From the Guidelines
For migraines, naproxen is considered the most effective over-the-counter NSAID option among those listed, due to its longer duration of action and efficacy in reducing inflammation and pain. When considering over-the-counter (OTC) options for migraines, it's essential to evaluate the effectiveness of each medication. According to the American College of Physicians guideline 1, NSAIDs such as naproxen, ibuprofen, and acetaminophen are recommended for treating mild episodic migraine headache.
Some key points to consider when choosing an OTC medication for migraines include:
- The dosage and potential side effects of each medication
- The individual's medical history and potential interactions with other medications
- The severity and frequency of migraines
- Patient preferences, such as route of administration and cost
Naproxen sodium (Aleve) is a good option for many migraine sufferers, with a longer duration of action (8-12 hours) compared to ibuprofen (4-6 hours) 1. Ibuprofen (Advil, Motrin) at doses of 400-600mg can be effective for milder migraines. Excedrin Migraine, which contains a combination of acetaminophen, aspirin, and caffeine, may also be effective for some individuals. However, regular Tylenol (acetaminophen) alone is typically the least effective for migraines. It's crucial to take any of these medications at the first sign of migraine symptoms rather than waiting until the pain becomes severe. If OTC medications aren't providing relief, or if you're experiencing frequent migraines (more than 4 per month), consult a healthcare provider about prescription options, such as triptans or CGRP antagonists-gepants, as recommended by the guideline 1.
From the Research
Comparison of OTC Medications for Migraines
- The following OTC medications are commonly used to treat migraines: naproxen, ibuprofen, Tylenol (acetaminophen), and Excedrin (a combination of acetaminophen, aspirin, and caffeine).
- Studies have shown that ibuprofen is an effective treatment for acute migraine headaches, providing pain relief in about half of sufferers 2.
- A combination of acetaminophen, aspirin, and caffeine (Excedrin) has been shown to be superior to ibuprofen in relieving migraine pain and associated symptoms 3, 4.
- Ibuprofen has been found to be effective in reducing migraine headache pain intensity, with a higher dose (400 mg) being more effective than a lower dose (200 mg) 2, 5.
- Naproxen is also considered an effective treatment for acute migraine headaches, although fewer studies have been conducted on its efficacy compared to ibuprofen and Excedrin 6.
- Tylenol (acetaminophen) is considered suitable for mild to moderate migraine attacks, but may not be as effective as other options for more severe attacks 6.
Efficacy of Each Medication
- Ibuprofen: effective in reducing migraine headache pain intensity, with a higher dose (400 mg) being more effective than a lower dose (200 mg) 2, 5.
- Excedrin (acetaminophen, aspirin, and caffeine): superior to ibuprofen in relieving migraine pain and associated symptoms 3, 4.
- Naproxen: considered an effective treatment for acute migraine headaches, although fewer studies have been conducted on its efficacy 6.
- Tylenol (acetaminophen): suitable for mild to moderate migraine attacks, but may not be as effective as other options for more severe attacks 6.