Cochrane for Clinicians
Putting Evidence into Practice
Aspirin With or Without an Antiemetic for Acute Migraine Headaches in Adults
FREE PREVIEW Log in or buy this issue to read the full article. AAFP members and paid subscribers get free access to all articles. Subscribe now.
FREE PREVIEW Subscribe or buy this issue. AAFP members and paid subscribers get free access to all articles.
Am Fam Physician. 2014 Feb 1;89(3):176-177.
This clinical content conforms to AAFP criteria for continuing medical education (CME). See CME Quiz Questions.
Author disclosure: No relevant financial affiliations.
Is aspirin, with or without an antiemetic, an effective therapy for acute migraine headache in adults?
Aspirin, with or without an antiemetic, is an effective treatment for acute migraine headache. Adding the antiemetic metoclopramide (Reglan) significantly reduces migraine-related nausea and vomiting compared with aspirin alone. (Strength of Recommendation: A, based on consistent, good-quality patient-oriented evidence.)
Migraines are an exceedingly common and disabling affliction; 16.6% of U.S. adults report having migraines or severe headaches.1 Direct costs average $1,533 per person annually,2 whereas indirect costs are an estimated $12 billion each year.3 Most persons who have migraines do not take preventive medications, but nearly all treat acute attacks. Commonly used treatments include triptans, nonsteroidal anti-inflammatory drugs, acetaminophen, and caffeine. Aspirin and metoclopramide are inexp
The views expressed in this article are those of the authors and do not reflect the official policy or position of the U.S. government, Department of the Army, or Department of Defense.
The practice recommendations in this activity are available at http://summaries.cochrane.org/CD008041.
Kirthi V, Derry S, Moore RA. Aspirin with or without an antiemetic for acute migraine headaches in adults. Cochrane Database Syst Rev. 2013;(4):CD008041.
1. Schiller JS, Lucas JW, Ward BW, Peregoy JA. Summary health statistics for U.S. adults: National Health Interview Survey, 2010. Vital Health Stat. 10. 2012;(252):1–207.
2. Stokes M, Becker WJ, Lipton RB, et al. Cost of health care among patients with chronic and episodic migraine in Canada and the USA: results from the International Burden of Migraine Study (IBMS). Headache. 2011;51(7):1058–1077.
3. Hawkins K, Wang S, Rupnow MF. Indirect cost burden of migraine in the United States. J Occup Environ Med. 2007;49(4):368–374.
4. Colman I, Brown MD, Innes GD, Grafstein E, Roberts TE, Rowe BH. Parenteral metoclopramide for acute migraine: meta-analysis of randomised controlled trials. BMJ. 2004;329(7479):1369–1373.
5. Headaches: diagnosis and management of headaches in young people and adults. NICE clinical guideline 150. London, United Kingdom: National Institute for Health and Care Excellence (NICE); 2012. http://www.nice.org.uk/CG150. Accessed August 4, 2013.
6. Beithon J, Gallenberg M, Johnson K, et al. Institute for Clinical Systems Improvement. Diagnosis and treatment of headache. 2013. https://www.icsi.org/_asset/qwrznq/Headache.pdf. Accessed August 4, 2013.
These are summaries of reviews from the Cochrane Library.
The series coordinator for AFP is Corey D. Fogleman, MD, Lancaster General Hospital Family Medicine Residency, Lancaster, Pa.
A collection of Cochrane for Clinicians published in AFP is available at http://www.aafp.org/afp/cochrane.
Copyright © 2014 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact firstname.lastname@example.org for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions