CMAJ - May 1, 1997 / Table 1: Guidelines for the diagnosis and management of migraine in clinical practice

Guidelines for the diagnosis and management of migraine in clinical practice

Table 1: Medications recommended for mild migraine attacks[22-36]

Medication Dosage* Main side effect Level of evidence

Acetylsalicylic acid (ASA),
  buffered or soluble tablet
  (not enteric coated) 650-1300 mg q4h × 2 GI§ upset I

Ibuprofen 400-800 mg q6h × 2 GI upset I

Naproxen sodium 275-550 mg PO q2-6h GI upset I

Acetaminophen† 650-1300 mg q4h × 2 III

Adjunctive medication
  Dimenhydrinate†
  Domperidone†
  Metoclopramide†‡
50-100 mg PO as needed
10-20 mg PO
10 mg PO or IV
Drowsiness
III
III
III

*PO = orally, IV = intravenously.
†Evidence for the drug's effectiveness is considered to be less convincing than that for ASA and ibuprofen.
‡In mild attacks with pronounced nausea, metoclopramide alone may relieve both the pain and the nausea.
§GI = gastrointestinal.

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| CMAJ May 1, 1997 (vol 156, no 9) / JAMC le 1er mai 1997 (vol 156, no 9) |

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Table 1: Medications recommended for mild migraine attacks[22-36]
Medication	Dosage*	Main side effect	Level of evidence
Acetylsalicylic acid (ASA), buffered or soluble tablet (not enteric coated)	650-1300 mg q4h × 2	GI§ upset	I
Ibuprofen	400-800 mg q6h × 2	GI upset	I
Naproxen sodium	275-550 mg PO q2-6h	GI upset	I
Acetaminophen†	650-1300 mg q4h × 2		III
Adjunctive medication Dimenhydrinate† Domperidone† Metoclopramide†‡	50-100 mg PO as needed 10-20 mg PO 10 mg PO or IV	Drowsiness	III III III
*PO = orally, IV = intravenously. †Evidence for the drug's effectiveness is considered to be less convincing than that for ASA and ibuprofen. ‡In mild attacks with pronounced nausea, metoclopramide alone may relieve both the pain and the nausea. §GI = gastrointestinal.