Drugs to Treat Migraine Headaches

Migraine headaches are among the symptoms of an actual condition known as migraine. Some medications can ease the pain and symptoms of a migraine headache. Other medications can help prevent the headaches. Talk to your doctor about which ones are right for you.

Drugs That Stop Migraine Headaches

You take these drugs at the first sign of a migraine attack to stop them. They are called "abortive" drugs. They prevent common symptoms like pain, nausea, and sound and light sensitivity. Some of these should not be used during a migraine with aura, so follow your doctor's instructions.

 

Category Generic Name Brand Name May be used during an aura? Some Side Effects
Over-the-counter ibuprofen Advil, Motrin  

Stomach upset or bleeding
Rash
Swelling

May raise risk of heart attack or stroke

  aspirin + acetaminophen + caffeine Excedrin Migraine,
Excedrin,
Goody's
  Heartburn
Anxiety
Insomnia
Allergic reaction
Liver damage
Blood in stool or vomit
Dizziness
Easy bruising
  acetaminophen Excedrin Tension Headache,
Tylenol,
Valorin
  Liver damage
Allergic reactions
Rashes
  naproxen

Aleve,
Anaprox (prescription only),
Naprosyn (prescription only)

 

  May raise risk of heart attack or stroke
Stomach upset
Stomach bleeding
Nausea
Vomiting
Rash
Liver damage
Ergot dihydroergotamine DHE-45 injection,
Ergomar,
Migranal nasal spray
Yes Nausea
Numbness of fingers and toes
Triptans sumatriptan succinate

Imitrex injection, oral, intranasal
Zembrace injection,

Onzetra inhaled

Not with hemiplegic migraine, migraine with brainstem aura, stroke, heart disease, uncontrolled hypertension, or pregnancy Dizziness
Tingling
Flushing
Feelings of chest heaviness, burning, or tightness
Nausea
  zolmitriptan Zomig Not with hemiplegic migraine, migraine with brainstem aura, stroke, heart disease, uncontrolled hypertension, or pregnancy Dizziness
Tingling
Flushing
Feelings of chest heaviness, burning, or tightness
Nausea
  rizatriptan Maxalt Not with hemiplegic migraine, migraine with brainstem aura, stroke, heart disease, uncontrolled hypertension, or pregnancy Dizziness
Tingling
Flushing
Feelings of chest heaviness, burning, or tightness
Nausea
  naratriptan Amerge Not with hemiplegic migraine, migraine with brainstem aura, stroke, heart disease, uncontrolled hypertension, or pregnancy Dizziness
Tingling
Flushing
Feelings of chest heaviness, burning, or tightness
Nausea
  almotriptan Axert Not with hemiplegic migraine, migraine with brainstem aura, stroke, heart disease, uncontrolled hypertension, or pregnancy Tiredness
Dizziness
Headache
Nausea
Chest pain
  frovatriptan Frova Not with hemiplegic migraine, migraine with brainstem aura, stroke, heart disease, uncontrolled hypertension, or pregnancy Dizziness
Flushing
Palpitations
Chest pain
Headache
Tingling
Nausea
  eletriptan Relpax Yes Dizziness
Tingling
Flushing
Feelings of chest heaviness, burning, or tightness
Nausea
Headache
Combination triptan + NSAID sumatriptan + naproxen Treximet Not with hemiplegic migraine, migraine with brainstem aura, stroke, heart disease, uncontrolled hypertension, or pregnancy Head, jaw, chest, and arm discomfort, tightening, or tingling
Throat discomfort
Muscle cramps
Flushing
Gastrointestinal upset or bleeding
Nausea
Vomiting
Rash
Liver damage
Ditan

Lasmidtan

 

Reyvow yes

yes

Dizziness

Sleepiness

Numbness

Feeling tired

Tingling

CGRP 

Antagonists 

Rimegepant Nutrec

yes

 

Nausea

UTI 

Allergic Reaction

  Ubrogepant Ubrelvy yes

Drowsiness

Nausea

Dry mouth

Continued

Drugs for Migraine Prevention

If you have four or more migraine days each month, you take these drugs regularly to keep migraines attacks from happening. They lessen the number and severity of your headaches.

You have to take them as prescribed for them to work. Your doctor may need to change the medications and adjust how much you take to figure out which drug or combination of drugs, and at which dosages, work best for you.

While you’re taking these drugs, write down how often you have headaches and how bad they are to help your doctor judge how well they are working. Most need days or weeks to take full effect.

Once your headaches are under control for 6 months or a year, it may be possible to taper off or stop these drugs. You may need to take the drugs for a longer time, though. Your doctor will advise you.

The medications listed include both over-the-counter and prescription drugs. These drugs aren't habit-forming, but any medication can cause unwanted side effects. Your doctor will adjust the dosage to give you the most relief with the fewest side effects.

 

Category Generic Name Brand Name Treatment Information Possible Side Effects
Nonsteroidal anti-inflammatories

diclofenac

 

Cataflam

generics available

Headache pain relief,
Menstrual migraine prevention
May raise risk of heart attack or stroke
Gastrointestinal upset
Drowsiness
Dizziness
Vision problems
Ulcers
  ibuprofen

Advil
Motrin

Headache pain relief
Menstrual migraine prevention
May raise risk of heart attack or stroke
Gastrointestinal upset or bleeding
Nausea
Vomiting
Rash
Liver damage
  naproxen sodium

Aleve
Anaprox

Naprosyn

Headache pain relief
Menstrual migraine prevention
May raise risk of heart attack or stroke
Gastrointestinal upset or bleeding
Nausea
Vomiting
Rash
Liver damage
Tricyclic antidepressants amitriptyline

Elavil

generics available

Often started at low dosages and slowly increased to a helpful level.
EKG may be needed.
Blood tests may be needed while taking this medication.
Taken nightly.
Fatigue
Dry mouth
Weight gain
Constipation
Drowsiness
Blurred vision
Older adults also may feel confusion or faintness
SNRI antidepressants

venlafaxine

duloxetine

Effexor Cymbalta generics available   Sleep problems
Drowsiness
Dizziness
Vision changes
Less sexual desire or ability
Headaches
Beta-blockers atenolol
metoprolol
nadolol
propranolol
timolol

Tenormin

Lopressor, Toprol XL

Corgard

Inderal

Depending on the form, may be taken one to three times a day. Fatigue
Depression
Weight gain
Memory disturbance
Faintness
Diarrhea
Anticonvulsants topiramate Qudexy XR
Topamax
Trokendi XR
Often started at low dosages and slowly increased to a helpful level. Tingling in the arms
Nausea
Drowsiness
Weight loss
  valproate Depakene
Depakote
Stavzor
Depends on the form. Usually once or twice a day. Nausea
Tiredness
Tremor
Dizziness
Weight gain
Hair loss
Birth defects
CGRP inhibitors

eptinezumab

Vypeti Quarterly IV infusion by healthcare provider

Stuff Nose
Scratchy throat
Allergic reactions

 

erenumab

Aimovig Once a month, self-injections with a prefilled pen. Mild pain and redness at the injection site
Constipation
Allergic reactions
  fremanezumab Ajovy Monthly or quarterly, self-injection with a prefilled syringe. Use with caution in people with heart or blood vessel disease. Mild pain and redness at the injection site
Allergic reactions
  galcanezumab Emgality Monthly, self-injection with a prefilled pen or syringe. Use with caution in people with heart or blood vessel disease. Mild pain and redness at the injection site
Allergic reactions
Botulinum toxin type A onabotulinumtoxin A Botox Multiple injections are given about every 3 months to prevent chronic headache. Headache
Neck pain

Continued

 

Warning: You should not take triptans together with SSRI or SNRI antidepressants. You may get a life-threatening condition called serotonin syndrome. Check all your medications with your doctor.

WebMD Medical Reference Reviewed by Arefa Cassoobhoy, MD, MPH on March 12, 2020

Sources

SOURCES: 

Cleveland Clinic.

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