Can Ibuprofen Prevent My Migraine?

An update on the AAN/AHS Guidelines for Prevention of Episodic Migraine

How An Over-The-Counter NSAID May Prevent Your Migraines
How An Over-The-Counter NSAID May Prevent Your Migraines. Peter Dazeley/Getty Images

Ibuprofen (Advil, Motrin) is a common non-steroidal anti-inflammatory (NSAID) used treat an episodic migraine attack. But can ibuprofen also be used to prevent a migraine?

In 2012, the American Academy of Neurology (AAN) and American Headache Society (AHS) released updated guidelines on medications for the prevention of episodic migraines. These guidelines were specifically updated to examine the use of NSAIDs and various herbal or complementary medications in reducing the number and frequency of migraine attacks.

Let’s review these guidelines and answer your question about using the common over-the-counter medication ibuprofen to prevent your migraine headaches. 

Classification of Preventive Episodic Migraine Medications (Only NSAIDs and Complementary Therapies)

The guidelines classify the medications into levels based on their deemed effectiveness.

Level A  Medications are determined to be “effective.” Petasites or butterbur is a Level A medication. This is an herbal or alternative medication that is taken twice daily. The main side effect is mild GI upset, especially burping.

Level B Medications are determined to be “probably effective.” Examples of level B medications include:

Level C Medications are determined to be “possibly effective.” Examples include:

  • NSAIDs (flurbiprofen, mefenamic acid)
  • Co-Q10
  • Estrogen
  • Antihistamine: cyproheptadine

Level U Medications are determined to be “inadequate” due to conflicting studies. A conflicting study means that while some studies support the use of the medication for migraine prevention, others disprove its use. Examples include:

  • NSAIDs (aspirin, indomethacin)

The guidelines also referred to medications that are considered “possibly or probably ineffective.” Montelukast (Singulair) is an example of a medication that is probably not useful in preventing migraine attacks.

Can I Take Ibuprofen to Prevent My Migraine Attacks?

According to the above guidelines, it may be reasonable to take ibuprofen to prevent your episodic migraines. That being said, studies evaluating the role of NSAIDs in migraine prevention are still sparse. With that, it's more likely that your doctor will recommend a better-researched migraine preventive medication like the anticonvulsant Topamax (topiramate) or a beta blocker, like metoprolol or propranolol. 

In addition, NSAIDs have several potential adverse effects and should be avoided by some individuals, particularly those with a history of stomach bleeding, kidney disease, and/or heart disease. This is why it's important to always speak with your doctor before taking an over-the-counter medication to ensure it is safe for you.

Also, please note that NSAIDs make up a large group of medications, some of which are labeled as Level B or “probably effective” (for example, ibuprofen) down to Level U or “inadequate” (for example, aspirin).

Just because you are taking a NSAID for another medical condition does not mean it is the appropriate one for preventing your migraines.

A Word From Verywell

Let’s take a step back. Remember, guidelines are meant to help “guide” your doctor in treating your headache. It does not necessarily mean that a certain treatment is best for you. Your doctor has to take into consideration other aspects of your health such as:

  • The type of migraine you suffer from.
  • Other medical conditions you suffer from in addition to migraines, like depression or high blood pressure.
  • Whether you are in your childbearing years as a certain migraine preventive medications may have potential adverse fetal effects.
  • Side effects of a migraine preventive medications.
  • The potential for medication overuse headache or progression of episodic to a chronic migraine.

The final point is especially relevant. The last thing you want it to develop a medication overuse headache when you are trying to prevent your migraines—a double whammy. 

Sources:

Headache Classification Committee of the International Headache Society. (2013). "The International Classification of Headache Disorders: 3rd Edition (beta version)". Cephalalgia, 33(9):629-808.

Holland, S., Silberstein, S.D., Freitag, F., Dodick, D.W., Argoff, C., & Ashman, E. (2012). Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults. Neurology, 78:1346-1353.

Continue Reading