Higher Dose Aspirin Effective for Acute Migraine Headache Pain

Addition of the antiemetic metoclopramide reduces nausea and vomiting

MONDAY, April 19 (HealthDay News) -- Aspirin is an effective option for the treatment of acute migraine headaches, and the addition of metoclopramide improves relief of nausea and vomiting, according to a review published in the April issue of the Cochrane Database of Systematic Reviews.

Varo Kirthi, of the University of Oxford in the United Kingdom, and colleagues searched the Cochrane CENTRAL, MEDLINE, EMBASE and the Oxford Pain Relief Database for studies through March 10, 2010. They included randomized, double-blind, placebo- or active-controlled studies that used aspirin to treat a migraine headache episode. Thirteen studies (4,222 participants) compared aspirin (900 mg or 1,000 mg), alone or in combination with metoclopramide (10 mg), with placebo or other active comparators, mainly sumatriptan (50 mg or 100 mg).

The researchers found that a single oral 1,000 mg dose of aspirin is effective in relieving migraine headache pain and associated symptoms, including nausea, vomiting, photophobia and phonophobia. Within two hours, pain was reduced from moderate or severe to no worse than mild pain or no pain in more patients taking aspirin than those taking placebo. The addition of 10 mg of the antiemetic metoclopramide substantially reduced nausea and vomiting compared to aspirin monotherapy, but had little effect on pain. The only major difference between aspirin with or without metoclopramide and sumatriptan 50 mg or 100 mg was that oral sumatriptan 100 mg was better than aspirin plus metoclopramide for pain-free response at two hours.

"Adverse events were mainly mild and transient, and were slightly more common with aspirin than placebo, but less common than with sumatriptan 100 mg," the authors write.

Three authors disclosed financial ties to pharmaceutical companies and/or industry sources.

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