Table of ContentsView AllTable of ContentsOTC Pain RelieversPrescription Pain RelieversNausea MedicationsPreventive Medications
Table of ContentsView All
View All
Table of Contents
OTC Pain Relievers
Prescription Pain Relievers
Nausea Medications
Preventive Medications
Migraine medications fall into two broad categories. When a migraine begins, you can turn to drugs that ease the pain (acute treatment). If you have recurrent or chronic migraines, you can take medications that reduce the number of future headaches (preventive treatment).
An over-the-counter (OTC) pain reliever may ease mild to moderate migraines but can’t prevent them. Some prescription medications relieve the pain of an acute migraine, while others reduce or prevent future migraine attacks.
The medication that works best for you depends on the characteristics of your migraines and how your body metabolizes the drug. Your healthcare provider has the expertise to recommend the drug and dose that’s appropriate and safe for your individual needs.
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Acute Treatment With OTC Pain Relievers
The first line of defense for mild to moderate migraine headaches is an OTC pain reliever. There are two classes of non-prescription painkillers: nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen.
You may need to try different medications to find the one that works best for you. However, a study published inNeurologyin 2023 offers some guidance.
The researchers reviewed information from millions of people with migraines. They found that ibuprofen was rated as the most effective and acetaminophen the least effective for relieving migraine pain. However, ibuprofen was only helpful 42% of the time.
NSAIDs
Over-the-counter NSAIDs include:
As a group, NSAIDs may cause side effects, including stomach pain, heartburn, bloating, and dizziness. NSAIDs other than aspirin may increase your risk of having a heart attack or stroke.Taking aspirin in high doses or for a long time may cause gastrointestinal bleeding.
Acetaminophen
There are numerous brand names for acetaminophen, with the most common beingTylenol. There are also many generic and store-brand versions available.
It’s important to never mix acetaminophen with alcohol. Talk to your healthcare provider if you are also taking any other medications, as drug interactions can occur. When not taken properly, acetaminophen can causeliver damagein some people.
OTC Products Targeting Migraines
Several OTC medications are formulated to target migraine headaches. Excedrin Migraine tablets contain aspirin, acetaminophen, and caffeine.Caffeine enhances the effect of the two pain relievers.
Advil Migraine and Motrin IB Migraine contain ibuprofen in a liquid form. The liquid provides faster pain relief compared to other forms of ibuprofen.
Acute Treatment With Prescription Pain Relievers
If OTC medications don’t help, your healthcare provider can prescribe one of several migraine medications. The following medications are for acute migraine treatment, which means you take them at the first sign of an oncoming migraine. They reduce your pain and may also shorten the duration of your headache.
Prescription NSAIDs
For many people, an OTC NSAID isn’t potent enough to bring relief for a migraine. If that happens, your healthcare provider may recommend one of the following prescription NSAIDs:
Triptans
Triptansare a class of prescription medication that stop an existing migraine from getting worse. Though triptans are not a preventive treatment for most people, they may help prevent menstrual migraines (migraine headaches that occur during menstruation).
Triptans are most effective for moderate to severe migraines and work best when taken at the earliest sign of an impending attack.
These drugs fend off pain and also help to alleviate nausea and sensitivity to light and sound, which are common symptoms of migraine attacks.
Triptans may also lower levels of a protein called calcitonin gene-related peptide (CGRP). CGRP levels increase during a migraine, resulting in dilated blood vessels, inflammation, and pain.
Triptan medications
There are seven triptans available for the acute treatment of migraine headaches. You may not respond to all of them, so your healthcare provider helps find the one that works best for you.
They’re all available as tablets, but several come in different forms (as noted below):
In addition to these single-ingredient triptans, there is a medication called Treximet that combines sumatriptan with the NSAID naproxen.
As with any medication, triptans have potential side effects. The most common ones include nausea, fatigue, chest or throat tightness, andparesthesias(unusual sensations like tingling, burning, prickling, and numbness).
CGRP Inhibitors
The FDA has approved three CGRP inhibitors, collectively called gepants, for the acute treatment of migraine with or without aura:
CGRP inhibitors are safe and usually well-tolerated. However, they may cause nausea, dry mouth, and constipation. These drugs are also considered to be safe for people with cardiovascular disease because they relax (dilate) blood vessels.
Lasmiditan
Lasmiditan, currently sold under the brand nameReyvow, is a prescription medication approved for the acute treatment of migraines with or without aura in adults. Similar to the triptans, lasmiditan can block a number of the processes that lead to the development of a full-blown headache.
This medication is considered to be safe for patients with heart conditions.However, it may cause side effects like dizziness, fatigue, and unusual sensations.
Dihydroergotamine
Dihydroergotamine is formulated in a way that makes it more tolerable for people who are prone to the nausea and vomiting that can sometimes accompany other medications.It is taken as a nasal spray or subcutaneous injection, usually in the thigh.
Your healthcare provider may give you the first dose to monitor your reaction and teach you how to use the shot or spray.
The most common side effects of this medication include upset stomach, dizziness, weakness, and fatigue. The nasal spray can cause a stuffy or dry nose, tingling or pain in the nose or throat, and nosebleed.
Some rare but potentially serious problems associated with dihydroergotamine require immediate medical attention. Contact your healthcare provider if you have:
You should not take dihydroergotamine if you are taking a triptan, have poorly controlled blood pressure and/or heart disease, or you’re pregnant.
Corticosteroids
Corticosteroids (steroids) are used in the emergency room for severe migraines and to treat acute migraine pain that doesn’t improve with other medications. In addition to treating pain, steroids may also prevent a migraine from recurring within 72 hours.
A study published in 2015 in the journalCephalagiareported that migraine headaches recur in up to 87% of migraine patients visiting the emergency department."
This research, which reviewed 25 studies in which corticosteroids were used to treat migraine headaches, found that when a patient received a single steroid shot as part of emergency treatment for migraine (usually along with a triptan), they were less likely to have another migraine within 72 hours.
Medications to Treat Nausea
Many people who have migraines are plagued withnausea and vomitingalong with head pain. Not only are these symptoms unpleasant, but they can lead to dehydration and make it difficult to keep medication down. For this reason,antiemeticsto reduce vomiting are often part of the pharmacologic arsenal for treating migraines.
Several treatments have been developed to reduce or prevent future migraine headaches.
CGRP Monoclonal Antibodies
CGRP monoclonal antibodies (mAbs) are injectable migraine medications for reducing the number and severity of migraine attacks. Your healthcare provider may recommend this treatment if you have four or more migraine days per month.
These injections are safe and seldom cause side effects. However, they may increase blood pressure and cause constipation. You may also have temporary soreness at the injection site.
There are currently four of these medications:
The first three in this list are self-injected at home. You inject them once a month or every three months, depending on the medication. Eptinezumab is administered through an intravenous infusion once every three months.
Some of the CGRP inhibitors (gepants) have emerged as effective medications for preventing episodic migraines.You have episodic migraines if your headaches occur on 15 or fewer days in one month.Chronic migraines occur if you have more than 15 headaches days per month for at least three months.
Botox
Botox injections are used for people with chronic migraines. In addition to reducing the number of future migraines you experience, Botox helps reduce the pain when a headache occurs. You need to have Botox injections every three months to maintain your results.
Other Medications
Several medications used to treat other health conditions can also help prevent migraines in some people. These medications include:
These medications come with the risk of side effects. A few examples include weight gain, dizziness, constipation, memory problems, and low blood pressure.
Summary
Migraines always need medications because they’re one of the most painful headaches you can experience. There are numerous migraine medication options for relieving the pain when a headache begins. OTC medications may help mild to moderate migraines. However, many people need prescription medications to achieve significant pain relief.
Preventive migraine medications reduce the number and severity of future migraines. This group includes Botox and advanced medications like CGRP inhibitors and CGRP monoclonal antibodies.
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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