What is the recommended dose of ibuprofen (Nonsteroidal Anti-Inflammatory Drug (NSAID)) for migraine treatment?

From the Guidelines

The recommended dose of ibuprofen for migraine treatment is 400-600 mg taken at the first sign of headache, which can be repeated every 6-8 hours as needed, not exceeding 3,200 mg per day. This dosage is based on the most recent guideline from the American College of Physicians, published in 2025 1. According to this guideline, ibuprofen is a recommended treatment option for mild episodic migraine headache, and the choice of a specific NSAID should be based on individualized decision making, taking into consideration patient preferences and factors such as route of administration and cost.

Key Considerations

• Ibuprofen should be taken with food to minimize stomach irritation.
• If migraine symptoms persist despite ibuprofen use, or if you require the maximum dose regularly, consult a healthcare provider as this may indicate the need for prescription migraine medications.
• Individuals with kidney problems, heart conditions, or a history of stomach ulcers should speak with their doctor before using ibuprofen for migraines, as NSAIDs can worsen these conditions.

Additional Treatment Options

• If patients do not achieve sufficient pain relief with ibuprofen, a triptan can be added to the treatment regimen, or alternative options such as CGRP antagonists-gepants or ergot alkaloid can be considered 1.
• For people having severe nausea or vomiting, a nonoral triptan and an antiemetic can be used.
• Patients should be aware of medication overuse and potential adverse effects, and counselled to begin treatment of migraine headache as soon as possible after its onset, using combination therapy to improve efficacy 1.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION ... Mild to moderate pain:400 mg every 4 to 6 hours as necessary for relief of pain. Do not exceed 3200 mg total daily dose.

The recommended dose of ibuprofen for mild to moderate pain, which includes migraine treatment, is 400 mg every 4 to 6 hours as necessary. The maximum daily dose should not exceed 3200 mg. 2

From the Research

Ibuprofen Dosage for Migraine Treatment

The recommended dose of ibuprofen for migraine treatment is typically between 200 mg and 400 mg.

• Studies have shown that both 200 mg and 400 mg doses are effective in reducing headache intensity and rendering patients pain-free at 2 hours 3, 4.
• The 400 mg dose has been found to be more effective than the 200 mg dose in some studies, with a higher percentage of patients achieving pain-free status at 2 hours 5, 3.
• The number needed to treat (NNT) for headache relief with ibuprofen 400 mg is around 3.2, indicating that 3-4 patients need to be treated with ibuprofen 400 mg to achieve headache relief in one patient 5.

Comparison with Other Treatments

Ibuprofen has been compared to other treatments for migraine, including paracetamol and aspirin.

• Ibuprofen 400 mg has been found to be as effective as rofecoxib 25 mg for 2-hour headache relief and 24-hour headache relief 5.
• Paracetamol 1000 mg has been found to be statistically superior to placebo for 2-hour pain-free and headache relief, but with a higher NNT than ibuprofen 400 mg 6.
• Aspirin 1000 mg has been found to be an effective treatment for acute migraine headaches, with a similar efficacy to sumatriptan 50 mg or 100 mg 7.

Safety and Tolerability

Ibuprofen has been found to be generally well-tolerated and safe for the treatment of migraine.

• Adverse events with ibuprofen are mostly mild and transient, and occur at a similar rate to placebo 5, 3, 4.
• The addition of an antiemetic to ibuprofen may help to reduce nausea and vomiting associated with migraine, but this has not been extensively studied 5.