Can Ibuprofen Prevent My Migraine?

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

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What medication is effective for preventing my migraines?. Wataru Yanagida/Getty Images

Ibuprofen (Advil, Motrin) is a common non-steroidal anti-inflammatory (NSAID) used to abort an episodic migraine. 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 our 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?

Yes, it may be reasonable to take ibuprofen to prevent your episodic migraines. That being said, studies are still limited to using NSAIDs to prevent migraines. So 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, please be sure to discuss any medication use with your doctor first. Remember 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. Always speak with your healthcare provider before taking an over-the-counter medication to make sure it is safe.

Also, please note that NSAIDs make up a large group of medications, some of which are labeled as Level B or “probably effective” (i.e. ibuprofen) down to Level U or “inadequate” (i.e. aspirin). Just because you are taking a NSAID for another medical condition does not mean it is the appropriate one for preventing your migraines.

The Bottom Line

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.

Lipton, R.B., Göbel, H., Einhäupl, K.M., Wilks, K., & Mauskop, A. (2004). Petasites hybridus root (butterbur) is an effective preventive treatment for migraine. Neurology, Dec 28;63(12):2240-4.

DISCLAIMER: This site is for informational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for advice, diagnosis, and treatment of any concerning symptoms or medical condition.

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