Using Ibuprofen to Treat Headaches and Migraines

When you have a headache that's severe enough to require medication, chances are you reach for an oral analgesic—a painkiller taken by mouth—such as ibuprofen. This familiar non-steroidal anti-inflammatory drug, or NSAID, is effective for all types of headaches, from those caused by garden-variety stress to severe migraines.

In fact, ibuprofen, along with a similar NSAID, naproxen, are among the medications most often used for migraine pain, according to the America Migraine Foundation: They often are just as effective as other migraine medications, such as triptans, and also cost less and are less likely to lead to what is called the "chronification" of headaches, in which pain occurs daily or near every day.

Ibuprofen is available over the counter (OTC) as well as by prescription. As an OTC product, it's sold under the brand names Advil and Motrin; it's also available in generic and store-brand forms, which often are less expensive. For very severe pain, a doctor may prescribe ibuprofen in a stronger dose than can be purchased over the counter.

The medication also is a common ingredient in certain multi-symptom cold and flu remedies—an important fact to be aware of in order to avoid taking too much of the drug at once and triggering potentially serious side effects.

That said, when used correctly, ibuprofen is safe for most people.

Ibuprofen is in company with other familiar NSAIDs, including over-the-counter aspirin and Aleve (naproxen), and prescription analgesics Celebrex (celecoxib) and Cambia (diclofenac).

All of these drugs work by blocking cyclooxygenase (COX), an enzyme that forms prostaglandins and other substances that are responsible for inflammation, pain, and temperature control.

Over-the-counter ibuprofen comes as a 200-milligram (mg) tablet or a chewable; it's also available as a liquid or drops for children. For mild to moderate headache pain, a single dose of nonprescription ibuprofen every four to six hours up to three times per day often is enough to bring relief to most otherwise-healthy adults (as well as kids over 12).

For more severe head pain, research has shown that a double dose is likely to be more helpful than a single one. In fact, this is the dosage frequently used in research looking at the effectiveness of ibuprofen for headache pain relief.

For example, in a 2015 review of 12 studies, people with episodic tension-type headaches were found to be pain-free two hours after taking 400 mg of ibuprofen, while those who took a placebo or only 200 mg of ibuprofen had no or less long-lasting relief.

Similarly, a 2013 study found that ibuprofen provides pain relief for about half of people with migraines, especially in doses of 400 mg (compared to 200 mg). What's more, people who don't get adequate relief from standard doses of ibuprofen may be prescribed a larger dose (up to 800 mg three times per day).

Ibuprofen is associated with side effects ranging from common and mild to potentially serious. These risks are heightened at higher doses, which is why taking it as directed is essential.

Common Side Effects

The most typical side effects of ibuprofen include:

• constipation
• diarrhea
• gas
• bloating
• dizziness
• nervousness
• ringing in the ears

Call your doctor right away if you're taking ibuprofen and experience more serious symptoms, such as:

• weight gain
• trouble breathing
• swelling of the abdomen, feet, ankles, or lower legs
• fever
• blisters
• rash
• cloudy or bloody urine
• stiff neck
• headache

Emergencies
Get medical help right away if you experience any of the following while taking ibuprofen. Note, too, that this drug may interact with other medications you're taking.

• Symptoms of an allergic reaction (rash, itching, or hives)
• Black stools
• Blood in stool, urine, or vomit
• Visual changes
• General ill feeling or flu-like symptoms
• Nausea or vomiting
• Redness, blistering, peeling, or loosening of the skin
• Stomach pain
• Unexplained weight gain or swelling
• Unusual fatigue
• Yellowing of eyes or skin

Ibuprofen (as well as other NSAIDS, except for aspirin) carries a boxed warning regarding a heightened risk of heart attack or stroke in people who take it—especially for extended periods of time.

If you've recently had a heart attack; have a family history of heart disease or stroke; smoke; or have ever had high cholesterol, hypertension (high blood pressure), or diabetes, you should check with your doctor before taking ibuprofen.

The boxed warning for NSAIDs also explains that these medications may cause ulcers, bleeding, or holes in the stomach or intestines. People who are older, are in poor health, or drink three or more alcoholic beverages per day are at highest risk for these adverse effects, as are those who take blood thinners or corticosteroids.

Ibuprofen can also cause an allergic reaction in some people, so seek medical attention immediately if you develop swelling of your face or throat.

Ibuprofen and Pregnancy

Studies have been inconclusive regarding how ibuprofen might affect a developing fetus during the first two trimesters. However, it is contraindicated in the last three months of pregnancy, as it can cause problems to an unborn baby or during delivery.

If you're expecting or breastfeeding, talk to your doctor about taking ibuprofen, even in standard doses. And if you happen to become pregnant while taking ibuprofen, stop taking it until you've spoken to your healthcare provider.