Which Medications Are Used For Preventing Migraines
Preventative therapy should be considered for patients who suffer from recurrent migraines that cause significant disability, frequent migraines that require treatment more than twice a week, or migraines that do not respond or respond poorly to symptomatic treatments. Currently there are no drugs that specifically target and prevent migraines. Certain blood pressure medications as well as some antidepressants, anti-seizure drugs, and herbals have been shown to have beneficial effects in preventing migraine headaches. It’s important to understand that prophylactic medicines may not produce any significant benefits right away and maximal effects may not be seen for weeks to up to 6 months.
Although a number of medications have been used for the prevention of migraines, the medications that have been shown to be effective in controlled clinical trials, and are therefore recommended by the American Headache Society and the American Academy of Neurology migraine prevention guidelines include:
The side effects associated with the herbals used for migraines include burping and gastrointestinal issues.
CGRP antagonists have fewer side effects than many other migraine medications and may include:
- Pain at the injection site
Over The Counter And Abortives
1. Three Over The Counter Products Are Approved
Thats right three. Only three OTC products are currently on my list of migraine medications because they are approved by The USFDA to specifically treat migraines. These are:
- Excedrin Migraine®
- Advil Migraine®
- Motrin Migraine Pain®
The ingredients for Excedrin combine: acetaminophen, aspirin and caffeine. It is recommended for reducing migraine pain and the accompanying symptoms.
Both Advil and Motrin contain ibuprofen. They are recommended to treat headaches and the associated pain.
This is what drugs.com says about Motrin Migraine Pain: “This medicine may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term.”
Always discuss the side effects with your doctor before you take anything, or the pharmacist. Remember Non-steroidal anti-inflammatory agents or NSAIDs carry risks too, even though you can get them over the counter.
I never found any of these OTC combinations by themselves to help reduce my severe migraine pain. Not even a little bit!
It was not until I combined ibuprofen with the triptan Naramig that I found effective relief from the attacks and symptoms.
Please work with your doctor on finding a combination that works for you.
2. Abortive Medications
Here is the approved A-Z list of migraine medications called Triptans, with my accompanying results.
My research reveals these are all potent serotonin 5HT1 agonists:
How Can I Manage Headache Pain
These steps can help you or a loved one manage headache pain:
- Limit OTC and prescription medication use to two days per week. Too much medicine can increase headaches.
- Take medicine at the first sign of a headache.
- Take prescription medications as directed.
- Keep regular follow-up visits with a healthcare provider.
- Educate yourself and your family about the type of headache you have and the treatment options.
- Maintain a headache diary to figure out headache patterns and triggers.
- Ask your provider for written instructions for what to do when a headache strikes.
- Dont skip meals, especially breakfast.
- Get at least seven hours of sleep every night.
- Exercise for 30 minutes a day.
- Drink six to eight glasses of water a day.
- Identify and avoid headache triggers. These may include caffeinated foods and beverages, as well as many types of chips and other junk food. They may also include chemicals known as nitrates and tyramine .
Strategies at home
- Use relaxation strategies to reduce stress.
- Apply a cold compress to your head.
What is an off-label drug?
Sometimes regulators approve a medicine for a specific use and researchers find it helps for another condition, too. Healthcare providers may then choose to prescribe the medicine for additional uses. Thats called off-label prescribing. It can also include healthcare providers giving children drugs approved for adults when there arent other good options.
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Antiemetics Available In Australia For Migraine
*Dosages apply to adults over 18. Take these medications only as directed by your doctor or pharmacist.
None of the above medications were developed specifically for migraine, except for those sold as a combined tablet with paracetamol. Metoclopramide and prochlorperazine are the antiemetics most commonly recommended for migraine, because they dont cause major blood pressure changes, require cardiac monitoring, and may themselves also bring additional pain relief .
There is also evidence to suggest that antiemetics can work synergistically with migraine treatments particularly in the setting of nausea or vomiting . One emergency department study showed that intravenous metoclopramide and prochlorperazine had a similar level of efficacy . Your doctor will be able to recommend which drug is more suitable based on your symptoms and reaction to previous medications.
Similar to triptans, ergotamine and dihydroergotamine are migraine-specific drugs that target serotonin receptors . However, triptans have mostly replaced ergotamines, because they are more effective and ergotamines tend to cause side effects such as nausea. There are no ergotamine compounds currently available in Australia .
Are Your Otc Medicines Really Working For You
Migraine medication routines can often become an automatic habit we never stop to think about, even if theyre not truly bringing relief. Were often more focused on day-to-day solutions and simply getting through the week, rather than assessing why theres so much pain in our lives. Ask yourself these questions about your over-the-counter medication use:
- Are your symptoms relieved or improved with your medication? Your go-to medication should bring relief.
- Are you taking more medicine to get the same results as in the past? You may be at risk of rebound headache syndrome, in which the overuse of medication creates a dependency. Its thought that the brain learns to crave the medicine and gets headaches as a withdrawal symptom. Rebound adds another layer of headaches on top of your already-existing migraine disease and needs to be avoided.
- Tip: If you are taking pain relief medication 10 or more days each month, thats too much.
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Strongest Migraine Medication Over
When discussing strength, we often refer to how much of a medication is given per dose.
Many of these OTC migraine medications are given in high doses. For example, the recommended dosages for aspirin and acetaminophen are typically around 1,000 mg.
However, when thinking about strength, you may also be considering how strongly these medications act against your migraine symptoms.
In this case, an argument can be made for the aspirin, acetaminophen, and caffeine combination. Older research has found that the combination of these three ingredients has a greater effectiveness than each individual ingredient alone.
Overall, its important to remember that the medication that most effectively alleviates acute migraine symptoms can vary by person. Because of this, focus on finding the treatment that best addresses your symptoms.
Treatment For Pregnant And Breastfeeding Women
In general, migraine treatment with medicines should be limited as much as possible when you’re pregnant or breastfeeding.
Instead, trying to identify and avoid potential migraine triggers is often recommended.
If medicine is essential, your GP may prescribe you a low-dose painkiller, such as paracetamol.
In some cases, anti-inflammatory medicine or triptans may be prescribed.
Speak to a GP or your midwife before taking medicine when you’re pregnant or breastfeeding.
Page last reviewed: 10 May 2019 Next review due: 10 May 2022
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Triptans Over The Counter Not Just Yet
The TGA have announced that triptans have been downscheduled so they can be sold in small packs over the counter at your local pharmacy without a prescription from 1 February 2021. While it is legal from February, it will be about another 3-6 months before the product is actually in your local pharmacy.
Triptans will be available in small pack without a prescription. The larger pack sizes, non-tablet forms and stronger doses you will still need a prescription for.
While this is great news for those who use triptans, giving them the capacity to get the medications they need quickly if they are out and about without their medication, there is a concern around people that do not know how triptans are to be used, and perhaps have never seen a doctor for their migraine.
Triptans are usually only effective if taken right at the beginning of the headache in a typical migraine attack. If the headache goes away and comes back in about two hours, you can take one more dose. If the first one doesnt work, you should not take any more. And whether it works or doesnt, you should not take more as the attack progresses.
Phases of migraine indicating when triptans should be used.
If triptans are taken more than 10 days a month, they can cause the secondary condition of medication overuse headache.
Triptans are commonly available in other countries from pharmacies without a prescription.
** How To Pick The Best One **
Take This List of Migraine Medications To Your Doctor
1. Copy and paste this entire page, or jot down a few migraine meds that sound right to you.
2. Take this list to your doctor to discuss your options.
3. Experiment . Keeping good records is essential.
Unfortunately finding what works the best can be trial and error. But with the numerous options in this list of migraine medications, you are off to a great start. If you can… start with testing the family of triptans for acute attacks. Then if they don’t work, you can consider these other options.
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Aspirin Acetaminophen And Caffeine
This OTC medication is actually a combination of three ingredients at a fixed dosage. These are:
Each of these ingredients has its own mechanism of action, which weve already discussed for aspirin and acetaminophen. What about caffeine?
When you have a headache, blood flow is increased in your brain. Caffeine can cause blood vessels in the brain to constrict , reducing this blood flow. Caffeine also has anti-inflammatory properties and can enhance the effects of aspirin and acetaminophen.
The combination of aspirin, acetaminophen, and caffeine is available OTC in a single dose pill or tablet.
Like the OTC medications that weve already discussed, studies have been performed on the effectiveness of aspirin, acetaminophen, and caffeine. In fact, some studies have found it to be more effective than alone.
Abortive Therapy For Headaches
How does abortive therapy work?
You take abortive therapy medications early during a headache. Theyre usually used for migraine headaches. These drugs stop the process causing headache pain. They help reduce headache symptoms, such as nausea, vomiting and sensitivity to light and sound.
For best results, take these medicines when you first notice the migraine. If you get a migraine aura , you may need to avoid some of these medications. Talk to your healthcare provider to figure out which medications are right for you.
Can IV drugs help stop a migraine?
Some headaches especially migraines last for more than 24 hours and dont respond to other abortive medications. In these situations, your healthcare provider may recommend you get medication at an infusion site.
This site is usually a set of rooms at a hospital or clinic where people receive IV drugs. A nurse monitors the people receiving infusions. Generally, IV drugs can end the migraine attack, even when other abortive medicines were unsuccessful. You may be at the infusion site for a few hours or a full day, depending on your symptoms.
Can children take abortive therapies?
The FDA has approved some abortive therapies for teenagers but none for younger children. Talk to your childs healthcare provider to figure out the best way to treat headaches.
What abortive therapy headache medicines are available?
Medications that can stop migraine headaches include:
Generic name: Ergot, dihydroergotamine, mesylate
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Whats A Rebound Headache
Some headaches rebound because you use medications too much. Then you need to take even more medication, which makes the pain worse. This cycle can happen with:
- Taking pain relievers more than two days a week.
- Overusing abortive medications, with headaches returning after the last dose.
Talk to your healthcare provider about stopping medications. If you stop, the pain may improve over the next six to 12 weeks.
What Is A Migraine And How Is It Treated
Have you ever had a headache that was so severe that light and noise made the pulsating pain on the side of your head feel like a hot stabbing knife for hours on end, and you wanted nothing more than to lie still in a dark and quiet room until the stabbing pain in your head stopped? If this sounds familiar, youve experienced a migraine headache.
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Could Preventive Meds Be The Best Medication For Migraine
If your migraine attacks are frequent, your doctor can prescribe a type of medicine to help prevent attacks from happening in the first place. Migraine prevention meds are often a smart addition to a treatment plan. There are many options to choose from and some can have side effects, so you should discuss the risks and benefits with your healthcare provider.
Bottom lineif over-the-counter medicine works well for you, fantastic. Its cheaper and easier to procure. But if your go-to meds arent resolving your migraine attacks, its time to call your doctor and look at your medication treatment plan. Just think, if you had fewer migraine attacks, it would mean more symptom-free days to get on with your life. Youre worth the effort.
Looking for more non-prescription options for your migraine? Learn about the nutritional supplements that can reduce headache in How Migraine Dietary Supplements Can Support You.
Migraine Pain Relief At Walgreens
Migraines are a type of headache that can cause mild to severe throbbing or pulsing pain in certain parts of the head. They may also include symptoms like nausea, vomiting, and sensitivity to light and sound. While there is no absolute cure for migraines, certain products and medicines can help to relieve symptoms for some people. Over-the-counter pain medications can help ease migraine symptoms, and other products like hot or cold compresses and massaging bands may also provide relief. These products are all available for purchase online or in stores at Walgreens.
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What Are The Best Otc Migraine Medications
There are a few main kinds of pain relievers youâll see on the shelves of your local drugstore:
Non-steroidal anti-inflammatory drugs
NSAIDs are less scary than they soundâitâs just the formal term for a very common type of pain medication. You may know these drugs by their individual generic or brand names, like:
These medications treat pain, fever, and inflammation. While there havenât been enough clinical trials to say definitively which one works best for migraine, researchers think ibuprofen may be more effective, and itâs also one of the least likely to cause side effects.
Itâs important to note that you shouldnât take multiple types of NSAIDs at the same time. As long as youâre not taking them too often, NSAIDs typically have pretty mild side effects , but the risk of more serious problems like kidney damage increases if you take more than one at the same time.
You may know acetaminophen by its brand name version, TylenolÂ®. Clinical studies have shown that itâs effective for migraine relief, though since it doesnât treat inflammation in the brain , it may not work as well as one of the medications above. If itâs all you have in the house or you donât like the side effects of NSAIDs, however, itâs another solid choice.
One other advantage of acetaminophen? You can take it at the same time as NSAIDs.
Combination migraine medications
A note on medication overuse headache
What Are Excedrin Migraines Ingredients
Excedrin Migraine contains three active ingredients acetaminophen, aspirin and caffeine. These drugs combined work together to help relieve pain. Acetaminophen acts as a pain reliever and fever reducer. Aspirin helps reduce pain, inflammation, and swelling. Caffeine increases the effectiveness and enhances the pain-relieving function of analgesics such as aspirin and acetaminophen.
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What To Do For Migraines
Over-the-counter pain medications can be highly effective at reducing pain for many people suffering from mild to moderate migraines. The primary ingredients in medications for pain relief include ibuprofen, aspirin, acetaminophen, naproxen, and caffeine. Many medications combine some of these ingredients to provide targeted relief from migraines.
Products such as Excedrin® Migraine combine acetaminophen, aspirin, and caffeine to reduce symptoms. Other products contain ibuprofen in tablet form or liquid gel capsules for quick relief. These products are available for purchase in stores or online at Walgreens. Ask a pharmacist for help choosing the best over-the-counter option for you. Be careful not to overuse over-the-counter pain medication, and speak with your healthcare provider if you are taking these medications more than two or three times per week. Some people suffering from severe migraines may require prescription medication to help prevent additional attacks, and a healthcare provider can help identify the best medication for each individual.
How To Determine If Your Patient Is Ready For Prophylactic Treatment For Their Headaches
Reviewing a patients headache diary will yield information about both headache frequency and duration. If patients record the effect of headaches on interactions with their loved ones or on their function at work, you can get a good idea of how they are affected.
Heres a list of things you should consider when trying to determine if your patient is ready for prophylactic treatment:
- What is a reasonable number of headaches a patient should be allowed to suffer before we consider prophylactic therapy?
- How does the number of headache days endured by a patient affect their function?
- Does the patients rescue regimen work for them? If so, all the time? Or is there room for improvement?
- How does the patient feel about a daily medicine to decrease the frequency and / or severity of headache events?
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