caused by medication overuse, with women five times more likely to be affected than men.

Martin Underwood, a GP and professor of primary care at Warwick Medical School, said he hoped the new Nice guidelines would raise awareness of the problem. "Patients with frequent tension-type headaches or migraines can get themselves into a vicious cycle, where their headaches are getting increasingly worse so they take more medication, which makes their pain even worse," he said.

The comments were echoed by Nice deputy chief executive Gillian Leng who said the guidelines should help healthcare professionals "better recognise patients whose headaches could be caused by their over-reliance on medications".

Read the full guidelines