Approach to Headache

EFNS guideline on the drug treatment of migraineSubstanceDoseLevelCommentAcetylsalicylic acid (ASA)1000 mg (oral)1000 mg (intravenous [i.v.])AAGastrointestinal side effects, risk ofbleedingIbuprofen200 – 800 mgASide effects as for ASANaproxen500 – 1000 mgASide effects as for ASADiclofenac50 – 100 mgAIncluding diclofenac-KParacetamol1000 mg (oral)1000 mg (suppository)AACaution in liver and kidney failureASA plus, paracetamol plusand caffeine250 mg (oral),200 – 250 mg and 50 mgAAs for ASA and paracetamolMetamizol1000 mg (oral)1000 mg (i.v.)BBRisk of agranulocytosisRisk of hypotensionPhenazon1000 mg (oral)BSee paracetamolTolfenamic acid200 mg (oral)BSide effects as for ASARating of RecommendationsLevel A rating (established as effective, ineffective, or harmful) requires at least one convincing class I study or at leasttwo consistent, convincing class II studies. Level B rating (probably effective, ineffective, or harmful) requires at least oneconvincing class II study or overwhelming class III evidence. Level C rating (possibly effective, ineffective, or harmful)requires at least two convincing class III studies.