Everything You Need to Know About NSAIDs for Migraine Treatment

Have you ever been told to take a nonsteroidal anti-inflammatory drug to alleviate your migraine pain? If so, your initial reaction might have been one of apprehension. And that’s understandable, as NSAIDs sound rather formidable.

However, nonsteroidal anti-inflammatory drugs—henceforth referred to as NSAIDs for brevity’s sake—shouldn’t be cause for alarm. Essentially, this is just a formal name for a widely familiar category of pain relief medication.

You're likely familiar with Nurofen®, Anadin®, and Cuprofen®, aren't you? Well, those are all NSAIDs. Although they relieve a myriad of pain types (from muscle aches and menstrual cramps to rheumatoid arthritis and tension headaches), our focus today is on migraine headache pain.

What are the most common NSAIDs?

Below is a succinct list of some of the most common NSAIDs along with their brand names available in the UK. Chances are, you might recognise several of these pain relievers.

  • ibuprofen (branded as Nurofen®, Cuprofen®)
  • aspirin (branded as Anadin®, Disprin®)
  • diclofenac (branded as Voltarol®)

Are NSAIDs prescription drugs or over-the-counter?

Both. Many NSAIDs (such as Nurofen®, Anadin®, and Cuprofen®) are available over-the-counter. The stronger NSAIDs, like migraine-strength naproxen, do necessitate a prescription from a healthcare professional.

How do I know if I need prescription-strength or over-the-counter NSAIDs?

Contemplating over-the-counter Nurofen® versus prescription products? Over-the-counter NSAIDs like Nurofen® aren’t as potent as prescription-strength naproxen, meaning you would need to take more tablets to achieve the same effect. If you’ve tried over-the-counter medications without success, it might be worth considering a prescription pain reliever like naproxen.

How do prescription NSAIDs work to treat migraines?

In simple terms, NSAIDs impede the inflammation responsible for migraine pain.

For a more scientific explanation, it’s important to recognise that there’s still no definitive research regarding the causes of migraines. It’s hypothesised that migraines initiate when the brain's blood vessels constrict, leading the brain to believe it needs more blood than is actually necessary. The blood vessels subsequently dilate, which results in a rush of blood to the brain. Cox-1 and Cox-2 are two of the enzymes involved in this inflammation process.

NSAIDs are Cox-1 and Cox-2 inhibitors, which means they obstruct these enzymes from creating inflammation.

How do you take NSAIDs?

Most NSAIDs are tablets, so it’s advisable to take them with a glass of water. Some individuals find that consuming them with a small amount of food helps to avert an upset stomach.

Not all NSAIDs, however, are in pill form. Voltarol®, for instance, is an MHRA-approved powder that you mix with water and drink. Research indicates that this formulation enables the medication to work more quickly—15 minutes for the powder vs. a full hour for tablets.

If you’re taking a prescription NSAID, make sure to follow the instructions given by your healthcare professional.

How long do they take to start working?

NSAIDs should begin to alleviate your migraine attacks within an hour of taking them.

How often can I take NSAIDs?

While NSAIDs are considered safe, it is advisable to use them judiciously to avoid side effects—a general guideline is not to take them more than three days a week.

Who should take NSAIDs for migraine?

Over-the-counter NSAIDs are worth trying if you experience mild migraine attacks. Prescription NSAIDs, such as naproxen, are recommended for individuals who need stronger treatment.

Who shouldn't take NSAIDs?

While NSAIDs are generally considered safe and effective, there are individuals who should explore other migraine treatments, including:

  • people who have asthma
  • people who are breastfeeding, pregnant, or planning to become pregnant
  • people who have heart disease, high blood pressure, liver cirrhosis, or kidney disease
  • people who have a history of stomach conditions (such as Crohn's disease or GERD)
  • people who are taking blood thinners or diuretics

Please consult your healthcare provider to discuss your specific needs and to find the best migraine treatment for you.

What are the possible side effects of NSAIDs?

Like many medications, NSAIDs can have side effects, including:

  • bloating, constipation, diarrhea, and gas
  • heartburn
  • nausea or vomiting
  • stomach pain

You should contact your healthcare provider immediately if you experience signs of a serious allergic reaction, dizziness, or difficulty breathing while taking these medications.

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