MIGRAINE DRUG TREATMENT BASICS
|
Drug |
Dosage |
Comment |
|
Acetaminophen (e.g. Tylenol) |
1000 mg every 4-6 hours (Maximum 4000mg per day) |
Mild to moderate attacks Minimal GI side effects |
|
Aspirin |
975mg – 1000mg |
Use effervescent tablets (e.g. Alka-Seltzer) for quick action |
|
Ibuprofen (e.g. Advil) |
400mg (may need repeat q4h) |
Often work quickly Use liquid gel caps for faster onset |
|
Diclofenac |
50mg (may need repeat q4h) |
Often work quickly Cambia powder for solution works even faster |
|
Naproxen (e.g. Aleve) |
500mg to 550mg |
Long-acting (12 hours) suited for prolonged migraine attacks |
|
Amerge (naratriptan) |
1 mg |
|
|
Axert (almotriptan) |
6.25mg |
Less side effects |
|
Frova (frovatriptan) |
2.5mg |
Less chance of headache return |
|
Imitrex (sumatriptan) |
50mg |
|
|
Maxalt (rizatriptan) |
5mg |
Tend to work quickly |
|
Relpax (eletriptan) |
20mg |
Tend to work quickly Less chance of headache return |
|
Zomig (zolmiriptan) |
2.5mg |
|
|
Maxalt RPD |
5mg |
Dissolves in mouth without water (convenience) Less chance of nausea Not faster onset |
|
Zomig Rapimelt |
2.5mg |
As Maxalt RPD |
|
Imitrex nasal spray |
5mg |
Faster onset than oral |
|
Zomig nasal spray |
2.5mg |
Faster onset than oral |
|
Imitrex Injection |
6mg |
Fastest onset of action |
|
Triptan + Naproxen |
500mg (naproxen) |
More effective than either alone Less recurrence of headache |
|
Migranal (dihydroergotamine) nasal spray |
1 spray (0.5mg) each nostril May repeat after 15-30 min |
An option if triptan-naproxen combo don’t work |