Can anti-inflammatories help migraines? A comprehensive guide to NSAIDs

October 10, 2025 •

3 min read

According to the American Migraine Foundation, non-steroidal anti-inflammatory drugs (NSAIDs) have long been a mainstay for managing migraine, providing an effective option for many sufferers, especially for mild to moderate attacks. The question of can anti-inflammatories help migraines is therefore often answered with a qualified 'yes'.

Quick Summary

This guide explains how non-steroidal anti-inflammatory drugs (NSAIDs) can treat acute migraine attacks by targeting inflammation. It details their mechanism, effectiveness for mild vs. severe migraines, potential side effects, and how they compare to triptans and other therapies.

Key Points

Effective for Mild to Moderate Migraines: Anti-inflammatories, or NSAIDs, are a recommended first-line treatment for managing acute migraine attacks of mild to moderate intensity.
Best When Taken Early: For optimal effectiveness, NSAIDs should be taken at the earliest sign of a migraine, before central sensitization makes pain harder to treat.
Combines Well with Other Treatments: Combining an NSAID with a triptan can be more effective than using either drug alone, addressing different pain pathways simultaneously.
Risk of Medication Overuse Headache: Frequent use of NSAIDs (more than 10-15 days a month) can lead to rebound headaches, making attacks more frequent.
Potential Side Effects: Long-term or overuse of NSAIDs can lead to gastrointestinal problems (ulcers, bleeding) and increase the risk of cardiovascular events and kidney issues.
Consider Fast-Acting Formulations: Options like liquid gels or dissolvable powders can lead to faster absorption and quicker relief during an attack when gastric motility is slower.
Not a Preventive Measure: NSAIDs are primarily used for acute treatment and are not typically recommended for preventing or reducing the frequency of migraine attacks.

How anti-inflammatories work for migraines

Migraine attacks involve the activation of the trigeminal nervous system, leading to sterile inflammation and the release of pro-inflammatory chemicals like prostaglandins in the dura mater surrounding the brain. This contributes to the pulsating pain of a migraine.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) reduce this inflammation by inhibiting cyclooxygenase (COX) enzymes, which produce prostaglandins. By blocking prostaglandin synthesis, NSAIDs help alleviate migraine pain and associated symptoms. COX-1 is involved in normal functions, while COX-2 is induced by inflammation; most NSAIDs block both.

The importance of early treatment

NSAIDs are most effective when taken early in a migraine attack, before central sensitization makes pain receptors more sensitive and peripheral-acting drugs less effective.

Common NSAIDs used for migraine

Common OTC and prescription NSAIDs for migraine include:

Ibuprofen: Popular for mild to moderate migraine; liquid-gels may offer faster relief.
Naproxen Sodium: Provides longer-lasting relief due to a longer half-life.
Aspirin: Effective, especially in combination products like Excedrin Migraine.
Diclofenac: Prescription-only, often in fast-acting powder form.
Ketorolac: Injectable, sometimes used for severe migraines in emergency settings.

Comparison: Anti-inflammatories vs. triptans

The choice between NSAIDs and triptans depends on migraine severity. Here's a comparison:


Feature	NSAIDs (e.g., Ibuprofen, Naproxen)	Triptans (e.g., Sumatriptan)
Mechanism of Action	Block prostaglandin synthesis to reduce inflammation, alleviating pain.	Act on serotonin receptors in the brain to constrict blood vessels and block pain signals.
Best Used For	Mild to moderate migraine attacks, especially when taken early.	Moderate to severe migraine attacks.
Speed of Action	Can be fast-acting, particularly in liquid-gel or dissolvable forms.	Typically fast-acting, with injections or nasal sprays providing rapid relief.
Combination Therapy	Can be combined with triptans for enhanced efficacy and reduced recurrence.	Often combined with NSAIDs to improve treatment outcomes.
Side Effects	Gastrointestinal issues, potential cardiovascular and kidney risks with long-term use.	Chest pressure, tingling, dizziness. Contraindicated in patients with certain heart conditions.
Cost	Generally more affordable, especially OTC versions.	Can be more expensive, depending on formulation and insurance.

Limitations and side effects of NSAIDs

Frequent NSAID use has potential risks:

Gastrointestinal Issues: Risk of heartburn, ulcers, and bleeding. Taking with food helps.
Cardiovascular Risks: Long-term use linked to increased risk of heart attack and stroke, particularly with existing heart conditions.
Kidney Impairment: Chronic use can affect kidney function.
Medication Overuse Headache (MOH): Using acute pain relievers more than 10–15 days monthly can worsen headaches.

Combining anti-inflammatories for enhanced effect

Combination therapy can be beneficial. Treximet, for example, combines sumatriptan and naproxen sodium. Combining an OTC NSAID with an anti-nausea medication can also improve absorption and efficacy during an attack.

Conclusion: A valuable tool with proper use

Anti-inflammatories are useful for mild to moderate migraines or in combination therapy. They target the inflammatory component of migraines. However, potential side effects and MOH risk require careful use. Consulting a healthcare provider is essential to determine the best approach for your specific needs and health conditions. Resources like the American Migraine Foundation offer more information.

The crucial need for professional guidance

Always discuss new medications with a healthcare provider, especially with chronic migraines or other health conditions, to create a safe and effective personalized treatment plan.

Frequently Asked Questions

Ibuprofen (Advil, Motrin) and naproxen sodium (Aleve) are common choices, with ibuprofen often recommended for acute attacks. Prescription-strength options like diclofenac (Cambia) are also available and can act more quickly.

The speed of relief depends on the formulation. Fast-acting liquid-gels or dissolvable powders can work within 15-30 minutes, while standard tablets may take up to an hour or more to provide significant pain relief.

Yes, for many people, combining an NSAID with a triptan provides more effective and longer-lasting relief than either medication alone. A doctor should be consulted before starting combination therapy.

Medication overuse headache (MOH) is a significant risk. Taking acute migraine medications, including NSAIDs, more than 10-15 days per month can cause MOH. It's important to limit frequency and follow a doctor's advice.

Yes. Individuals with a history of gastrointestinal bleeding or ulcers, heart conditions, high blood pressure, kidney disease, or who are taking blood thinners should avoid NSAIDs or use them only under strict medical supervision.

NSAIDs are not typically used for migraine prevention. Their primary role is in the acute treatment of attacks. Some studies have investigated naproxen for prophylaxis, but they are not a standard preventive treatment.

Common side effects can include nausea, stomach upset, heartburn, and bloating. To minimize these, taking NSAIDs with food or milk is recommended.