Migraine Medications: Rescue & Preventive Options to Discuss With Your Doctor

Written and verified by Holly Hazen

If you live with migraine, navigating the world of migraine medications can feel overwhelming. There are dozens of options, each with different purposes, side effects, and ways of taking them. But when you understand the main categories and how they fit into your treatment plan, you can have more productive conversations with your doctor and make more informed choices.

This page is your complete overview of migraine medications, from rescue treatments you take during an attack to preventive options that may reduce their frequency over time. You’ll also find links to detailed guides on each type of medication, so you can dig deeper into the ones your doctor recommends.

How Migraine Medications Are Categorized

When you and your doctor discuss migraine treatment, medications are usually grouped into two main categories:

• Acute (rescue) medications - taken during a migraine attack to stop or lessen the pain and other symptoms.

• Preventive medications -  taken regularly to reduce the number, severity, or duration of attacks over time.

You’ll also hear about:

Prescription vs. over-the-counter options. Some treatments require a doctor’s prescription, while others are available without one.

Migraine-specific vs. non-migraine medications. Certain drugs were developed specifically for migraine (like triptans), while others (such as beta blockers) were originally designed for other conditions but can help some people with migraine.

Tip: Keeping an organized record of the medications you’ve tried (and how they worked) can save you time and frustration at appointments. My Printable Migraine Medication List helps you track what’s working, what’s not, and what you want to discuss next with your doctor.

Acute (Rescue) Migraine Medications

Acute (also called rescue) migraine medications are designed to stop or reduce an attack once it starts. The goal is to act quickly, ideally at the very first signs of migraine, to minimize pain, shorten duration, and reduce related symptoms like nausea and sensitivity to light or sound.

Main categories include:

• Triptans - migraine-specific drugs that target serotonin receptors.

• Gepants - a newer class of CGRP receptor antagonists.

• Ditans - serotonin (5-HT1F) receptor agonists for those who can’t take triptans.

• Ergotamines - older migraine medications, sometimes used when triptans aren’t effective.

• NSAIDs & other pain relievers - can help in mild-to-moderate attacks, sometimes combined with caffeine.
  

Tips: Some acute medications come in nasal spray or injectable forms for faster relief - important if nausea or vomiting make swallowing tablets difficult.

When you’re in the middle of an attack, remembering medication names, doses, and timing can be almost impossible. I keep notes on a little recipe card, or you could use this form to get all the right details so you (or someone helping you) can act fast without scrambling for details.

Preventive Migraine Medications

Preventive (also called prophylactic) migraine medications are taken regularly, often daily or monthly, to help reduce the frequency, severity, or duration of attacks over time.

They are especially useful if you:

• Have frequent attacks (more than 4–5 days per month)

• Experience prolonged or disabling symptoms

• Cannot tolerate acute medications
  
  

Main preventives include:

• Beta blockers - e.g., propranolol, metoprolol (often first choice if no asthma or certain heart conditions)

• Anticonvulsants - e.g., topiramate, valproic acid (use with caution; can have cognitive or mood side effects)

• CGRP monoclonal antibodies - e.g., Aimovig (erenumab), Ajovy (fremanezumab), Emgality, Vyepti (injections or IV infusions, usually monthly or quarterly)
  

• Preventive gepants - e.g., atogepant (Qulipta), rimegepant (Nurtec ODT for prevention).

• Antidepressants - e.g., amitriptyline, venlafaxine.

Plan with precision: Preventive therapy works best when you and your doctor have a clear overview of what you’ve tried, what’s worked, and what hasn’t.

My Printable Migraine Medication List includes space for both acute and preventive options - helping you track results, side effects, and adjustments over time.

New Migraine Medications

The last few years have brought the biggest leap in migraine-specific treatments in decades.

These newer drugs target migraine mechanisms more directly than older “borrowed” medications, offering additional options for people who haven’t found relief with traditional therapies.

Key classes include:

• CGRP monoclonal antibodies (preventive) - Aimovig (erenumab), Ajovy (fremanezumab), Emgality (galcanezumab), and Vyepti (eptinezumab)

• Gepants (acute & preventive) - Nurtec ODT (rimegepant), Ubrelvy (ubrogepant), Qulipta (atogepant)

• Ditans (acute) - Reyvow (lasmiditan)

• New formulations of existing drugs - such as faster-dissolving triptans and nasal sprays
  
  

These drugs are not suitable for everyone, and some are still relatively new to long-term safety studies. Costs and insurance coverage can also vary.

Stay current, stay prepared! Migraine treatment options evolve quickly. What wasn’t available last year could be the best fit for you now.

My Printable Migraine Medication List includes the latest CGRP drugs, gepants, and ditans, so you can walk into your next doctor’s appointment with an up-to-date shortlist in hand.

Over-the-Counter Migraine Medications

For some people, over-the-counter (OTC) medications can be enough to ease mild to moderate migraine attacks, especially when taken early. While they’re widely available, OTC drugs still carry risks and may not be suitable for frequent use.

Common OTC options include:

• NSAIDs -  ibuprofen (Advil, Nurofen), naproxen (Aleve), diclofenac

• Acetaminophen (Paracetamol) - Tylenol, Panadol

• Combination analgesics - acetaminophen + aspirin + caffeine (e.g., Excedrin Migraine)
  
  

Important cautions:

• Regular use (more than 10–15 days per month) can lead to medication overuse headache (MOH)

• NSAIDs can cause stomach irritation, ulcers, or bleeding

• Acetaminophen in high doses can damage the liver

• Caffeine may worsen rebound headaches in some people
  
  

>> See more: Over the Counter Migraine Medication

Why include OTC meds in your plan?
Even if you rely on prescription options, OTC drugs may help for breakthrough attacks, or while you wait for prescriptions to be filled.

The Printable Migraine Medication List organizes OTC choices alongside prescription options, with space to note what you’ve tried and how well it worked.

Side Effects & Cautions

All migraine medications can cause side effects and the type, frequency, and severity vary widely depending on the drug class and your personal health profile. Always read the patient information leaflet and talk to your doctor or pharmacist about possible reactions.

Common side effects by drug class:

• Triptans (e.g., sumatriptan, rizatriptan) -  flushing, tingling, dizziness, tightness in chest or throat (not for people with certain heart or vascular conditions)

• Gepants (e.g., ubrogepant, rimegepant) - nausea, sleepiness, mild stomach upset, dry mouth (generally fewer cardiovascular concerns than triptans)

• Ditans (e.g., lasmiditan) - dizziness, fatigue, may impair driving for 8 hours, not habit-forming, but sedation is common

• Ergotamines - nausea, muscle pain, tingling in fingers/toes, risk of overuse headache, avoid in pregnancy

• NSAIDs & OTC Options (e.g., ibuprofen, naproxen) - stomach irritation, ulcers, kidney effects (use with caution if you have GI or kidney problems)

• Preventives (beta blockers, anticonvulsants, antidepressants, CGRP) - vary widely by class; may include weight changes, fatigue, mood changes, or low blood pressure
  
  

Special populations to discuss with your doctor:

• Pregnancy & breastfeeding - many migraine drugs are not recommended

• Children & teens - dosing and safety vary greatly

• Older adults - higher risk of side effects, more likely to have drug interactions

• Cardiovascular risk - some acute drugs (e.g., triptans, ergotamines) may be unsafe if you have heart disease or uncontrolled hypertension
  
  

Important: Overusing acute medications (even over-the-counter) can lead to medication overuse headache (MOH), which can make migraines more frequent and harder to treat.

Feeling Overwhelmed by Migraine Medications?

Don’t try to remember every option - take a clear, organized list to your next appointment.

Get my Printable Migraine Medication List - a 26-page, easy-to-use PDF that organizes:

• Over-the-counter options

• Rescue medications

• Preventives

• New treatments

• Side effects overview
  
  

Print it, mark your top choices, and work through them with your doctor.

>> Download your medication list for $4.99 ➜

Rescue Migraine Medications to Keep You Out of the ER

Sometimes a migraine attack escalates so fast or so severely that you may be tempted to head straight to the emergency room.

In many cases, having access to fast-acting rescue medications, prescribed and supervised by your doctor, can help you manage those severe attacks at home instead.

Important: These are not first-line treatments. They are typically used when standard acute medications (like triptans or NSAIDs) fail, or when symptoms are unusually intense. They require a prescription and a clear action plan from your doctor on when and how to use them safely.

So... work with your healthcare provider to identify which migraine medications are safe and effective for you and have them ready before you need them. Preparation can help you act faster, stay safer, and possibly avoid an ER visit.

Common Rescue Options

Discuss each of these with your doctor to see if they’re appropriate for you.

1. Injectable Triptans

Sumatriptan (Imitrex®) injection - works within minutes for many people. Ideal for attacks with vomiting or very rapid onset.

2. Nasal sprays

Triptans or dihydroergotamine for rapid absorption.

3. Dihydroergotamine (DHE)

Available as injection or nasal spray (Migranal®). Often used in ER settings, but some patients are prescribed home kits. Sometimes combined with anti-nausea medication

4. Steroids

Dexamethasone or prednisone may be given short-term to break a prolonged migraine cycle (status migrainosus). Not a long-term solution due to side effects.

5. Anti-nausea Medications (Injectable or Suppository)

Metoclopramide, prochlorperazine - can relieve nausea/vomiting and sometimes ease pain.

6. IV Infusion Cocktails (usually in clinic or ER)

May include magnesium sulfate, fluids, NSAIDs, antiemetics, and sometimes DHE. While you can’t self-administer these, some headache clinics offer urgent infusion appointments.

Why Have a Rescue Plan?

• Reduces risk of ER visits for severe attacks

• Gives you clear next steps when first-line medications fail

• Avoids medication overuse by keeping your plan structured and supervised
  
  

Tip: Keep your rescue medications ready and accessible at home, along with instructions from your doctor on when and how to use them.

If you need a complete printable checklist for all migraine medications - rescue, preventive, and over-the-counter >> download my 26-page Migraine Medication List here

The 10 Rescue Migraine Medications (A - Z)

Here’s a quickreference list of 10 injectable migraine medications your doctor might consider for severe or prolonged attacks.

1. Chlorpromazine (Thorazine, Largactil)

Class – Phenothiazine - antipsychotic and antihistamine. May relieve nausea/anxiety.

Some common side effects – agitation, constipation, dizziness, sedation, hypotension, restlessness causing a continuous need to walk or more commonly referred to as a shuffle. Tremor or twitching (dystonia) are considered to be serious side effects.

2. Dexamethasone

Class – anti-inflammatory, corticosteroid.

Brand names - Baycadron, Dexamethasone Intensol, DexPak 10 Day Taperpak, DexPak 13 Day Taperpak, DexPak 6 Day Taperpak, Dexpak Jr. Taperpak, Zema Pak 10-Day, Zema Pak 13-Day, Zema Pak 6-Day, and Decadron (this brand is no longer sold in the US, generic brands may be available).

Some common side effects: mood changes, acne, insomnia, headache, dizziness, increased sweating, nausea, vomiting, skin rash, easy bruising, muscle weakness, anxiety and depression.

Severe side effects are: GI bleeding, swelling and increased susceptibility to infections.

3. Droperidol

Class – sedative, anti-nausea, antidopaminergic, antiemetic, and antipsychotic.

Brand names - Droleptan, Dridol, Inapsine, Xomolix, Innovar (combination with fentanyl which is a narcotic analgesic).

This one seems to have the least amount of side effects listed. They include anxiety, drowsiness, hyperactivity, restlessness, depression (Dysphoria), hypotension, complete sedation, and some other things I cannot pronounce.

4. Dihydroergotamine + Prochlorperazine (DHE 45 + Compazine)

Class – ergotamine and antiemetic combo.

Brand name - D.H.E. 45 is Migranal and prochlorperazine is also called Compazine (first to combat nausea from DHE 45).

Some common side effects: abnormal skin sensations, anxiety, diarrhea, dizziness, headache, increased sweating and flushing, nausea and vomiting.

Some of the more severe allergic reactions are: temporary increasing or decreasing of your heart rate, itchy skin, chest pain or tightness, “swelling of the mouth, face, lips, or tongue”, breathing difficulties, muscle pain, numbness or weakness in your limbs, tingling in the fingers and toes, and itching at the injection site.

5. Magnesium Sulfate

Class – laxative, anticonvulsant; may help in certain migraine subtypes.

Brand names – Sulfamag, Epsom Salt.

NO common side effects have been reported.

There is a small list of the severe allergic reactions to watch for. These include irregular heartbeat, breathing difficulties, itchy skin rashes or hives, chest tightness, swelling of the mouth, face, lips, or tongue, dizziness, hot flushing, muscle weakness, fatigue, and increased sweating.

6. Methylprednisolone (Medrol)

Class – anti-inflammatory, corticosteroid; may reduce inflammation and recurrence risk.

Brand names – Medrol, Depo-Medrol.

Common side effects are acne, dry skin, and bruising, slow wound healing, increased sweating, nausea, sleep problems (insomnia), mood changes, stomach pain, and bloating.

7. Olanzapine (Zyprexa)

Class – atypical antipsychotic.

Brand names - Zyprexa, Zyprexa Relprevv, Zyprexa Zydis.

Common side effects: back pain, diarrhea, constipation, sore throat, tiredness, light headedness, headache, nausea, vomiting swelling at the injection site, increased appetite and weight gain.

8. Prochlorperazine (Compazine)

Class – anti-nausea, typical antipsychotic, antiemetic. Can relieve migraine-associated nausea and headache.

Brand names - Compazine, Compazine Spansule, Compro, Stemetil, Phenotil, Buccastem, Stemzine.

Common side effects are constipation; dizziness; drowsiness; dry mouth; agitation; nausea; and stuffy nose.

Some severe allergic reactions include: seizures, constipation, irregular heartbeat, itchy skin, difficulty breathing, chest pain or tightness, swelling of the mouth, hands, ankles, feet, face, lips, or tongue, decreased coordination of motor skills, drooling, feeling faint, muscle spasms and muscle weakness, numbness, prolonged or painful erection, trouble urinating, agitation, tremors or twitching movements, involuntary muscle movements. There’s more - unusual bruising or bleeding; and blurred vision or visual disturbances.

9. Sumatriptan (Imitrex)

Class – Triptan; works by narrowing blood vessels and reducing inflammation.

Brand names - Alsuma, Imitrex, and Sumavel DosePro.

Common side effects are abnormal skin sensations like burning, tingling or numbness; anxiety; dizziness; drowsiness; or the reverse feeling of heaviness and pressure. Muscle aches or cramps; nausea and vomiting; neck stiffness. You may also experience pain, swelling, bruising, or bleeding at the injection site.

Severe allergic reactions are: increased or decreased heart rate, breathing difficulties, seizures, dizziness, vomiting, skin rash or hives, chest pain or tightness, swelling of the mouth, face, lips, or tongue. You may experience: vision changes, wheezing, bloody diarrhea, confusion, fainting or fever, hallucinations, hearing problems, numbness or tingling of an arm or leg. But wait there’s more: one-sided muscle weakness; pain or pressure in the jaw, neck, or chest; severe or prolonged flushing, stomach pain, trouble swallowing; and very cold or blue fingers or toes.

10. Valproic Acid (Depacon)

Class - anti-seizure; sometimes used for migraine rescue.

Brand names - Depakene, Stavzor, Depacon or Depakon.

Common side effects: hair loss, tremors, diarrhea, constipation, diarrhea, dizziness, drowsiness, trouble sleeping, visual problems, weakness, stomach cramps, nausea, vomiting and indigestion.

When to Seek Emergency Care

Most migraine attacks, while painful and disruptive, are not life-threatening.

However, there are situations where you must treat the headache as a medical emergency, even if you’ve had migraines for years.

Call emergency services immediately (for example, 911 in the U.S.) if you experience:

• A sudden, severe "thunderclap" headache that peaks in seconds to minutes

• A headache that is significantly different from your usual migraine pattern

• Weakness, numbness, or paralysis on one side of your body

• Trouble speaking, understanding speech, or confusion

• Sudden vision loss, double vision, or difficulty moving your eyes

• Headache with fever, stiff neck, rash, or sensitivity to light (possible meningitis)

• Seizure or loss of consciousness

• Headache following a head injury

• New headache during pregnancy or postpartum period
  
  

Important: These symptoms may indicate a stroke, brain bleed, infection, or other serious condition, not just migraine. Never try to "tough out" a headache if it feels different from your usual migraine or comes with alarming symptoms. It’s better to get checked quickly.

Always err on the side of caution.

Tip: I keep a Migraine Emergency Info Card in my wallet with my diagnosis, medication list, and my doctor’s contact details. This ensures I get faster, safer care if I can’t communicate during an attack.

In Case of Emergency Phone Numbers

Just in case you have any of these serious side effects from migraine medications you have taken, or experience something out of the ordinary, then please call your local poison control center - in US at 1-800-222-1222 or your local emergency number in:

• Canada #911

• China #120
  

• US #911

• Europe #112

• Australia #000 (mobile #000 or #112)

• UK #999 or #112

• Mobile phones are preset to #112, #999, and #911 in most cases.
  

If you don’t know your local number, please click here for international emergency phone numbers, the information is from Wikipedia. It seems to be updated often and is current.

Tools to Work With Your Doctor

Finding the right migraine medication often comes down to clear communication and careful tracking. Your doctor will be better able to help you if you arrive prepared with accurate information about your attacks and treatment history.

Here are some practical tools that can make your appointments more productive:

1. Track your symptoms

Track frequency, triggers, duration, response to treatments.

Record each migraine’s start time, symptoms (before-during-after), suspected triggers, and medications taken. Note the time to the pain phase. Over time, patterns may emerge that guide both preventive and acute treatment choices.

Use my free migraine diary & tracker to record frequency, triggers, duration, and treatment response or even more detailed is my symptom tracker.

>> Get the Migraine Symptom Tracker here ➜

2. Bring a shortlist

Instead of asking your doctor "What should I take?", present your top two or three preferred medications you'd like to discuss (research them first). This allows you to focus on what’s realistic for your health profile, insurance coverage, and personal comfort.

3. Questions list

Before each appointment, write down your most important questions so you don’t forget them during the visit.

4. Have a rescue plan

Know what to do if first-line treatments fail.

5. Review your plan regularly

At least once a year or if your migraines change.

Why This Matters

By walking into your appointment with a clear record, realistic shortlist, and specific questions, you give your doctor the best chance of tailoring a treatment plan that works for you.

Pro Tip: Keep both your Medication List and Symptom Tracker in a folder or binder you can grab quickly if your migraine flares unexpectedly before an appointment.

Turn Your Migraine Research Into a Doctor-Ready Plan

Reading about migraine medications is one thing, presenting your options clearly to your doctor is another.

The Printable Migraine Medication List gives you:

• A full overview of migraine drug categories

• Space to track what you’ve tried

• A quick way to highlight your next 3 options
  
  

>> Download it instantly for $4.99 ➜

Make it easier on yourself. The printable list organizes all your current and potential medications (acute, preventive, and rescue) in one easy-to-use format. Just fill it in and bring it to your next appointment.

Resources & References

Medical References & Further Reading

I’ve gathered reputable, evidence-based sources so you can explore each medication class in more detail:

• American Migraine Foundation - Treatment Options

• Mayo Clinic - Migraine Treatments and Drugs

• National Institute of Neurological Disorders and Stroke - Migraine Information

• American Academy of Neurology - Migraine Guidelines

• FDA - Approved Migraine Medications
  
  

FAQ - Migraine Medications

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<sub>Migraine Medications References:
1. WebMD (2025) Dexamethasone [Online], Available at: https://www.rxlist.com/decadron-drug.htm Original Access June 12, 2016.
2. Drugs.com (2025) Prochlorperazine side effects [Online], Available at: https://www.drugs.com/sfx/prochlorperazine-side-effects.html 
3. Drugs.com (2025) Sumatriptan side effects [Online], Available at: https://www.drugs.com/sfx/sumatriptan-side-effects.html Original Access June 12, 2016.
4. FDA Drug Approval (2025) [Online], Available at: https://www.fda.gov/drugs Initial Access June 12, 2016.
Updated 18 August 2025.</sub>

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