People can take a range of medications for migraine, including nonsteroidal anti-inflammatory drugs such as aspirin. For many, aspirin is an affordable, convenient, and effective migraine treatment.
It is available over the counter (OTC) and on prescription. However, this medication is not suitable for everyone.
This article offers an overview of taking aspirin for migraine, including how it works, dosages, and side effects. It also looks at how it compares with other migraine treatments.
People can take aspirin, a common nonsteroidal anti-inflammatory drug (NSAID), to stop the progression of migraine. Typically, a person takes a single dose as soon as they feel symptoms developing. The aim is to prevent the progression of the migraine to reduce pain.
Aspirin may also work as a preventative medication when taken daily at lower doses, although evidence on the effectiveness of this approach is mixed.
Aspirin works by blocking an enzyme that makes the body produce prostaglandins, which are compounds with many bodily functions, including inflammation and pain processes. By stopping this production process, aspirin can control pain and inflammation.
People generally use aspirin for mild-to-moderate migraine that does not trigger nausea or vomiting, as vomiting may mean they do not absorb the medication. Those who experience vomiting during migraine episodes may need antiemetics to ensure the body can absorb other medicines.
A 2020 review states that people using aspirin as a treatment for current migraine symptoms can take a single high dose between 900–1,300 milligrams (mg).
The review also states it is possible to take aspirin daily at lower doses to prevent recurring episodes. However, the evidence is mixed for this approach. People who wish to try this method can take between 81–325 mg per day.
A 2014 review of previous research found that taking 1,000 mg of aspirin was comparable to a standard dose of sumatriptan in terms of acute pain relief. Aspirin also caused fewer side effects than sumatriptan.
In the review, out of 2,027 participants from six studies, 24% were pain-free 2 hours after taking aspirin, compared to 11% taking a placebo.
Many people who take aspirin tolerate it well at safe dosages. However, as with all NSAIDs, it can lead to side effects.
While the 2014 review found that aspirin had fewer side effects than sumatriptan, aspirin has the highest risk of side effects out of all NSAIDs available for migraine.
The most common side effects of aspirin are:
- digestive irritation
Less commonly, people can experience:
Rarely, severe adverse effects include:
- gastrointestinal bleeding
- severe allergic reactions
A 2018 review cautions against using OTC pain medications for long periods. If a person experiences migraine episodes or headaches frequently, they may need to consider other options.
Some people should not take aspirin, including:
- children under 12 years old
- children and adolescents with symptoms of flu or chickenpox
- people who are allergic or sensitive to NSAIDs
- people with stomach ulcers
- people with bleeding disorders, such as hemophilia
- people who are pregnant, unless otherwise instructed by a doctor
Children and adolescents should not use aspirin because the medication has links with Reye’s syndrome. People with this condition may develop swelling in the brain, which can lead to coma and even death.
People should speak with a doctor before trying aspirin if they have a preexisting condition, such as:
- digestive conditions
- liver or kidney disease
- glucose-6-phosphate dehydrogenase deficiency, as aspirin may trigger anemia in these individuals
Certain medications may also interact with aspirin. If someone takes existing medicines, speak with a doctor or pharmacist before using aspirin.
NSAIDs are a first-line treatment for mild-to-moderate migraine. Examples that doctors and pharmacists may recommend include:
- ibuprofen (Advil, Motrin)
Naproxen is the slowest acting NSAID, but it has the longest duration of action. Aspirin works more quickly, but does not last as long.
Acetaminophen (Tylenol) is not an NSAID, but a common OTC pain medication that may help with migraine pain.
A 2018 review notes that acetaminophen is not as effective as NSAIDs for treating migraine. However, it may cause fewer side effects in some people.
Those who cannot take other types of migraine medication may instead try a combined regimen of acetaminophen, aspirin, and caffeine.
People with moderate-to-severe migraine may require triptans. These medications work specifically for migraine, including drugs such as:
The 2014 review found that sumatriptan and aspirin are similarly effective for migraine. However, they come with their own side effects and risks, particularly if people combine them with medications that affect serotonin levels, such as certain antidepressants.
Other medications for migraine include:
- ergots, such as ergotamine and dihydroergotamine
- dexamethasone, a steroid that does not reduce immediate pain but can reduce the frequency of migraine episodes
- calcitonin gene-related peptide antagonists
- opioids, although the 2018 review notes these should be a last resort
Sometimes, migraine headaches or episodes are unavoidable. While people do not always understand what causes them, they can try to identify specific triggers and find relief with diet or lifestyle changes.
Keep a migraine diary to record symptoms when they occur, alongside any factors that may have contributed to migraine that day. Over time, a person may notice a pattern.
Factors that may lead to migraine include:
- hormonal changes
- specific foods, such as cheese or chocolate
- strong smells or tastes
- bright lights
- skipped meals
- weather changes
- being too hot
- too much or not enough sleep
- drinking alcohol
- cigarette smoke
In some people, muscle tension can also trigger migraine headaches. However, if a person’s headaches often precede neck pain, they may be experiencing cervicogenic headaches. These feel similar to migraine, but nerve, muscle, or bone issues in the neck are the cause.
Depending on a person’s triggers, they may be able to reduce the frequency of migraine episodes with:
- relaxation training
- physical therapy
- sleep aids such as melatonin
- dietary changes
- stopping smoking or drinking
Migraine pain can be severe, but severe pain can sometimes indicate another condition that requires medical treatment.
Anyone experiencing the following should seek emergency help:
- a headache that feels excruciating or comes on suddenly
- a severe headache that gets increasingly severe
- symptoms of a severe allergic reaction, such as swollen airways and trouble breathing
It is also important to speak with a doctor promptly if:
- a person is over 50 years old when migraine episodes begin
- they have symptoms of other disorders, such as high blood pressure, weight loss, or other pain
- they have signs of infection, such as fever
People experiencing these symptoms may need a referral to a specialist.
If a person has any new symptoms while taking aspirin, stop taking it and speak with a doctor as soon as possible.
Aspirin can be an effective and affordable migraine treatment. People often use it in a single high dose to prevent migraine headaches or episodes from getting worse.
However, this medication is not suitable for everyone, so check with a doctor before taking it. A healthcare professional or pharmacist can recommend the best dosage and advise on alternatives if aspirin triggers side effects or is not effective.