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Drugs to Treat Migraine Headaches

Medically Reviewed by Melinda Ratini, DO, MS on November 06, 2020

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.

 

CategoryGeneric NameExamples of Brand NamesMay be used during an aura?Some Side Effects
Over-the-counteribuprofenAdvil, Motrin 

Stomach upset or bleeding
Rash
Swelling

May raise risk of heart attack or stroke

 aspirin + acetaminophen + caffeineExcedrin 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
ErgotdihydroergotamineDHE-45 injection,
Ergomar,
Migranal nasal spray
YesNausea
Numbness of fingers and toes
Triptanssumatriptan 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 pregnancyDizziness
Tingling
Flushing
Feelings of chest heaviness, burning, or tightness
Nausea
 zolmitriptanZomigNot with hemiplegic migraine, migraine with brainstem aura, stroke, heart disease, or uncontrolled hypertensionDizziness
Tingling
Flushing
Feelings of chest heaviness, burning, or tightness
Nausea
 rizatriptanMaxaltNot with hemiplegic migraine, migraine with brainstem aura, stroke, heart disease, or uncontrolled hypertensionDizziness
Tingling
Flushing
Feelings of chest heaviness, burning, or tightness
Nausea
 naratriptanAmergeNot with hemiplegic migraine, migraine with brainstem aura, stroke, heart disease, or uncontrolled hypertensionDizziness
Tingling
Flushing
Feelings of chest heaviness, burning, or tightness
Nausea
 almotriptanAxertNot with hemiplegic migraine, migraine with brainstem aura, stroke, heart disease, or uncontrolled hypertensionTiredness
Dizziness
Headache
Nausea
Chest pain
 frovatriptanFrovaNot with hemiplegic migraine, migraine with brainstem aura, stroke, heart disease, or uncontrolled hypertensionDizziness
Flushing
Palpitations
Chest pain
Headache
Tingling
Nausea
 eletriptanRelpaxNot with hemiplegic migraine, migraine with brainstem aura, stroke, heart disease, or uncontrolled hypertensionDizziness
Tingling
Flushing
Feelings of chest heaviness, burning, or tightness
Nausea
Headache
Combination triptan + NSAIDsumatriptan + naproxenTreximetNot with hemiplegic migraine, migraine with brainstem aura, stroke, heart disease, or uncontrolled hypertensionHead, jaw, chest, and arm discomfort, tightening, or tingling
Throat discomfort
Muscle cramps
Flushing
Stomach upset or bleeding
Nausea
Vomiting
Rash
Liver damage
Ditan

Lasmidtan

 

Reyvowyes

Dizziness

Sleepiness

Numbness

Feeling tired

Tingling

CGRP 

Antagonists 

RimegepantNutrec

yes

 

Nausea

UTI 

Allergic reaction

 UbrogepantUbrelvyyes

Drowsiness

Nausea

Dry mouth

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.

 

CategoryGeneric NameExamples of Brand NamesTreatment InformationPossible 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 antidepressantsamitriptyline

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-blockersatenolol
metoprolol
nadolol
propranolol
timolol

Tenormin

Lopressor, Toprol XL

Corgard

Inderal

Depending on the form, may be taken one to three times a dayFatigue
Depression
Weight gain
Memory disturbance
Faintness
Diarrhea
AnticonvulsantstopiramateQudexy XR
Topamax
Trokendi XR
Often started at low dosages and slowly increased to a helpful levelTingling in the arms
Nausea
Drowsiness
Weight loss
 valproateDepakene
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

VypetiQuarterly IV by health care provider

Stuffy nose
Scratchy throat
Allergic reactions

 

erenumab

AimovigOnce a month, self-injections with a prefilled penMild pain and redness at the injection site
Constipation
Allergic reactions
 fremanezumabAjovyMonthly 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
 galcanezumabEmgalityMonthly, 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 Aonabotulinumtoxin ABotoxMultiple injections are given about every 3 months to prevent chronic headache.Headache
Neck pain

 

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

Sources

SOURCES: 

Cleveland Clinic.

UpToDate.

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