There is an overwhelming list of migraine medications available.
There are basically two categories that I have broken down so you can easily see what’s approved and recommended.
Not just what's available for headaches, but the approved medications specifically designed to target migraines.
Headache tablets are not recommended for migraines as they have the wrong action.
1. Three Over The Counter Products Are Approved
That’s right – Three. Only three OTC products are currently on my list of migraine medications because they are approved by The Food and Drug Administration (FDA) to specifically treat migraines. These are:
Migraine (a combination of aspirin, acetaminophen and caffeine) is
indicated for migraine and its associated symptoms. Advil® Migraine and
Motrin® Migraine Pain, both ibuprofen medications, are approved to
treat migraine headache and its pain.”
2. Abortive Medications
Here is the approved A-Z list of migraine medications called Triptans, with my accompanying results.
From what I read they are all potent serotonin 5HT1 agonists:
• Almotriptan (Axert®)
• Eletriptan (Relpax®)
• Frovatriptan (Frova®)
• Naratriptan (Amerge®, Naramig®) seems to be working the best for me long term.
• Rizatriptan (Maxalt®) is available as a rapidly dissolving tablet. This one is nice it just dissolves and tastes like peppermint. Fantastic for those of us who experience nausea as a symptom. However, it was not long enough acting for my long episodes, so I felt I had to take too many for just one migraine. And waiting to take more in the recommended time ironically resulted in more nausea and vomiting.
• Sumatriptan (Imitrex®, Imigran®) is available in self-injection form, nasal spray and rapidly dissolving tablets. I found this tablet really strong. I felt like I was having a heart attack. But it aborted the migraine and boy did I feel euphoric after that.
• Sumatriptan and Naproxen Sodium (Treximet™) contains both Sumatriptan and Naproxen sodium which is a non steroidal anti-inflammatory drug (NSAID). There are strong warnings that this may increase the chance of a heart attack or stroke, and this chance increases with longer use of NSAID medicines.
• Zolmitriptan (Zomig®) available in tablets and nasal spray. Too strong for me! I experienced hot flushes and heart attack like side effects.
Some common side effects of these Triptans - and these are only a few - are: high cholesterol, heart disease, increased susceptibility to strokes, uncontrolled hypertension and diabetes. I recommend getting the complete print out from your Pharmacist as there are contra indications with other medications like ergotamine and selective serotonin re-uptake inhibitors (SSRI's).
3. Ergotamine Medications
Ergot Alkaloids relieve migraine or cluster headache symptoms by stimulating the chemical serotonin which is needed to transmit various nerve signals to the brain.
It decreases inflammation and reverses blood vessel dilation surrounding the brain.
Here are just a few to add to the list of migraine medications:
• Dihydroergotamine (DHE-45) is available by self injection and as a nasal spray called Migranal.
• Methysergide (Sansert)
• Ergotamine Tartrate (Bellamine, Cafergot, Ergostat)
Ergotamine preparations are no longer available here in Australia, so they may not be in other countries either. Ergotamine is the oldest "first line" of treatment and it is also known to have more severe side effects.
Watch out for stomach or chest pain, tingling in your fingers and toes, blurred vision or any weakness experienced in your limbs. Please note - these drugs must not be taken for prolonged periods over weeks or months due to these high risks.
My body severely rejected
Cafergot on a number of occasions. The suppository made me vomit almost
instantly for hours. So much for that! This was not a good medication
for me. I wish you better luck with this one. My doctor takes this for her migraines because of its track record of successes.
4. Other Medications Recommended for Acute Migraine Attack Treatment
• Acetaminophen – isometheptene - dichloralphenazone (Midrin®). This combination constricts blood vessels, is a pain reliever and a mild sedative.
According to the National Headache Foundation there is some research that shows this is not “usually” an effective treatment for migraine headache and it is subject to additional rebound headaches if you take it too often. Only occasional use for mild migraine headaches is recommended. Personally, I would not add this one to my list of migraine medications.
• Corticosteroids may be used due to their anti-inflammatory effects.
• Other alternative medical treatments that have proven useful using medications belonging to the group of Phenothiazines are non-analgesic options for treating severe migraine headaches and for attacks lasting more than 24 hours (called status migraine).
• And the approved over-the-counter medications listed above.
**Please note that the medications can have very different names in different countries. And note that ALL medications on this list of migraine medications have side effects. Please treat them, yes even natural herbs and supplements, with care and caution. Always check with your Doctor first before taking anything. Develop a treatment plan ahead of time to manage your attacks.
I told you the list of migraine medications was long, I hope you are not overwhelmed yet. So please keep reading ...
The goal of preventative treatment medications is to lessen the frequency and severity of the migraine attacks.
The FDA has approved
four drugs for migraine prevention – these are considered the “first
line” of treatment medications:
o Divalproex sodium (Depakote®)
o Propranolol (Inderal®)
o Timolol (Blocadren®)
o Topiramate (Topamax®)
is essential that you take the adequate dose of the medicine for a
sufficient length of time in order to determine its effectiveness for
your migraine. You may need to reduce the dose if you are experiencing
side effects. This is called “Titration” and needs to be discussed with
Don't give up hope yet - here is the list of migraine medications for other alternatives for prevention if your migraines do not respond to the first line treatment of medications. Some of these include:
Tricyclic Antidepressants :
Amitriptyline (Elavil®, Endep®)
Nortriptyline (Pamelor®, Aventyl®)
Anti-seizure medications :
Sodium Valproate (Epilim®)
Valproic Acid (Depakote®)
Propranolol (Inderal®, Timolol®)
Calcium channel blockers :
Diltiazem ( Dilacor®)
Some drugs are used in the treatment for headaches but are not specific for migraines.
These include analgesics, narcotics, and barbiturates. Since they can be addictive, they are less desirable than specific headache drugs listed above.
A narcotic analgesic like Codeine (or Fioricet, or Tylenol#3) can also be used as a "backup" for the occasions when a specific drug does not work, assuming it works for you in the first place.
I hope you found this list of migraine medications helpful.
When I researched this area, I found some lists overwhelming. There are over 100 different migraine headache medications available on prescription and in some cases they have different names in different countries. These medications may not have passed through the most stringent clinical tests but they have been through randomized controlled clinical trials.
No matter what you read or what you decide to take as your migraine treatment, always consult your doctor first. Migraine is a serious medical condition and the medications used must not be taken lightly.
I am very skeptical of the Triptan drugs being sold over the internet.
Please feel free to click on this US pharmacy’s link where you can get your prescriptions refilled automatically (US only) and mailed out to you. They are reputable and reliable and have compounding services. Plus you can ask the pharmacists questions on-line in a 'chat' for free:
1. The National Headache Foundation (2011) Headache Topic Sheet: Migraine. www.headaches.org.
2. The U.S. Food and Drug Administration (2011) Patient Information Medication Guide: Treximet™ at: www.fda.gov/downloads/Drugs/DrugSafety/ucm089804.pdf.
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- my adaptation on Charles Barkley's quote
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