How And When To Take It
Always follow your doctor’s instructions when taking this medicine.
Take your first dose as soon as the pain starts.
Do not take it at the warning stage, before your migraine starts. This is when some people get symptoms of “aura”.
Swallow the tablet whole with a drink of water. Do not chew or crush it.
If you find tablets difficult to swallow, some come with a line in the middle to help you break them in half. Check the information leaflet inside the medicine packet to see if you can do this with your medicine.
The usual dose is 50mg. But some people may be prescribed 100mg.
The tablets should work in 30 to 60 minutes. If your migraine improves but then comes back, you can take the same dose again after 2 hours.
However, if the first dose of sumatriptan does not help, do not take another dose for the same attack.
Read the instructions that come with your medicine to find out how to use the pre-filled syringe and how to get rid of it safely afterwards.
Use the pre-filled syringe to inject 1 dose. This contains 6mg of sumatriptan. You’ll usually inject it into your thigh.
The medicine generally works in 10 to 15 minutes.
If your headache improves but then comes back, you can inject another dose after 1 hour.
However, if the first sumatriptan injection does not help, do not have another one for the same attack.
Read the instructions that come with your medicine to find out how to use the single-use nasal spray. Each spray contains 1 dose .
Medications For Migraine Prophylaxis
SEEMA MODI, M.D., and DIONNE M. LOWDER, PHARM.D., B.C.P.S. Brody School of Medicine at East Carolina University, Greenville, North Carolina
Am Fam Physician. 2006 Jan 1 73:72-78.
Patient information: See related handout on migraine prevention, written by the authors of this article.
Sufficient evidence and consensus exist to recommend propranolol, timolol, amitriptyline, divalproex, sodium valproate, and topiramate as first-line agents for migraine prevention. There is fair evidence of effectiveness with gabapentin and naproxen sodium. Botulinum toxin also has demonstrated fair effectiveness, but further studies are needed to define its role in migraine prevention. Limited evidence is available to support the use of candesartan, lisinopril, atenolol, metoprolol, nadolol, fluoxetine, magnesium, vitaminB2 , coenzyme Q10, and hormone therapy in migraine prevention. Data and expert opinion are mixed regarding some agents, such as verapamil and feverfew these can be considered in migraine prevention when other medications cannot be used. Evidence supports the use of timed-release dihydroergotamine mesylate, but patients should be monitored closely for adverse effects.
SORT: KEY RECOMMENDATIONS FOR PRACTICE
First-line therapies for migraine prophylaxis in adults include propranolol , timolol , amitriptyline, divalproex , sodium valproate, and topiramate .
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Algorithm for pharmacologic migraine prophylaxis.
Medicines For Migraine Attacks In Children
Many of the medicines used by adults for migraine are not licensed for children. Paracetamol or ibuprofen is suitable and commonly used. Apart from these you must check with your doctor or pharmacist before giving a child any other medicine for migraine.
- Paracetamol or ibuprofen is suitable. Do not use aspirin.
- As regards anti-sickness medicines, domperidone is licensed for children of all ages, and prochlorperazine is licensed for children older than 12 years.
- Triptans are not licensed for children and so should not be used .
Don’t Miss: Migraines Side Effects
What Foods And Other Things Trigger Migraines
Many factors have been identified as migraine triggers.
- Normal hormone fluctuations, which occur with regular menstrual cycles, and some types of oral contraceptives
- Various foods such as:
- Moderate or severe pain intensity
- Aggravation by or causing avoidance of routine physical activity
Limit The Use Of All Pain Medicines
- Do not use prescription pain medicine for headaches for more than nine days in a month.
- Do not use non-prescription pain medicine for more than 14 days in a month.
This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
Don’t Miss: Migraine Medication Side Effects Weight Loss
There Are Three Different Classes Of Acute Migraine Medication:
These include over-the-counter pain relief medications, like ibuprofen and acetaminophen, as well as prescription pain relief medications, like opioids. Dr. Michael recommends over-the-counter analgesics for patients experiencing mild migraine symptoms.
These are migraine-specific medications. There are seven different triptans that are all available as tablets, while one is available as an injection, some as a nasal spray, and others as an oral dissolving tablet . Triptans, which have been specifically designed to treatment migraine, can be more effective for more moderate to severe migraine attacks or in those who have not responded adequately to analgesics, Dr. Michael says.
These drugs are not used commonly, and are typically reserved for patients who dont respond to analgesics or triptans, Dr. Michael says. Migranal and Ergomar are both ergot alkaloids. Dihydroergotamine is also used by specialists as an injection or intravenous infusion in patients with attacks that are not responsive to usual medications.
Acute medication should not be used more than 10 days per month, Dr. Michael says, or a patient will be at risk for medication-overuse headache, also known as rebound headache. Consult your health care provider or a headache specialist if you suspect that your current pain medicine is exacerbating your migraine symptoms.
There Are Three Categories Of Preventive Medication:
These drugs treat high blood pressure, as well as migraine. Beta blockers, calcium channel blockers and angiotensin receptor blockers are forms of antihypertensive drugs used for migraine prevention.
Certain anticonvulsants can prevent migraine. Topiramate is a commonly used anticonvulsant for migraine prevention.
In addition to treating depression, antidepressantssuch as amitriptyline and venlafaxinecan be an effective preventive treatment for migraine.
Recommended Reading: Tylenol For Migraines
What Is A Migraine With Aura
About a quarter of all migraines happen with auras. But you may not have one with every migraine. Some children and older adults may get an aura but no pain.
Though they can hurt a lot and make you feel “off,” these headaches aren’t life-threatening. There are things you can do as well as medications and devices that can treat the symptoms and prevent migraine with aura.
What is aura?
“Aura” is the term for any of the sensory changes that happen before a migraine headache. They can affect your vision, hearing, or ability to speak. You could also have muscle weakness or tingling.
What Is A Migraine Headache
Although the term “migraine” is often used to describe any severe headache, a migraine headache is the result of specific physiologic changes that occur within the brain, and lead to the characteristic pain and associated symptoms of a migraine.
Migraines usually are associated with sensitivity to sound, light, and smells. A migraine attack may be accompanied by nausea or vomiting. This type of headache often involves only one side of the head, but in some cases, patients may have pain bilaterally or on both sides. The pain is often described as throbbing or pounding and it may be made worse with physical exertion.
Not all headaches represent migraines, and migraine is not the only condition that can cause severe and debilitating headaches. For example, cluster headaches are very severe headaches that affect one side of the head in a recurrent manner . The pain is sometimes described as “drilling,” and can be worse than migraine pain in some cases. Cluster headaches are less common than migraine.
Tension headaches are a more common cause of headache. These occur due to contraction of the muscles of the scalp, face, and neck.
Don’t Miss: Side Effects Of Migraine Medicine
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.
Medicines Plus Behavioural Therapy
An interesting research study published in 2010 compared two groups of people who had frequent migraines. One group took a beta-blocker medicine alone. Another group took a beta-blocker but also had a course of behavioural migraine management . BMM included education about migraine, helping to identify and manage migraine triggers, relaxation techniques and stress management. After a number of months the group of people who took the beta-blocker plus BMM had, on average, significantly fewer migraines compared with the group who took beta-blockers alone. Further research is needed to confirm this and to look at BMM combined with other medicines to prevent migraine.
You May Like: Chills With Migraine
Which Medications Are Suitable For Children And Teenagers
Medications sometimes have different effects in children and teenagers than they do in adults. They need other doses, and some of the side effects are also different. The following medications have been approved in Europe for the treatment of migraines in children and teenagers:
- acetaminophen : for children ages 12 and up, also in combination with metoclopramide
- sumatriptan: as a nasal spray for children ages 12 and up
It’s not clear whether acetaminophen can relieve migraine symptoms in children and teenagers. Several studies show that ibuprofen can help relieve migraine attacks. There were no serious side effects in the studies involving children with migraines. Mild side effects like stomach ache were rare.
The sumatriptan nasal spray also helped relieve migraine attacks in children and teenagers. Mild side effects were more common though, such as an unpleasant taste or nausea.
Children and teenagers can also be prescribed medication that hasn’t been approved for their age group. This is known as “off-label use.” If your doctor prescribes a medication off-label, then he or she needs to explain why and tell you about the associated risks.
What Ingredients Should I Look For In Otc Migraine Medications
Pain is the main symptom of a migraine. You might also feel nauseous during migraines or notice changes in your vision, like seeing blind spots or flickering lights. For a mild, moderate, or even a severe migraine, there are several ingredients in OTC migraine products that can offer you sweet relief.
Recommended Reading: Migraine Killer Piercing
Migraine With Aura Prevention
If other treatments donât work and you have 4 or more migraine days a month, your doctor may suggest preventive medicines. You take these regularly to make migraines less strong or happen less often. These include seizure medicines, blood pressure medicines , and some antidepressants. A new class of preventive medicine called CGRP inhibitors may also help.
Your doctor can also prescribe a device, Cefaly, that uses a method called transcutaneous supraorbital nerve stimulation. You wear it as a headband on your forehead and turn it on daily for 20 minutes to prevent migraines.
Avoid your triggers. Common ones include:
- Certain foods
Botulinum Toxin Injections To Prevent Migraine
In July 2010 the Medicines and Healthcare products Regulatory Agency licensed the use of botulinum toxin injections for the prevention of migraine. This decision was based on research studies that seemed to show it to be an effective treatment at reducing the number of migraine attacks .
Treatment consists of up to five courses of treatment with botulinum toxin injections every 12 weeks. The injections are given into muscles around the head and neck. It is not clear how this treatment may work for migraine. Botulinum toxin relaxes muscles but it may also have some sort of action to block pain signals. The theory is that these actions may have an effect of stopping a migraine headache from being triggered.
In 2012, guidelines were issued by NICE on this treatment. NICE recommends botulinum toxin type A as a possible treatment for preventing headaches in some adults with persistent migraine. The criteria set down by NICE for people who may be considered for this treatment are:
- If you have chronic migraine and
- You have already tried at least three different medicine treatments to prevent your chronic migraine headaches, but these have not worked and
- You are not taking too many painkillers or using them too often.
Also, treatment should be stopped if:
How to use the Yellow Card Scheme
If you think you have had a side-effect to one of your medicines you can report this on the Yellow Card Scheme. You can do this online at www.mhra.gov.uk/yellowcard.
- The side-effect.
Recommended Reading: Sumatriptan And Pregnancy
Medicines For Migraine When Pregnant Or Breastfeeding
Many of the medicines used to treat migraine should not be taken by pregnant or breastfeeding women.
- For relief of a migraine headache:
- Paracetamol is the medicine most commonly used, as it is known to be safe during pregnancy.
- Ibuprofen is sometimes used but do not take it in the last third of the pregnancy .
- Aspirin – avoid if you are trying to conceive, early in pregnancy, in the third trimester and whilst breastfeeding.
- Triptans – should not be taken by pregnant women at all. Triptans can be used during breastfeeding, but milk should be expressed and discarded for 12-24 hours after the dose .
Check with your pharmacist or doctor if you are not sure.
Medicine For Migraine Onset
If migraines have already begun, its important to treat them as soon as possible. Earlier intervention is generally better for the overall outcome, reducing the severity of pain and duration of the attacks.
Several classes of drugs, both prescribed and over-the-counter, may be used to help ease symptoms.
Read Also: Migraine With Chills
Dealing With Nausea And Vomiting
Migraine attacks may cause a feeling of sickness or cause you to actually be sick . The nausea makes it harder for your body to absorb migraine tablets into your body. If you take painkillers, they may remain in your stomach and not work well if you feel sick. You may even vomit the tablets back. Tips that may help include:
- Use soluble painkillers. These are absorbed more quickly from your stomach and are likely to work better.
- As mentioned, one brand of diclofenac comes as a suppository. This may be useful if you usually vomit with a migraine.
- You can take an anti-sickness medicine in addition to painkillers. A doctor may prescribe one – for example, domperidone, prochlorperazine or metoclopramide.
- Like painkillers, anti-sickness medicines work best if you take them as soon as possible after symptoms begin.
- An anti-sickness medicine, domperidone, is available as a suppository if you feel very sick or vomit during migraine attacks.
- Prochlorperazine comes in a buccal form which dissolves between the gum and cheek. This can be useful if you feel sick and do not wish to swallow a tablet.
What Are The Side Effects
Side effects are rare since painkillers are usually only used for a short time in migraine treatment. In studies, ibuprofen caused stomach ache in less than 1 out of 100 people. Other drugs didn’t have any side effects. But taking painkillers may be a problem for people who already have certain conditions, such as kidney damage.
NSAIDs can also affect the stomach lining, so they aren’t suitable for people who have stomach ulcers. Acetylsalicylic acid can reduce the blood’s ability to clot, increasing the risk of bleeding. Usually the bleeding is slight, for instance a nosebleed or bleeding gums. In rare cases it may be more serious, for example in the gastrointestinal tract. High doses of NSAIDs can also increase the risk of complications in people who have cardiovascular disease.
Acetaminophen is not suitable for people with impaired liver function because it is broken down in the liver. At high doses it can even cause liver damage in people who are otherwise healthy. So it’s important not to exceed the maximum recommended daily dose.
Recommended Reading: Headache Medicine Liquid
Causes Of Migraine Headaches
Migraines are believed to arise from waves of increased activity in certain brain cells, which causes the release of the hormones serotonin and estrogen. As a result, blood vessels supplying the brain become narrowed, which leads to headache and the other symptoms.
While the exact reasons someone may develop migraines are unknown, several risk factors have been identified:
- Physical overexertion