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Overreliance on OTC agents contributes to preventable morbidity and drug\u2010induced headaches. To evaluate the role of OTC drugs in the management of migraine headaches, we performed a qualitative systematic literature search by using MEDLINE (January 1966\u2010April 2002), analyzed the references of articles returned by the MEDLINE search, and reviewed other pertinent literature. In the studied populations, acetaminophen, aspirin, ibuprofen, and an aspirin\u2010acetaminophen\u2010caffeine combination product were shown to be more effective than placebo at reducing moderate or severe migraine pain to mild or no pain by 2 hours after administration. However, published trials of OTC agents have systematically excluded patients enduring morbidity with 50% or more of attacks and\/or vomiting with 20% or more of attacks. Patients who experience disability during the predominance of their attacks are poor candidates for OTC\u2010exclusive therapy and should seek a physician's help for migraine\u2010specific prescription drugs. For those with migraine who encounter disability with less than 50% of attacks and\/or vomiting with less than 20% of attacks, sole treatment with OTC products is a feasible option. Patients who fail to obtain acceptable relief after an adequate trial of OTC agents also should be referred to a physician. Pharmacists are well positioned to assess whether patients could benefit from OTC agents or should seek a physician's assistance.<\/jats:p>","DOI":"10.1592\/phco.23.4.494.32124","type":"journal-article","created":{"date-parts":[[2004,5,11]],"date-time":"2004-05-11T08:01:46Z","timestamp":1084262506000},"page":"494-505","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Over\u2010the\u2010Counter Drugs for Acute Migraine Attacks: Literature Review and Recommendations"],"prefix":"10.1002","volume":"23","author":[{"given":"Richard G.","family":"Wenzel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carrie A.","family":"Sarvis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle L.","family":"Krause","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,1,16]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4610.2001.041007638.x"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4610.2001.041007646.x"},{"key":"e_1_2_1_4_2","first-page":"S25","article-title":"The impact of migraine: how this disorder affects us all","volume":"40","author":"Kaniecki RG","year":"2000","journal-title":"Consultant"},{"key":"e_1_2_1_5_2","doi-asserted-by":"crossref","first-page":"67","DOI":"10.2165\/00019053-199202010-00008","article-title":"Healthcare resources and lost labor costs of migraine headache in the U.S","volume":"2","author":"Osterhaus JT","year":"1992","journal-title":"Pharmacol Econ"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.8.813"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4610.2001.041006573.x"},{"issue":"4","key":"e_1_2_1_8_2","first-page":"S47","article-title":"Migraine: patterns of healthcare use","volume":"44","author":"Stang PE","year":"1994","journal-title":"Neurology"},{"key":"e_1_2_1_9_2","first-page":"365","article-title":"Epidemiology and patterns of health care use for migraine in the United States","volume":"39","author":"Lipton RB","year":"1999","journal-title":"Headache"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.1992.hed3205223.x"},{"key":"e_1_2_1_11_2","unstructured":"Glaxo SmithKline.Imitrex (sumatriptan) prescribing information. 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