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Table 7 Recommended drugs and doses for acute migraine therapy, step one

From: Aids to management of headache disorders in primary care (2nd edition)

Analgesics Antiemetics
 Non-steroidal anti-inflammatory drugs:
  • Acetylsalicylic acid 900–1000 mg or
  • Ibuprofen 400–800 mg or
  • Diclofenac 50–100 mg
• Domperidone 10 mg (supportive evidence of efficacy is for 20 mg, but the European Medicines Agency recommends restriction to 10 mg orally [up to three times daily] or 30 mg by suppository [up to twice daily]), or
• Metoclopramide 10 mg (the European Medicines Agency restricts dosing to 10 mg [up to three times daily])
Or (where these are contraindicated):
  • Paracetamol 1000 mga
Or (possibly benefiting from the different mechanisms of action):
  • Combinations of paracetamol with acetylsalicylic acid or ibuprofen
Children (when needed)
 Ibuprofen 200–400 mg according to age and weight • Domperidone (dosage according to age and weight)
  1. aParacetamol on its own has lower efficacy and is not first-line treatment