- 25 Oct Aspirin and Migraine
- Migraine headaches? Consider aspirin for treatment and prevention
- Short circuit migraines before they start
- Oral aspirin for treatment of acute episodic tension-type headache in adults
- Will a High Dose of Aspirin Relieve Your Migraine?
- Aspirin Effective in Treating Acute Migraine, Preventing Recurrent Migraine, Review Finds
- Should you use aspirin for a migraine?
- Aspirin with or without an antiemetic for acute migraine headaches in adults
- Uses, benefits, and risks of aspirin
- Bigger Isn’t Better
- Aspirin / Caffeine Dosage
- Usual Adult Dose for Fever
- Renal Dose Adjustments
- Liver Dose Adjustments
- Dose Adjustments
- Other Comments
- Further information
- More about aspirin / caffeine
25 Oct Aspirin and Migraine
Posted at 22:50h in Headache Fact Sheets by headache
For nearly a century, aspirin has been used to treat migraine and other headaches. It has several actions that make it useful for treating migraine. First, it is an analgesic or pain reliever. Secondly, it blocks or reduces inflammation. This action is controlled in the body in part by a series of chemicals called prostaglandin. Aspirin blocks the ability of the body to manufacture these compounds. Thirdly, it reduces the ability of platelets to aggregate or stick together. The aggregation of platelets is important as it serves as the first step in the body’s ability to stop bleeding. It also plays a role in migraine attacks and other processes. In migraine, platelets aggregate, causing them to release serotonin into the blood stream, which eventually leads to the vascular actions and other effects of migraine.
In migraine preventive therapy, aspirin has been tried several times with some benefit. Previous studies used large amounts of aspirin in order to reduce the frequency of migraine attacks. Several years ago, a study was conducted among physicians to determine if low doses of aspirin would help reduce heart attacks. An additional finding of this study was a 10% reduction in the frequency of migraine attacks among male physicians taking low-dose aspirin.
Your doctor may recommend daily aspirin to reduce your risk of heart attack or stroke. These daily doses of aspirin vary from 81 mg (baby aspirin) to 325 mg. Buffered or coated aspirin may reduce stomach irritation but the risk of bleeding in the stomach or brain does exist. Only use daily aspirin under a doctor’s care.
Migraine headaches? Consider aspirin for treatment and prevention
There are effective prescription medications available to treat acute migraine headaches as well as to prevent recurrent attacks. Nonetheless, in the United States many patients are not adequately treated for reasons that include limited access to health care providers and lack of health insurance or high co-pays, which make expensive medications of proven benefit unaffordable. The rates of uninsured or underinsured individuals have been estimated to be 8.5 percent nationwide and 13 percent in Florida. Furthermore, for all patients, the prescription drugs may be poorly tolerated or contraindicated.
Researchers from Florida Atlantic University’s Schmidt College of Medicine have proposed aspirin as a possible option for consideration by primary care providers who treat the majority of patients with migraine. Their review includes evidence from 13 randomized trials of the treatment of migraine in 4,222 patients and tens of thousands of patients in prevention of recurrent attacks.
Their findings, published in the American Journal of Medicine, suggest that high-dose aspirin, in doses from 900 to 1,300 milligrams given at the onset of symptoms, is an effective and safe treatment option for acute migraine headaches. In addition, some but not all randomized trials suggest the possibility that daily aspirin in doses from 81 to 325 milligrams may be an effective and safe treatment option for the prevention of recurrent migraine headaches.
“Our review supports the use of high dose aspirin to treat acute migraine as well as low dose daily aspirin to prevent recurrent attacks,” said Charles H. Hennekens, M.D., Dr.PH, corresponding author, first Sir Richard Doll Professor and senior academic advisor in FAU’s Schmidt College of Medicine. “Moreover, the relatively favorable side effect profile of aspirin and extremely low costs compared with other prescription drug therapies may provide additional clinical options for primary health care providers treating acute as well as recurrent migraine headaches.”
Common symptoms of migraine include a headache that often begins as a dull pain and then grows into a throbbing pain, which can be incapacitating and often occurs with nausea and vomiting, and sensitivity to sound, light and smell. Migraines can last anywhere from four to 72 hours and may occur as many times as several times a week to only once a year.
“Migraine headaches are among the most common and potentially debilitating disorders encountered by primary health care providers,” said Bianca Biglione, first author and a second-year medical student in FAU’s Schmidt College of Medicine. “In fact, about 1 in 10 primary care patients present with headache and three out of four are migraines. Aspirin is readily available without a prescription, is inexpensive, and based on our review, was shown to be effective in many migraine patients when compared with alternative more expensive therapies.”
Approximately 36 million Americans suffer from migraine headaches and the cause of this disabling disorder is not well understood. There is a higher prevalence in women (18 percent) than men (9 percent). In women, the prevalence is highest during childbearing age.
Approximately 90 percent of migraine sufferers report moderate to severe pain, with more than 50 percent reporting severe impairment or the need for bed rest as well as reduced work or school productivity.
Short circuit migraines before they start
Author and migraine sufferer Joan Didion once wrote, “That no one dies of migraine seems, to someone deep into an attack, an ambiguous blessing.” At that time, migraines weren’t something that could be prevented. Today, that’s a possibility for some people who have severe migraines, frequent migraines (more than three or four times a month), or migraines that don’t respond well to treatment.
The cornerstone of migraine prevention is managing triggers like stress or certain foods or strong perfumes. Alternative and complementary therapies (like acupuncture) help some migraine sufferers keep headaches at bay.
In some cases, taking medication even when you aren’t having a migraine attack can help. This usually involves taking the medication every day, with the goal of gradually tapering the dose, and, ideally, eventually discontinuing it altogether. Here are some of the medications commonly used to prevent migraine. Because they have different effects, and potential side effects, it’s important to work with your doctor to find the one that’s right for you.
Commonly prescribed for high blood pressure, abnormal heart rhythms, and heart-related chest pain, beta blockers may prevent migraines by not allowing blood vessels to expand too much (and put pressure on nerves). There are many beta blockers available, and it may take a while to find the one that works best for you.
These medications are sometimes used to help manage pain, including headache. Amitriptyline (Elavil, Endep) is the best studied for pain relief and the most often prescribed for migraine prevention: it’s about 60% effective in thwarting such headaches.
Calcium-channel blockers are also used primarily for treatment of high blood pressure and heart-related conditions, but help some people prevent migraine.
Topiramate (Topamax) and divalproex (Depakote) are anti-seizure drugs that are also specifically approved for migraine prevention. Gabapentin (Neurontin) is another that, while not specifically approved to prevent migraines, does work well for some people.
Although low-dose aspirin is far less effective than the standard migraine headache preventive medications, it may improve migraine control when used in combination with another preventive medication. It is important to check with your doctor before starting to take aspirin daily.
For more information on preventing, diagnosing and treating migraine and other types of headache, buy Headaches: Relieving and Preventing Migraine and Other Headaches, a Special Health Report from Harvard Medical School.
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
Oral aspirin for treatment of acute episodic tension-type headache in adults
We included five studies enrolling adults with frequent episodic TTH; 1812 participants took medication, of which 767 were included in comparisons of aspirin 1000 mg with placebo, and 405 in comparisons of aspirin 500 mg or 650 mg with placebo. Not all of these participants provided data for outcomes of interest in this review. Four studies specified using IHS diagnostic criteria; one predated commonly recognised criteria, but described comparable characteristics and excluded migraine. All participants treated headaches of at least moderate pain intensity.
None of the included studies were at low risk of bias across all domains considered, although for most studies and domains this was likely to be due to inadequate reporting rather than poor methods. We judged one study to be at high risk of bias due to small size.
There were no data for aspirin at any dose for the IHS preferred outcome of being pain free at two hours, or for being pain free at any other time, and only one study provided data equivalent to having no or mild pain at two hours (very low quality evidence). Use of rescue medication was lower with aspirin 1000 mg than with placebo (2 studies, 397 participants); 14% of participants used rescue medication with aspirin 1000 mg compared with 31% with placebo (NNTp 6.0, 95% confidence interval (CI) 4.1 to 12) (low quality evidence). Two studies (397 participants) reported a Patient Global Evaluation at the end of the study; we combined the top two categories for both studies to determine the number of participants who were ‘satisfied’ with treatment. Aspirin 1000 mg produced more satisfied participants (55%) than did placebo (37%) (NNT 5.7, 95% CI 3.7 to 12) (very low quality evidence).
The quality of the evidence using GRADE comparing aspirin doses between 500 mg and 1000 mg with placebo was low or very low. Evidence was downgraded because of the small number of studies and events, and because the most important measures of efficacy were not reported.
There were insufficient data to compare aspirin with any active comparator (paracetamol alone, paracetamol plus codeine, peppermint oil, or metamizole) at any of the doses tested.
Will a High Dose of Aspirin Relieve Your Migraine?
Taking three regular-strength, 325-milligram aspirin is a good migraine treatment for many people, according to a recent review of 13 studies involving 4,222 patients.
“Patients who suffer from migraine headache pain have known for a long time that taking a few aspirins, sometimes combined with a little caffeine from a cola or a coffee, is a cheap and effective migraine treatment,” says Kinan Hreib, MD, a neurologist and director of stroke services at the Lahey Clinic in Burlington, Mass.
The findings come from an extensive review comparing the effectiveness of aspirin to either a placebo or a prescription-strength drug for the relief of migraine headache pain. Researchers were aware that many people with migraine headaches rely on over-the-counter (OTC) medications for their migraine treatment.
The research review also showed:
- Using this high dosage, 52 percent of aspirin users got significant headache pain relief within two hours, compared to 32 percent who were given a placebo.
- Aspirin also reduced other migraine symptoms like nausea and sensitivity to noise and light.
- Combining high-dose aspirin with the anti-nausea drug metoclopramide (Reglan) was better for reducing nausea than aspirin alone.
What isn’t fully understood is why aspirin works on migraine pain as well as on atypical migraine symptoms like visual disturbances. “It may be due to aspirin’s ability to regulate the brain chemical serotonin or to the anti-inflammatory properties of aspirin,” says Dr. Hreib.
Who Should Take Aspirin for Migraine?
Hreib said he would recommend aspirin as a migraine treatment for anyone with mild to moderate migraine symptoms who has attacks about one to three times per month. Hreib cautions that aspirin doesn’t work for everyone, and patients with severe or more frequent headache pain may need stronger medication.
A common side effect of aspirin is stomach irritation; others include increased tendency for bleeding and ringing in the ears (tinnitus). These side effects might come into play if large and frequent doses of aspirin are used to treat migraine. Here are some cases in which taking aspirin is not recommended:
- Stomach ulcer disease or gastric bleeding
- Blood clotting problems
- A history of aspirin-induced asthma
- Existing ringing in the ears
- As a children’s migraine treatment
Do the Benefits Outweigh the Risks?
“For most people, the benefits of aspirin for migraine treatment outweigh the risks,” notes Hreib. Patients in these studies took a single dose of aspirin in the range of 900 to 1000 milligrams, which is equal to three adult-strength aspirins, a safe dose for most people. “Aspirin is also easily available and very cheap compared to prescription migraine treatments,” he adds.
Hreib also points out that people with migraines should pay attention to migraine triggers, and that prevention is sometimes the best treatment. Common migraine triggers include:
- Getting overly tired
- Missing meals
- Changes in sleep patterns
- Consuming certain food and drink like red wine, aged cheese, chocolate, soy sauce, and processed meats
Hreib says migraine headaches are more common than people realize. “We now know that most ‘sinus headaches’ are probably migraines. If you have migraine headaches, an OTC medication like aspirin may be adequate treatment,” says Hreib. But before deciding on any migraine treatment, talk to your doctor about what treatment is best for you.
Aspirin Effective in Treating Acute Migraine, Preventing Recurrent Migraine, Review Finds
Aspirin, in high doses from 900 to 1300 mg, was shown to be an effective and safe treatment option for acute migraine headaches, with further research showing its potential efficacy in preventing recurrent migraine headaches through lower doses of 81 to 325 mg, according to a November review published in The American Journal of Medicine.1
As the authors note, treatment for acute migraine as well as prevention of recurrent attacks can be achieved using effective prescription drugs of shown benefit, but for those with high co-pays or without health insurance, these medications may not be available or affordable. Nationwide, rates of uninsured or underinsured individuals are estimated to be 8.5%, with a stark 13% prevalence in Florida.
Researchers from Florida Atlantic University’s Schmidt College of Medicine sought to address issues regarding affordability and access by examining the efficacy of low-cost aspirin as an effective and preventive treatment of acute migraine. Assessments conducted in the review included a meta-analysis of 13 randomized trials for the treatment of migraine in 4222 patients given either 900 to 1000 mg of aspirin, with and without 10 mg of metoclopramide, or 50 to 100 mg of sumatriptan. The review additionally included studies totaling more than 40,000 patients for prevention of recurrent attacks.
High-Dose Aspirin for Treatment at Onset of Acute Migraine
In the meta-analysis, the prespecified primary end point was distinguished as reduction in headache pain or complete remission of pain at 1 hour, 2 hours, and sustained reduction/remission over 24 hours.
Study results revealed that there were no significant differences between the 2 treatments between high-dose aspirin and either 50 mg or 100 mg of sumatriptan. For the primary end point, high-dose aspirin significantly reduced headache at 1 hour by 60% (95% CI, 1.3-2.0) when compared with 50 mg of sumatriptan. While 100 mg of sumatriptan produced a definite 37% reduction (95% CI, 0.45-0.87) when compared with high-dose aspirin and metoclopramide after 2 hours, the effectiveness of high-dose aspirin at initial onset of migraine stresses its efficacy as a low-cost treatment.
Low-Dose Aspirin for Preventive Treatment of Recurrent Migraines
In testing efficacy of low-dose aspirin as a preventive treatment, the researchers referenced multiple studies examining its impact on recurrent migraines. In a trial among British doctors cited in the review, 5139 men were randomized to 500 mg daily aspirin in an open design, with a significant 29% reduction in recurrent migraines exhibited at the end of the trial.
Additionally, the United States Physicians’ Health Study randomized 22,071 male physicians to either 325 mg aspirin on alternate days or matching placebo, and after 60.2 months of treatment and follow-up, the trial was terminated early based on the unanimous recommendation of the Data and Safety Monitoring Board. The recommendation was attributed to the statistically significant 44% reduction in first myocardial infarction among those assigned randomly to aspirin, and among this group, a 22% reduction in subsequent attacks of migraine at baseline was shown.
In an editorial on the review,2 Joseph Alpert, MD, editor-in-chief of The American Journal of Medicine, highlighted that “since aspirin is readily available without a prescription in the US, it certainly seems like something that should be tried in migraine sufferers before physicians prescribe more complex, expensive, and hence less available medications.” As only 20% of people with migraine are shown to see a physician for their condition, and less than 10% receive effective therapy, the potential of aspirin as an over-the-counter, low-cost therapy could reduce migraine incidence and severity.
“If aspirin works to abort or ameliorate the headaches, then it should be tried as a prophylactic measure to see if it can prevent the occurrence of these debilitating headaches. Hopefully, this would lead to less disability and loss of employment time for these patients who are so common in the US and throughout the world,” said Alpert.
1. Biglione B, Gitin A, Gorelick PB, et al. Aspirin in the treatment and prevention of migraine headaches: possible additional clinical options for primary healthcare providers . Am J Med. doi: 10.1016/j.amjmed.2019.10.023.
2. Alpert JS. A common drug may help patients with debilitating migraine headaches . Am J Med. doi: 10.1016/j.amjmed.2019.11.002.
Should you use aspirin for a migraine?
NEW YORK (Reuters Health) – A single dose of aspirin can bring at least temporary pain relief to about half of people with migraines, a new research review suggests.
Research shows that about half of people with migraines opt to use over-the-counter pain relievers only, with aspirin being a common choice. But it has not been clear exactly how well aspirin performs, or where it fits into the migraine treatment arsenal.
In the new review, UK researchers analyzed 13 clinical trials in which patients were randomly assigned to treat their migraine attacks with either a single dose of 900 to 1,000 milligrams (mg) of aspirin or a comparison treatment — either a placebo or an active drug, usually the prescription migraine drug sumatriptan.
Overall, the review found, 52 percent of aspirin users got at least some pain relief within two hours — meaning their pain was reduced from moderate to severe to “no worse than mild.” That compared with 32 percent of those using a placebo.
Similarly, one-quarter of aspirin users were pain-free within two hours, versus 11 percent of placebo users.
Aspirin also appeared to reduce some of the other symptoms that can come with migraine attacks, including nausea and sensitivity to light and sound. But a combination of aspirin and the anti-nausea medication metoclopramide – marketed as Reglan – worked even better, the researchers report in the Cochrane Database of Systematic Reviews.
Across two studies, for instance, 46 percent of patients who used aspirin plus 10 mg of metoclopramide got relief from vomiting within two hours, compared with none of those given a placebo.
Still, aspirin — with or without metoclopramide — is no magic bullet, said Dr. R. Andrew Moore, one of the researchers on the review.
“For about half of people with migraine, aspirin will help at a level of pain relief that is useful. For half it will not,” Moore, of John Radcliffe Hospital in Oxford, told Reuters Health by email.
“No medicine for migraine works in everyone,” he added, “and for the individual the key is finding that medicine — and formulation — that works for them.”
The review also found that the short-term relief from aspirin often did not last. Three studies looked at 24-hour pain relief among patients who partially improved within two hours; 39 percent had sustained pain relief for a full day, compared with 24 percent of placebo users. No study assessed 24-hour relief among people who were pain-free within two hours of taking aspirin.
In addition, while aspirin plus metoclopramide was similarly effective against symptoms as a 50-mg dose of sumatriptan, the prescription drug seemed to work better against pain when taken at a 100-mg dose. Across two studies, 28 percent of sumatriptan users were pain-free at two hours, versus 18 percent of those using aspirin and metoclopramide.
According to Moore, “it’s useful to know” that an over-the-counter pain reliever works for some people’s migraines. And that’s especially true, he noted, for people in developing parts of the world, since aspirin is cheap and readily available.
“But,” he added, “no one suffering frequent headaches should just self-medicate — it’s always better to see your primary care physician for a chat.”
People should also be aware that aspirin, like any medication, carries a risk of side effects. Used regularly, Moore noted, the drug may lead to problems like ulcers and gastrointestinal bleeding, and older adults — who are at increased risk of such problems — should be particularly cautious about frequently using aspirin for pain relief.
Moore said that parents should also avoid using aspirin for children’s migraines. Aspirin, when used by children and teenagers with chickenpox or flu-like symptoms, is associated with Reye’s syndrome — a rare but serious condition marked by brain inflammation. It’s generally recommended that parents talk with their doctor before giving aspirin to a child younger than 12.
SOURCE: here Cochrane Database of Systematic Reviews, online April 14, 2010.
Our Standards:The Thomson Reuters Trust Principles.
Aspirin with or without an antiemetic for acute migraine headaches in adults
This is an updated version of the original Cochrane review published in Issue 4, 2010 (Kirthi 2010); no new studies were found. A single oral dose of 1000 mg of aspirin reduced pain from moderate or severe to none by two hours in approximately 1 in 4 people (24%) taking aspirin, compared with about 1 in 10 (11%) taking placebo. Pain was reduced from moderate or severe to no worse than mild pain by two hours in roughly 1 in 2 people (52%) taking aspirin compared with approximately 1 in 3 (32%) taking placebo. Of those who experienced effective headache relief at two hours, more had that relief sustained over 24 hours with aspirin than with placebo. Addition of 10 mg of the antiemetic metoclopramide substantially increased relief of nausea and vomiting compared with aspirin alone, but made little difference to pain.
Oral sumatriptan 100 mg was better than aspirin plus metoclopramide for pain-free response at two hours, but otherwise there were no major differences between aspirin with or without metoclopramide and sumatriptan 50 mg or 100 mg. Adverse events with short-term use were mostly mild and transient, occurring slightly more often with aspirin than placebo, and more often with sumatriptan 100 mg than with aspirin.
Uses, benefits, and risks of aspirin
Acetaminophen (paracetamol, Tylenol) and ibuprofen are generally used instead.
A low dose of aspirin, at 75-81 milligrams (mg) per day, can be used as an antiplatelet medication, to prevent blood clots from forming.
This may be given to patients following:
- a coronary artery bypass graft operation
- a heart attack
- a stroke
- atrial fibrillation
- acute coronary syndrome
People may also be given low-dose aspirin if they have the following risk factors, and if the doctor believes there is a chance of heart attack or stroke:
- high blood cholesterol levels
- hypertension, or high blood pressure
Others who may be advised to take low-dose aspirin include:
- those with damage to the retina, or retinopathy
- people who have had diabetes for over 10 years
- patients who are taking antihypertensive medications
The United States (U.S.) Preventive Services Task Force currently recommend daily low-does aspirin use to prevent cardiovascular disease and colorectal cancer in adults aged 50 to 59 years who:
- have a 10 percent or higher risk of cardiovascular disease
- who do not have a high risk of bleeding
- are likely to live at least another 10 years
- are willing to take the dose for at least 10 years
In all these cases, the individual will normally continue to take low-dose aspirin daily for the rest of their life.
Bigger Isn’t Better
“These findings are completely consistent with every other report that has examined aspirin dosage,” cardiologist and researcher Ron J.G. Peters, MD, tells WebMD. “There is no indication whatsoever that increasing the dosage improves the outcome of aspirin therapy. But there is a very clear relationship between higher doses and an increased risk for bleeding.”
AHA spokesman Sidney C. Smith, MD, agrees that the studies to date suggest that low-dose aspirin therapy is just as effective as higher-dose treatment and probably safer. But he adds that there remains a need for a large-scale, definitive study to answer the question once and for all and to address the role of aspirin therapy in the 15% to 20% of patients who appear to be resistant to its beneficial heart effects.
The newly reported study was actually designed to assess the value of adding the anti-blood clotting drug Plavix to different doses of aspirin therapy in patients with unstable angina. Slightly more than 12,500 patients were randomly selected to receive the drug and aspirin doses ranging from 75 mg to 325 mg daily. The typical baby aspirin is 81 mg, and an adult tablet is 325 mg.
In an earlier report, the combination treatment was found to be superior to aspirin alone, regardless of the aspirin dose given.
Aspirin / Caffeine Dosage
Medically reviewed by Drugs.com. Last updated on Apr 3, 2019.
- Side Effects
Applies to the following strengths: 400 mg-32 mg; 845 mg-65 mg; 500 mg-32 mg; 1000 mg-65 mg; 421 mg-32 mg; 500 mg-32.5 mg; 500 mg-65 mg
Usual Adult Dose for:
Usual Pediatric Dose for:
Additional dosage information:
- Renal Dose Adjustments
- Liver Dose Adjustments
- Dose Adjustments
- Other Comments
Usual Adult Dose for Fever
Aspirin 325 to 650 mg orally every 4 hours or Aspirin 500 to 1000 mg orally every 6 hours with Caffeine (in doses up to 65 mg) as needed
Maximum number of daily doses: 4
Maximum daily dose: Aspirin: 4000 mg
-Dosing ranges are provided; consult product labeling for specific dosing.
-Caffeine use should be limited when using this product.
Uses: For the temporary relief of minor aches and pains due to headache, toothache, muscular aches, backache, arthritis, and menstrual cramps; for the temporary relief of pain and fever due to colds.
Renal Dose Adjustments
Use with caution; routine aspirin use is not recommended in patients with severe renal impairment (CrCl less than 10 mL/minute) due to an increased risk of salicylate toxicity
Liver Dose Adjustments
Use with caution; routine aspirin use is not recommended in patients with severe hepatic impairment due to the potential for increased risk of clinically significant bleeding and other adverse effects.
Elderly: Use with caution due to increased risk of adverse events; consider the maximal dose in elderly patients to be less than that the adult maximal dose
-Hypersensitivity to active substances, aspirin, other salicylates, nonsteroidal anti-inflammatory agents (NSAIDs) or any or any product excipients
Safety and efficacy have not been established in patients younger than 12 years.
Consult WARNINGS section for additional precautions.
Data not available
Tablets: Take orally with a full glass of water
Effervescent Tablets: Fully dissolve tablets in 16 ounces of water and drink
-To open, fold on line to expose notch, then tear at notch or use scissors
-Place 1 or 2 powders on tongue and swallow with or without water
-Drink a full glass of water or liquid with each dose
-Effervescent tablets may contain phenylalanine; see labeling
-Adolescents recovering from chicken pox or flu-like symptoms should not use this product due to risk of Reye’s syndrome.
-Monitor for signs and symptoms of bleeding
-Patients should be instructed to read the product labeling.
-Patients should understand that this product is for occasional use; they should be advised to contact their healthcare provider if their symptoms worsen while using this product or last more than 10 days.
-Patients should be advised to avoid caffeine-containing drugs, foods, or drinks because too much caffeine may cause nervousness, irritability, sleeplessness, or palpitations.
-Patients should be instructed to seek immediate medical assistance if they have an allergic reaction.
-Patients should contact their healthcare professional promptly if they experience signs of stomach bleeding such as vomiting blood, black or bloody stools, or stomach pain that does not get better.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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