A Cochrane review [Abstract] 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.
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