Thank you for your inquiry,
For your case, majority of adverse effects associated with
spironolactone are dose-dependent except headache when it intensifies or induces your
migraine. Therefore, in your case decreasing dosage cannot help.
There is not convincing scientific evidence to show medication interaction happens when you use
Ibuprofen with Spironolactone, and it means there is not absolute contraindication for your current medication therapy.
According to my experience, the treatment of your migraine is prior to your
Acne, however it does not imply to ignore your Acne treatment. My suggestion is to continue your treatment for migraine but consider that taking too many medications is not recommended. In this case, I cannot prescribe 600 mg Ibuprofen at one time, while you have experienced gastric difficulties already. You had better to consider its interval use. Please consult with your family doctor to find other alternative drugs, which suit your case.
In conclusion, my recommendations are, firstly use appropriate medication for your migraine treatment, and secondly you can test 1 more time for Acne treatment with spirinoloctone100mg/day ,however if you experience migraine attach once again, stop spironolactone treatment and ask your doctor replace it with other appropriate medication specified for Acne.
Hope you get well soon,