Your symptoms strongly suggest migraines. Since paracetamol is ineffective once the pain starts, you may benefit from prescription medications called Triptans (such as Sumatriptan), which specifically target migraine pathways and work best when taken early. To address the vomiting, an antiemetic like metoclopramide can be prescribed; this also helps your body absorb painkillers faster. NSAIDs like Naproxen are also stronger alternatives to paracetamol. Please consult a healthcare professional for a proper diagnosis and to obtain the correct prescription safely.

Since your migraines are infrequent (3 to 4 times a year), you do not need daily preventive medication. Instead, you should focus on 'acute' or rescue treatment to stop an attack when it starts. For mild-to-moderate pain, over-the-counter relievers like ibuprofen, naproxen, or combination formulas with caffeine are often effective. For moderate-to-severe pain, prescription medications called triptans (such as sumatriptan or rizatriptan) are the gold standard. Please consult your doctor to get a personalized prescription, ensure you have no contraindications (like cardiovascular issues), and discuss how to safely manage your symptoms.

For immediate relief of a mild to moderate migraine, you can try over-the-counter pain relievers like Ibuprofen, Naproxen, or a combination formula containing acetaminophen, aspirin, and caffeine. If these are ineffective, a doctor can prescribe migraine-specific medications called triptans (e.g., sumatriptan), which should be taken at the first sign of an attack. Resting in a dark, quiet room and staying hydrated also helps. Please limit the use of acute pain relievers to fewer than 10 days per month to avoid medication-overuse headaches. If your headaches are frequent or severe, consult a healthcare provider for a personalized treatment plan.