100 Migraine Drugs, A to Z: flurbiprofen

Flurbiprofen is just another nonsteroidal antiinflammatory drug (NSAID), which is reflected in the name of its branded version – Ansaid. All NSAIDs can relieve acute pain of migraine and some have been proven to prevent attacks if taken on a daily basis. Aspirin, ibuprofen, ketoprofen and naproxen are some of the NSAIDs that have been shown to prevent migraines.

Flurbiprofen is not one of the more popular NSAID drugs, however it was tested for the prevention of migraines in a double-blind placebo-controlled crossover trial. The trial involved 23 patients who were given first placebo or 100 mg of flurbiprofen twice a day for 8 weeks and after a 2-week “washout” period switched (crossed over) from placebo to flurbiprofen and from flurbiprofen to placebo. Flurbiprofen significantly reduced migraine intensity, total hours with migraine, and the dosing frequency of relief (abortive) medications. Total hours with migraine decreased by 41%, and the use of abortive medications decreased by 31%.

Even though this trial involved a small number of patients, very similar mechanism of action to other NSAIDs suggests that flurbiprofen, like other NSAIDs, is an effective preventive agent. However, the reason they are not widely used for this purpose is their safety. They all can cause stomach upset and peptic ulcers, which can bleed and even cause death. They can also cause kidney damage and in those predisposed to heart disease, increase the risk of heart attacks (except for aspirin). On the other hand, millions of arthritis sufferers take these drugs for years with good effect. Because the majority of migraine sufferers are young healthy people, NSAIDs should be used more widely, especially considering that serious side effects can also occur from other preventive drugs such as topiramate (Topamax), divalproex sodium (Depakote), antidepressants, and other.

My pet peeve is the mistaken notion that triptans and NSAIDs is a frequent cause of medication overuse headaches and the fact that NSAIDs taken daily prevent rather than worsen migraines helps refute this myth.