100 Migraine drugs, A to Z: Acetylsalicylic acid

April 30, 2018

Acetylsalicylic acid, also known as aspirin, is a truly miracle drug. It is an excellent pain and fever-reducing medicine and prevents several types of cancer and cardiovascular disease.

Aspirin has been proven to be a very effective migraine medicine, especially if you take 3 regular strength (975 mg) or two extra strength tablets (1,000 mg). Aspirin works fast, but it can relieve a migraine even faster if it is taken in an effervescent form. These are more common in Europe, but in the US you can buy Alka-Seltzer, which contains aspirin and sodium bicarbonate. Sodium bicarbonate (baking soda)is an excellent antacid and reduces the risk of stomach irritation by aspirin.

Stomach irritation and peptic ulcers, along with bruising and bleeding are the main potential side effects of aspirin. These can be dangerous and even life-threatening, but are not likely to occur if aspirin is taken for an occasional migraine.

The risk of side effects goes up with taking aspirin daily, which has been proven to prevent migraines and to reduce the risk of episodic migraines becoming chronic. It definitely does not cause medication overuse headaches. Some studies suggest that as little as 81 mg a day is sufficient to prevent migraines, but 325 mg appears to be a more effective dose. Anecdotally, aspirin has been also reported to prevent migraine auras.

So, how does one decide whether to take aspirin daily. The decision is easier if you have another reason to take it, such as risk factors for coronary or cerebrovascular disease or family history of colorectal or another type of cancer. If you have a history of gastritis or peptic ulcers, bleeding disorder, or allergy to aspirin, the decision is also easy – don’t take it. If none of the above applies to you and you are in good general health, it may be worth trying, especially if you have failed to respond to Botox injections, beta blockers amd other preventive migraine drugs.

Written by
Alexander Mauskop, MD
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Insights from Dr. Alexander Mauskop on headaches and migraines
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