From the Guidelines
Aspirin is recommended for the short-term treatment of migraine headaches, as evidenced by the most recent and highest quality study 1.
Key Points to Consider
- The 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline for the management of headache recommends aspirin-acetaminophen-caffeine for the short-term treatment of migraine 1.
- Aspirin works by blocking the production of prostaglandins, chemicals that cause inflammation and pain, and by inhibiting platelet aggregation which may help reduce migraine symptoms.
- However, aspirin isn't typically considered a first-line treatment for migraines; medications like triptans, NSAIDs such as ibuprofen or naproxen, or combination medications containing acetaminophen, aspirin, and caffeine (like Excedrin Migraine) are often more effective.
- People with certain conditions should avoid aspirin, including those with bleeding disorders, stomach ulcers, aspirin allergies, or children under 18 (due to risk of Reye's syndrome).
- If you experience frequent migraines, consult a healthcare provider for a comprehensive treatment plan that might include preventive medications rather than relying solely on aspirin for symptom management.
Important Considerations
- The use of aspirin for migraine treatment should be closely monitored to avoid overuse, which can lead to rebound headaches 2.
- Aspirin is effective in combination with acetaminophen and caffeine, but acetaminophen alone has not been shown to be beneficial in migraine treatment 2.
- Other treatment options, such as triptans, NSAIDs, and preventive medications, may be more effective for some patients and should be considered as part of a comprehensive treatment plan 1, 3.
From the Research
Efficacy of Aspirin for Migraine Headaches
- Aspirin is considered an effective treatment option for acute migraine headaches, with studies showing that high-dose aspirin (900-1300 mg) taken at the onset of symptoms can provide significant pain relief 4, 5, 6, 7, 8.
- The efficacy of aspirin for migraine headaches has been demonstrated in several clinical trials, with aspirin being shown to be as effective as sumatriptan 50 mg or 100 mg for acute migraine headaches 5, 8.
- Aspirin has also been shown to be effective in reducing associated symptoms of nausea, vomiting, photophobia, and phonophobia 5, 6, 8.
Dosage and Formulation
- The recommended dosage of aspirin for acute migraine headaches is 900-1300 mg, taken at the onset of symptoms 4, 5, 6, 7, 8.
- The effervescent highly buffered preparation of aspirin has been shown to be effective, safe, and well-tolerated compared to other treatment options 7.
- The addition of an antiemetic, such as metoclopramide, can improve relief of nausea and vomiting associated with migraine headaches 5, 8.
Safety and Tolerability
- Aspirin has been shown to be generally well-tolerated, with adverse events being mostly mild and transient 5, 6, 8.
- The side effect profile of aspirin is relatively favorable, with fewer side effects compared to other prescription drug therapies 4.
- Aspirin is considered a safe and effective treatment option for acute migraine headaches in appropriately selected patients 6.