Global Practical Recommendations of the International Headache Society on Acute Pharmacological Treatment of Migraine 2024: NSAIDs Remain First-Line Treatment

Migraine is a common disorder that significantly impacts quality of life and requires thorough diagnosis and effective treatment. According to ICHD-3 criteria, migraine is classified into two main types: with aura and without aura. Diagnosis depends on patient history and exclusion of other causes of headache. Nonsteroidal anti-inflammatory drugs (NSAIDs) remain first-line treatments for mild and moderate migraine attacks. Dexketoprofen, due to its rapid absorption and prolonged effect, is one of the most effective NSAIDs. It inhibits prostaglandin synthesis, quickly reducing pain and inflammation. The drug begins to act after 15–30 minutes, providing an effect from 4–6 to 8 hours, depending on the route of administration and form of release. Clinical studies have confirmed its efficacy for various types of pain, including migraine. Combining dexketoprofen with triptans or antiemetics enhances its therapeutic effects. Studies showed that dexketoprofen provided faster symptom relief compared to ibuprofen and metoclopramide. In emergency settings, it significantly reduced the need for additional medications. The combination of dexketoprofen with frovatriptan is particularly effective for menstrual-associated migraine, with pain relief noted within 2 hours and lasted up to 48 hours. Thus, due to its rapid onset of action and high efficacy, dexketoprofen remains an important component of the treatment of acute pain in migraine attacks.