Hi, Nimek-para is a combination medications of paracetamol and a non-steroidal anti-inflammatory drug. It is very effective at reducing the intensity and severity of migraine as you already know I m sure. Looking at this drug over the long term, it does have the potential to cause significant gastric upset and irritation perhaps even causing some gastritis. This category of medications if taken for a long-enough period of time can also lead to gastric ulcers. A consideration for long term management, may be to be prescribed a daily prophylactic migraine medication which would reduce the severity and likelihood of the migraines. Typically I prescribe Topiramate 25mg orally and patients report significant improvement on this. This drug is found to be what they call weight-neutral and does not cause weight gain and in fact my produce some mild weight loss. This is an attractive secondary effect for many people. Another consideration is to look into a medication like Imitrex which can be taken when the migraine starts, this is very successful at averting the full impact of the migraine and usually resolving it entirely. This drug is very well tolerated and I have not seen any significant side effects in my patients. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. David Girardi, Internal Medicine Specialist