IBUPROFEN
PLACE IN THERAPY
Ibuprofen is considered to be a mainstay in the treatment of acute tension-type headache. Ibuprofen 800mg, 400mg, and 200mg have demonstrated clinically significant beneficial effects in multiple trials. Four studies reported ibuprofen to be significantly more effective than placebo1-4, whilst two trials displayed a significant difference in short-term pain relief in favour of ibuprofen over acetaminophen1,3. Several trials have also displayed no difference between ibuprofen and other non-steroidal anti-inflammatory medications6,7. Multiple guidelines have also listed ibuprofen as initial choice of therapy rather than acetaminophen alone5,6. This conclusion is supported by a systematic review which concluded that due to ibuprofen’s generally favourable side effect profile, it is a reasonable first choice in acute tension-type headache treatment.7
Multiple trials have also evaluated the safety profile of ibuprofen. According to the EFNS Guidelines, ibuprofen seems to have the most favourable side effect profile amongst the non-steroidal anti-inflammatory drugs (NSAIDs).6 This was supported by a systematic review which found ibuprofen to have the lowest relative risk of serious gastrointestinal complications when compared to other NSAIDs.7 Despite this favourable side-effect profile,patients must be educated on measures that must be employed in order to reduce possible side effects associated with ibuprofen use.
References
1. Schachtel BP, Furey SA, Thoden WR. Nonprescription Ibuprofen and Acetaminophen in the Treatment of Tension-Type Headache. J Clin Pharmacol. 1996;36:1120-25
2. Van Gerven JMA et al. Self-medication of a single headache episode with ketoprofen, ibuprofen or placebo, home-monitored with an electronic patient diary. Br J Clin Pharmacol. 1996;42:475-481
3. Packman B et al. Solubilized Ibuprofen: Evaluation of Onset, Relief, and Safety of a Novel Formulation in the Treatment of Episodic Tension-type Headache. Headache. 2000;40(7):561-7
4.Nebe J, Heier M, Diener, HC. Low-dose ibuprofen in self-medication of mild to moderate headache: a comparison with acetylsalicylic acid and placebo. Cephalalgia. 1995;15(6):531-5
5. MacGregor EA, Steiner TJ, Davies PTG. Guidelines for All Healthcare Professionals in the Diagnosis and Management of Migraine, Tension-Type, Cluster and Medication-Overuse Headache. British Association for the Study of Headache. 2010;3(1):1-53
6. Bendsten L et al. EFNS Guideline on the Treatment of Tension-Type Headache. Europe an Journal of Neurology 2010, 17: 1318–13 25
7. Verhagen AP et al. Is Any One Analgesic Superior for Episodic Tension-type Headache? J Fam Pract. 2006;55(12):1064-72.
Multiple trials have also evaluated the safety profile of ibuprofen. According to the EFNS Guidelines, ibuprofen seems to have the most favourable side effect profile amongst the non-steroidal anti-inflammatory drugs (NSAIDs).6 This was supported by a systematic review which found ibuprofen to have the lowest relative risk of serious gastrointestinal complications when compared to other NSAIDs.7 Despite this favourable side-effect profile,patients must be educated on measures that must be employed in order to reduce possible side effects associated with ibuprofen use.
References
1. Schachtel BP, Furey SA, Thoden WR. Nonprescription Ibuprofen and Acetaminophen in the Treatment of Tension-Type Headache. J Clin Pharmacol. 1996;36:1120-25
2. Van Gerven JMA et al. Self-medication of a single headache episode with ketoprofen, ibuprofen or placebo, home-monitored with an electronic patient diary. Br J Clin Pharmacol. 1996;42:475-481
3. Packman B et al. Solubilized Ibuprofen: Evaluation of Onset, Relief, and Safety of a Novel Formulation in the Treatment of Episodic Tension-type Headache. Headache. 2000;40(7):561-7
4.Nebe J, Heier M, Diener, HC. Low-dose ibuprofen in self-medication of mild to moderate headache: a comparison with acetylsalicylic acid and placebo. Cephalalgia. 1995;15(6):531-5
5. MacGregor EA, Steiner TJ, Davies PTG. Guidelines for All Healthcare Professionals in the Diagnosis and Management of Migraine, Tension-Type, Cluster and Medication-Overuse Headache. British Association for the Study of Headache. 2010;3(1):1-53
6. Bendsten L et al. EFNS Guideline on the Treatment of Tension-Type Headache. Europe an Journal of Neurology 2010, 17: 1318–13 25
7. Verhagen AP et al. Is Any One Analgesic Superior for Episodic Tension-type Headache? J Fam Pract. 2006;55(12):1064-72.