A Cochrane review «Ibuprofen with or without an antiemetic for acute migraine headaches in adults»1 «Rabbie R, Derry S, Moore RA. Ibuprofen with or without an antiemetic for acute migraine headaches in adults. Cochrane Database Syst Rev 2013;4():CD008039. »1 included 9 RCTs with a total of 4373 participants with migraine. Ibuprofen was compared with placebo or other active comparators. All studies treated attacks with single doses of medication.
• Ibuprofen 400 mg vs placebo: NNTs for 2-hour pain-free (26% vs 12% with placebo), 2-hour headache relief (57% vs 25%) and 24-hour sustained headache relief (45% vs 19%) were 7.2, 3.2 and 4.0, respectively.
• Ibuprofen 200 mg vs placebo: NNTs for 2-hour pain-free (20% vs 10%) and 2-hour headache relief (52% vs 37%) were 9.7 and 6.3, respectively. The higher dose was significantly better for 2-hour headache relief than the lower dose.
• Soluble formulations of ibuprofen 400 mg were better than standard tablets for 1-hour, but not 2-hour headache relief.
• Ibuprofen 400 mg did not differ from rofecoxib 25 mg for 2-hour headache relief, 24-hour headache relief or use of rescue medication.
Associated symptoms of nausea, vomiting, photophobia, phonophobia and functional disability were reduced within 2 hours, and fewer participants used rescue medication with ibuprofen compared with placebo. Similar numbers of participants experienced adverse events, which were mostly mild and transient.