Drugs to Treat Migraine Headaches

Migraine headaches are among the symptoms of a condition called migraine. Some medications can ease the pain and symptoms of a migraine headache. Others 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. They’re 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 Examples of Brand Names 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  Tylenol
 
  Liver damage
Allergic reactions
Rashes
  naproxen

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

 

  Stomach upset
Stomach bleeding
Nausea
Vomiting
Rash
Liver damage
May raise risk of heart attack or stroke
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,

Tosymra nasal spray

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

Lasmidtan

 

Reyvow yes

Dizziness

Sleepiness

Numbness

Feeling tired

Tingling

CGRP 

Antagonists 

Rimegepant Nutrec

yes

 

Nausea

UTI 

Allergic reaction

  Ubrogepant Ubrelvy yes

Drowsiness

Nausea

Dry mouth

Continued

Nausea Drugs for Migraines

Many people who have migraines often have nausea and vomiting along with head pain. Those symptoms usually get better when you treat the migraine. But sometimes, the nausea and vomiting are bad enough to keep a person from taking their migraine medications. In these cases, a nausea drug can ease your symptoms so you can get the treatment you need.

Most nausea medicines come in pill form, but if the problem is severe, you can take them as a rectal suppository.

Generic Name

Examples of Brand Names

Possible Side Effects

promethazine hydrochloride (tablet, syrup, injection, or suppository)

Phenergan

Confusion, drowsiness, dizziness, upset stomach, excitability, nightmares, uncontrollable muscle movements, lip smacking or chewing movements

chlorpromazine (suppository)

Thorazine

Confusion, drowsiness, dizziness, upset stomach, excitability, nightmares, uncontrollable muscle movements, lip smacking or chewing movements

prochlorperazine (tablet and suppository)

Compazine

Confusion, drowsiness, dizziness, upset stomach, excitability, nightmares, uncontrollable muscle movements, lip smacking or chewing movements

Trimetho-benzamide hydrochloride (capsule, injection, syrup, or suppository)

Tigan

Low blood pressure, blurred vision, drowsiness, dizziness, feeling disoriented, uncontrollable muscle movements, lip smacking or chewing movements

metoclopramide hydrochloride (syrup, tablet, or injection)

Reglan

Uncontrollable muscle movements, lip smacking or chewing movements, sensitivity to sunlight, aching in the lower legs, diarrhea

Drugs for Migraine Prevention

If you have 4 or more migraine days each month, you may take these drugs regularly to keep migraine attacks from happening. They lessen the number of headaches you have and how severe they are.

You have to follow your doctor’s directions for them to work. Your doctor may need to change the medications and adjust how much you take to figure out what works 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, you might be able to taper off or stop these drugs. Your doctor will advise you.

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

Continued

 

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

diclofenac

 

Cataflam

generics available

Headache pain relief,
Menstrual migraine prevention

Stomach upset
Drowsiness
Dizziness
Vision problems
Ulcers
May raise risk of heart attack or stroke

  ibuprofen

Advil
Motrin

Headache pain relief
Menstrual migraine prevention

Stomach upset or bleeding
Nausea
Vomiting
Rash
Liver damage
May raise risk of heart attack or stroke

  naproxen sodium

Aleve
Anaprox DS

Naprosyn

Headache pain relief
Menstrual migraine prevention

Stomach upset or bleeding
Nausea
Vomiting
Rash
Liver damage
May raise risk of heart attack or stroke

Tricyclic antidepressants amitriptyline

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 by health care provider

Stuffy 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 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 Melinda Ratini, DO, MS on November 06, 2020

Sources

SOURCES: 

Cleveland Clinic.

UpToDate.

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