Pain Relievers (Nonopioid)
Nonopioid analgesics are pain relievers that do not contain opioid, or narcotic, drugs. These drugs are recommended by the U.S. Headache Consortium as the first line of treatment for people with mild-to-moderate pain and disability from migraine. Nonsteroidal anti-inflam-matory drugs (NSAIDs) are effective because they reduce inflamma-tion and ease mild head pain. Aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), and ketorolac (Toradol) are all NSAID drugs. Acetaminophen is not an NSAID, but it is a nonopioid analgesic.
Caffeine is sometimes combined with nonopioid analgesics to relieve migraine pain, and in combination can boost the potency of these drugs by approximately 40 percent. Excedrin Migraine is a combination acetaminophen, aspirin, and caffeine formula. In addition, nonopioid analgesics are often combined with antiemetics, or antinausea, medication to reduce vomiting and stomach upset in migraine.
Liquid gel capsules or caplets, such as Advil Migraine, may be a better choice for fast head pain relief than standard tablets because the medication is predissolved and therefore is absorbed more quickly in the body.
Because they are not addictive, nonopioid analgesics are frequently a first treatment choice for migraine headache. These medications should be used with caution, as they can have significant side effects. These include fluid retention (edema), nausea, vomiting, diarrhea, constipation, reduced appetite, heartburn, and fatigue. People with kidney problems, liver problems, asthma, heart disease, and ulcers should consult their doctor before taking NSAIDs for migraine, as these drugs can make these conditions worse. If you take NSAIDs, you should not drink alcohol, as this can increase your chance of stomach bleeding. Some NSAIDs can increase your sensitivity to the sun, so avoid prolonged sun exposure and use sunscreen when taking them.
Acetaminophen is often a preferred drug for mild migraine pain because it has virtually no side effects. However, if taken in large doses, acetaminophen can cause liver damage, so caution should be taken to stay within the recommended dosage. Many prescription and over-the-counter drugs, including some cough and cold remedies, contain acetaminophen — so always check with your doctor before combining other medications with acetaminophen because of the risk of accidental overdose. There are a number of drugs that interact with acetaminophen and with NSAIDs, so you should tell your doctor about all prescription and over-the-counter medications you take if he prescribes these drugs for your migraines.
