Aspirin

In this section
Does it work?
What is it?
How can it help?
Why should it work?
Can it be harmful?
What's the evidence?

You can take aspirin on its own or combined with paracetamol and caffeine. You can also take aspirin with drugs that stop you feeling sick (anti-emetics).

Does it work?

Yes. There is good evidence that your headache will feel better if you take aspirin alone or combined with an anti-emetic. (You can get aspirin with an anti-emetic only on prescription from your doctor).

Effervescent aspirin (the type you dissolve in water and then drink) taken alone or combined with the anti-emetic metoclopramide will also make you feel better. Taking aspirin in this way may work faster than taking tablets because, as your migraine attack starts, your stomach and gut slow down. When this happens, it takes longer for tablets to be digested and get into your system.

What is it?

Aspirin is a popular painkiller. It is a type of nonsteroidal anti-inflammatory drug (NSAID).

• The brand name for aspirin combined with paracetamol and caffeine is Anadin Extra.
• The brand name for aspirin combined with a drug to stop you feeling sick is Migramax.

How can it help?

Aspirin can make your headache better, whether you take it on its own or combined with paracetamol or caffeine.^{1 2 3 4}

• Aspirin can make mild and moderate migraine attacks better, but it needs to be taken early on.
• Aspirin can also reduce the pain of a more severe headache but may not get rid of it.
• Aspirin, paracetamol and caffeine taken together may help other symptoms, such as being extra-sensitive to light or noise.⁵
• Aspirin works whichever way you take it. You can take it as tablets that you swallow with water and as tablets that dissolve in water or that dissolve in your mouth.^{6 7 8}
• One study found aspirin worked as well as a prescription drug called sumatriptan.⁹
• Another study found aspirin works as well as paracetamol combined with codeine.¹⁰

Why should it work?

No one knows exactly how aspirin works to relieve migraine attacks. But we do know that aspirin stops your body making chemicals called prostaglandins. Your body makes these chemicals when you are in pain or injured. They cause inflammation and make you more sensitive to pain.

By stopping the prostaglandins, aspirin may reduce the inflammation that causes migraines. Aspirin may also tell your brain to stop feeling so much pain.¹

Caffeine, metoclopramide and paracetamol can work with aspirin to help relieve the symptoms of migraine.

• Caffeine causes blood vessels in your brain to narrow, and it may make aspirin work better as well.
• Metoclopramide makes you feel less sick.
• Paracetamol can help ease your pain.

Can it be harmful?

Stomach problems

The main drawback of aspirin and other NSAIDs is that they can irritate the lining of your stomach. This can sometimes cause bleeding in the stomach, and stomach ulcers, especially if you are elderly. This is a serious problem that can be life-threatening.¹¹

• One study we looked at found that 3 in 100 people had serious side effects. But 2 in 100 people who took a dummy treatment (a placebo) also had these side effects. So we can't be sure that aspirin actually caused the side effects.³
• A study of people taking a combination of aspirin, paracetamol and caffeine found that patients had no serious side effects.⁵

You need to be sure not to take more than the recommended dose. Higher doses are more likely to cause side effects. Check with your doctor or pharmacist how many tablets you can take every day. Doctors are advised to use the lowest dose that will control your pain. And you shouldn't take more than one NSAID at a time.¹²

Your doctor may prescribe another drug to protect your stomach, if you have a high risk of getting stomach ulcers.¹¹ There are several types of protective drugs. Their names are:

• Proton pump inhibitors, such as omeprazole (Losec) and esomeprazole (Nexium)
• Misoprostol (Cytotec)
• H2 blockers, such as cimetidine (Dyspamet) and ranitidine (Zantac).

Some people shouldn't take NSAIDs at all. If you've had a stomach ulcer before, or if you have one now, you shouldn't take NSAIDs.¹² Talk to your doctor to find out what painkillers are safe for you.

Other side effects

Between 1 in 10 and 2 in 10 people who take aspirin with or without other medicines may get mild side effects. But aspirin has been used by millions of people for many years, and serious problems are rare.⁵

The most common side effects are:

• Sleepiness or drowsiness
• Pain in the abdomen
• Nausea or vomiting
• Tiredness
• Headache.

What's the evidence?

What's the evidence for aspirin?