Triptans are recommended for early use in the treatment of migraine attacks; however, real-world medication-taking behaviors and their relationship with interictal burden remain insufficiently understood. This study investigated the association between triptan use patterns and interictal burden in patients with migraine. A web-based cross-sectional survey was conducted among 302 women aged 20–59 years with migraine. Interictal burden was assessed using the Migraine Interictal Burden Scale (MIBS-4), and participants were classified into high- and low-burden groups. Triptan use, including frequency, timing of administration during migraine attacks, and patterns of medication use, was evaluated. Triptan use days were lower than headache days in both groups, suggesting that triptans were not used for all headache episodes. No significant differences were observed between groups in the type of triptan used or the timing of administration. In contrast, medication-taking behaviors differed significantly between groups. The high-burden group more frequently exhibited underuse behaviors, such as delaying or avoiding medication, as well as overuse behaviors, including early or additional dosing driven by anxiety. Satisfaction with triptan treatment was higher in the low-burden group, whereas the use of preventive medications did not differ between groups. Multivariable logistic regression analysis identified the coexistence of underuse- and overuse-related behaviors and HIT-6 score as independent factors associated with high interictal burden. These findings suggest that medication-taking behaviors characterized by both underuse- and overuse-related tendencies are independently associated with interictal burden in migraine. Future studies should evaluate whether interventions targeting maladaptive medication-taking behaviors are associated with improvements in headache management and disease burden.