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Ibuprofen for Headaches


  • Generic name: Ibuprofen
  • Brand names: Advil, Brufen, Motrin, Nurofen, IBU
  • Pharmacologic category: Nonsteroidal Anti-inflammatory Drug
  • FDA approved: September 19, 1974
  • Pregnancy risk factor: C

Medical uses

Ibuprofen belongs to a class called non-steroidal anti-inflammatory drugs (NSAIDs). It is used for the management of mild to moderate pain, fever, and inflammation. Ibuprofen is used to relieve the symptoms of a wide range of illnesses such as headaches, backache, neuralgia, migraine, cold and flu symptoms, arthritis; dental rheumatic and muscular pain.

Ibuprofen lysine is indicated for closure of a patent ductus arteriosus in premature infants. The lysine salt makes ibuprofen more soluble in water.

Ibuprofen Effectiveness for Headaches

NSAIDs are a mainstay of symptomatic headache treatment. Ibuprofen provides both analgesic and anti-inflammatory benefits. It can be used as monotherapy or in combination with other medications. Ibuprofen is widely used for the acute treatment of childhood headache and migraine8.

Ibuprofen is effective for the following forms of headache:

  • Tension-type headache, the most common type of primary headache 1, 2
  • Sinus headache 3
  • Migraines 5
  • High altitude headache 4
  • Headache during pregnancy 6

Ibuprofen and other NSAIDs are NOT recommended for headaches after concussion or mild head injury as they may increase the risk of bleeding.

Dosage

200 to 400 mg every 4 to 6 hours as needed. Maximum daily dose 2400 mg.
Remember: Always take the lowest effective dose and for the shortest period of time.

Benefits

  • Reduces headache intensity and provides relief of headache overall
  • Works better, than acetaminophen 2
  • Suitable for childhood headaches
  • NSAIDs may have some potential in reducing the risk of progression of migraine into chronic form relative to other acute migraine medications. In epidemiological studies, an NSAID taken up to 12 times per month had a protective effect in lowering the risk of developing chronic migraine7.
  • Beneficial effect on accompanying symptoms of migraine such as nausea, photophobia, and phonophobia 5
  • Low risk of medication-overuse headache
  • Cost-effective symptomatic treatment.
  • Relatively inexpensive compared to other NSAIDs.
  • Amongst the NSAIDs, ibuprofen seems to have the most favourable side effect profile, including the lowest incidence of gastrointestinal adverse drug reactions

Disadvantages

  • High potential for drug interactions. May diminish cardioprotective antithrombotic effect of aspirin.
  • Taking ibuprofen around the time of conception or early in pregnancy elevates the risk of miscarriage.
  • Usually requires to be taken 3-4 times per day.
  • Not suitable for patients with gastrointestinal or bleeding disorders, renal dysfunction, or in the presence of anticoagulation.

Pharmacological characteristics

  • Onset of action: Analgesic: 30-60 minutes; Anti-inflammatory: 7 days
  • Duration of action: 4-6 hours
  • Metabolism: Hepatic
  • Elimination half-life:
    Children 3 months to 10 years: 1.6 ± 0.7 hours
    Adults: 2-4 hours
  • Excretion: Urine (1% as free drug); some feces

Mode of action

Ibuprofen has three types of action: anti-inflammatory, pain-relieving, and antipyretic (fever-reducing).

Ibuprofen works through inhibition of cyclooxygenase (COX), thus inhibiting production of prostaglandins (hormones, released by damaged tissues and promote inflammation). There are at least 2 variations of cyclooxygenase (COX-1 and COX-2 ), and ibuprofen inhibits both COX-1 and COX-2. Its analgesic, antipyretic, and anti-inflammatory activities are achieved mainly through COX-2 inhibition; whereas COX-1 inhibition is responsible for its unwanted effects on platelet aggregation and the GI mucosa.

References

  • 1. Derry S, Wiffen PJ, Moore RA, Bendtsen L. Ibuprofen for acute treatment of episodic tension-type headache in adults. Cochrane Database Syst Rev. 2015 Jul 31;7:CD011474 PubMed
  • 2. Schachtel BP, Furey SA, Thoden WR. Nonprescription ibuprofen and acetaminophen in the treatment of tension-type headache. J Clin Pharmacol. 1996 Dec;36(12):1120-5. PubMed
  • 3. Sinus Headaches. Patient Health Information. American Academy of Otolaryngology
  • 4. Harris NS, Wenzel RP, Thomas SH. High altitude headache: efficacy of acetaminophen vs. ibuprofen in a randomized, controlled trial. J Emerg Med. 2003 May;24(4):383-7. PubMed
  • 5. Codispoti JR, Prior MJ, Fu M, Harte CM, Nelson EB. Efficacy of nonprescription doses of ibuprofen for treating migraine headache. a randomized controlled trial. Headache. 2001 Jul-Aug;41(7):665-79. PubMed
  • 6. Gendolla A, Evers S. Difficult decisions: headache treatment in pregnancy and childhood. Schmerz. 2004 Oct;18(5):378-84. PubMed
  • 7. Bigal ME, Serrano D, Buse D, Al Scher, Stewart WF, Lipton RB. Migraine medications and evolution from episodic to chronic migraine: a longitudinal population based study. Headache. 2008;48:11571168.
  • 8. Lewis DW, Kellstein D, Dahl G, Burke B, Frank LM, Toor S, Northam RS, White LW, Lawson L. Children's ibuprofen suspension for the acute treatment of pediatric migraine. Headache. 2002 Sep;42(8):780-6. PubMed

By HealthyStock Research Group, September 2009
Medical resources reviewed: August 2018

Interesting facts

motrin

  • Ibuprofen was developed by the Boots Company, a British drug manufacturer and retailer.
  • Its development resulted from a search to find a drug more powerful and better tolerated than aspirin.
  • Ibuprofen has been associated with a lower risk of Parkinson's disease, and may delay or prevent Parkinson's disease. Aspirin, other NSAIDs, and paracetamol had no effect on the risk for Parkinson's.
  • Ibuprofen became the first prescription NSAID to become available as a non-prescription (OTC) analgesic.
  • According to Johns Hopkins University and the National Institute on Aging, the likelihood of developing Alzheimer's disease may be reduced by up to 60% with frequent consumption of ibuprofen over two or more years, and that use for an even shorter period may reduce risk by 30%. Researchers in that study caution, however, that consistent use of ibuprofen can cause kidney failure. In a conflicting article published in the American Journal of Medical Science in 1990, authors believe ibuprofen itself is not an independent predictor of risk of kidney damage; however, when taken by patients 65 years or older or who have coronary artery disease, the risk factor increases.

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