Tolfenamic acid in combination with caffeine: absorption during acute migraine.

Tolfenamic acid is an anti-inflammatory analgesic which is used in the treatment of migraine attacks. Because caffeine is used in certain analgesic combinations, its effects on the absorption of tolfenamic acid was studied in a crossover study in migraine patients. Caffeine did not significantly change the absorption of tolfenamic acid during migraine attacks. The extent of absorption following oral administration of tolfenamic acid is decreased during migraine attacks, irrespectively if the volunteers received caffeine or placebo in combination with the drug. The reasons are discussed. It seems obvious that the migraine itself is responsible for the lack of absorption that cannot be counteracted with caffeine. Pain relief within a five-hour testing period was not influenced by concomitant administration of caffeine. It is concluded that tolfenamic acid alone is sufficient in treating migraines.