Migraines are debilitating headaches, usually affecting one side of the head with throbbing or pulsating pain. Some people get a warning in the form of a “prodrome” of symptoms that may occur a few days before the headache itself strikes. Approximately 20 to 30 percent of migraine sufferers notice an aura shortly before the pain begins. This is a sensory disturbance; it could be sounds, smells or sensations, but visual auras are more frequent. People may have bright flashes, zig-zags or other distortions in their vision. If a person prone to migraines can use migraine medicine during the short time that an aura is present, they may be able to prevent the pain. That is what some readers report.
Taking Aspirin During an Aura Wards Off the Migraine:
Q. I use Bayer aspirin for my migraines and have since I was 20. I am now 76. At first, I had one a year, then more often, and now I get two a month.
At the first sight of flickering in my vision (aura), I take aspirin and get in the dark or put on dark sunglasses. In 15 minutes, the aura is gone. If I don’t get to it in time, I have a migraine headache all day. For me, simple aspirin seems like a miracle.
A. Thanks for sharing your story. As many as one third of people with migraine headaches experience an aura before the headache begins. This may appear as sparks of light, wavering lines, blind spots or other changes in vision.
Taking aspirin at the first sign of visual changes can sometimes keep the headache from developing Revue Neurologique, Sept. 2021(). The FDA has even approved the combination of aspirin (250 mg), acetaminophen (250 mg) and caffeine (65 mg) for migraine relief. This is the formula found in Excedrin.
Not everyone who suffers from migraines gets the kind of relief that you describe from aspirin. There are now many new migraine medicines to prevent or treat the pain. You can learn more about them in our eGuide to Headaches & Migraines.
Early Aspirin Treatment Works Best:
Q. I’ve had migraines, maybe a couple of them a year, for many years. When I first see the aura, I’ve found that taking an aspirin within minutes of the beginning of the aura does the trick for me. It halts the migraine entirely. I don’t know if this would work for anyone else, but it’s been a lifesaver for me.
A. Medical guidelines suggest that aspirin or another NSAID is effective for mild to moderate migraine attacks (Acta Neurologica Taiwanica, June 15, 2017). Acetaminophen (Tylenol) in combination with an NSAID such as diclofenac, ibuprofen or naproxen can also stop an attack (Continuum, Aug. 2015).
Aspirin and Coffee At the First Sign of Headache Pain (Aura):
This reader shares her mother’s strategy when pain rears its ugly head:
Q. When my mother suffered bad headaches many years ago, she always took two aspirins and a cup of coffee. What is it about that combination that works so well?
A. The caffeine in the coffee works synergistically with aspirin to improve pain relief. Headache specialists consider a combination of acetaminophen (Tylenol) with aspirin and caffeine to be helpful for episodic tension-type headache as well as migraines (StatPearls, Jan. 2021).
Acetaminophen, Aspirin & Caffeine:
The makers of Excedrin Migraine have capitalized on the combination of acetaminophen, aspirin and caffeine. The dose of Excedrin Migraine and Excedrin Extra Strength is 500 mg of acetaminophen, 500 mg of aspirin and 130 mg of caffeine.
According to the FDA, an 8 oz cup of coffee contains about 80 to 100 mg of caffeine. If someone makes strong brewed coffee, though, an 8 oz cup could have as much 160 mg. Bottom line, the dose of caffeine in a standard Excedrin dose is pretty close to the amount you would get in a full cup of brewed coffee.
Caffeine plus Aspirin plus Acetaminophen Vs. Nasty Pain:
A randomized controlled trial demonstrated that this combination is better than placebo for treating migraines (Cephalalgia, Nov. 2014). This combination is cost-effective, and the relief sets in more quickly than it does with ibuprofen (Headache, March 2006).
People who suffer migraines tell us that utilizing the treatment at the first hint of an aura increases the chance of success. Instead of medication, some people use cold ice cream, a milkshake or iced coffee. These too work best if taken when the aura is first apparent.
You can read more about averting migraine pain in our Guide to Headaches and Migraines. You may also wish to listen to some of our radio interviews on this topic, including Show 1133: How Can You Overcome Migraine Headaches? with Dr. Jennifer Kriegler of the Cleveland Clinic; and Show 1294: New Treatments for Migraine Headaches with Paula Dumas and Dr. Deborah Friedman.