A single oral dose of 1000 mg of aspirin is effective in relieving migraine headache pain and associated symptoms (nausea, vomiting, photophobia, phonophobia). Pain will be reduced from moderate or severe to no pain by 2 hours in approximately 1 in 4 people (24%) taking aspirin, compared with about 1 in 10 (11%) taking placebo. Pain will be reduced from moderate or severe to no worse than mild pain by 2 hours in roughly 1 in 2 people (52%) taking aspirin compared with approximately 1 in 3 (32%) taking placebo. Of those who experience effective headache relief at 2 hours, more have that relief sustained over 24 hours with aspirin than with placebo. Addition of 10 mg of the antiemetic metoclopramide substantially increases relief of nausea and vomiting compared with aspirin alone, but makes little difference to pain.
Oral sumatriptan 100 mg is better than aspirin plus metoclopramide for pain-free response at 2 hours, but otherwise there are no major differences between aspirin with or without metoclopramide and sumatriptan 50 mg or 100 mg. Adverse events with short-term use are mostly mild and transient, occurring slightly more often with aspirin than placebo, and more often with sumatriptan 100 mg than with aspirin.