MIGRAINE DRUG TREATMENT BASICS

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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

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