Acute migraine remedy relieves ongoing migraine assaults and relieves ache, nausea, and photosensitivity. These embrace over-the-counter (OTC) painkillers, triptans, gepants, dihydroergotamine, steroids (often used for assaults that don’t reply to different remedies), and anti-nausea medicines.
Some are preventative. That’s, those that take them intention to cut back the variety of assaults and their severity. Individuals who have frequent or extreme migraine assaults that intrude with their day by day life could also be candidates for migraine prevention medicines.
Preventive medicines embrace antiepileptic medication, beta blockers, calcium channel blockers, CGRP monoclonal antibodies, and sure antidepressants. Discovering the preventative remedy that is best for you might require attempting completely different choices, and it might take a number of months earlier than your migraine assaults start to minimize. Decrease doses can scale back unwanted side effects and enable you to discover the remedy that is best for you.
over-the-counter painkillers
This class contains nonsteroidal anti-inflammatory medication (NSAIDs) similar to ibuprofen (Advil, Motrin), naproxen (Aleve), aspirin, and acetaminophen (Tylenol). A mixture drug containing aspirin, acetaminophen, and caffeine (Excedrin Migraine) could also be efficient in decreasing the ache related to delicate to reasonable migraines. Nonetheless, it’s not very efficient in opposition to heavy assaults.
In case your physician recommends merchandise containing NSAIDs or aspirin, these medication can have unwanted side effects similar to ulcers and gastrointestinal bleeding. Day by day use can result in drug overuse complications.
triptan preparations
Triptans are also called 5-HT1B/1D receptor agonists as a result of they block ache pathways within the mind by binding to particular serotonin receptors on neurons. Medical doctors usually prescribe them if different migraine remedies haven’t labored. Seven sorts of triptans can be found.
- Almotriptan (Accelto)
- Eletriptan (Relpax)
- Frovatriptan (Frova)
- Naratriptan (Amage)
- Rizatriptan (Maxalt)
- Sumatriptan (Imitrex)
- Zolmitriptan (Zomig)
Based on the On a regular basis Well being community website Migrene Once more, triptans are available in quite a lot of dosage types, together with oral tablets, nasal sprays, nasal powders, and injections. Parenteral strategies (nasal sprays or injections) are simpler for individuals who expertise migraine signs of nausea and vomiting as a result of the digestive system tends to perform poorly throughout assaults.
Widespread unwanted side effects of triptans embrace nausea, dizziness, drowsiness, muscle tingling, numbness, and weak spot. As a result of one of many actions of triptans is to constrict blood vessels, medical doctors don’t suggest triptans for people who find themselves at excessive danger of stroke or coronary heart assault or who’ve uncontrolled hypertension. Triptans will not be really helpful for some girls who’ve migraines with aura and are taking oral contraceptives.
Triptan plus NSAID
In January 2025, the U.S. Meals and Drug Administration (FDA) accepted a mix drug for the acute remedy of migraines containing the triptan rizatriptan and the NSAID meloxicam, which is primarily used for arthritis ache.
This new mixture drug is called Synbravo and is taken as a capsule.
Combining triptans and NSAIDs to alleviate migraines is nothing new, however Symbravo makes use of a brand new formulation of meloxicam that’s shortly absorbed and begins to take impact inside an hour. Rizatriptan can be fast-acting, nevertheless it wears off comparatively shortly. In distinction, the results of newer formulations of meloxicam final about 18 hours.
When used collectively, these two medication can present fast ache reduction that lasts for a lot of hours.
dewclaw
Ergot interacts with the identical mind receptors as triptans. Nonetheless, medical doctors usually prescribe triptans reasonably than ergot as a result of there may be rising analysis supporting their effectiveness in treating migraine assaults.
If triptans would not have the specified impact on ache, an ergot referred to as dihydroergotamine (Migranal, Trudhesa) could also be used. Dihydroergotamine is simplest when given intravenously (IV), however then it have to be administered by a well being care skilled. It will also be used as a self-injection or as a nasal spray.
armor
CGRP is a peptide (or brief chain of amino acids) discovered within the mind and nervous system that causes vasodilation and performs a job in transmitting ache. Research have proven that CGRP ranges within the blood and saliva improve throughout migraine assaults. CGRP antagonists, additionally referred to as “gepants,” stop CGRP from binding to receptors on numerous cell sorts within the mind. FDA-approved Gepants embrace:
- Atogepant (Qulipta)
- Rimegepant (Nurtech ODT)
- Ubrogepanto (Ubrelvi)
- greens
Completely different medication require completely different doses. For instance, atogepant is obtainable in doses of 10 milligrams (mg), 30 mg, and 60 mg. Zavgepant is a nasal spray that can be utilized as a single spray (10 mg) in a single nostril as wanted. Most dose inside 24 hours is one 10mg spray.
In 2023, atogepant was additionally accepted as a preventive remedy for power migraine primarily based on a examine that confirmed roughly 7 days fewer migraine days when taken at 30 mg twice a day or 60 mg as soon as a day for 12 weeks in comparison with a placebo.
antiemetic
In case your migraine assault contains nausea and vomiting, your physician might prescribe oral anti-nausea medicines (also called anti-emetics) for use with ache remedy. Antiemetics used to alleviate migraines embrace:
- Chlorpromazine
- Prochlorperazine (Compro)
- Metoclopramide (Reglan)
- Droperidol (Inapsin)
Metoclopramide will increase the contraction of muscle groups within the higher gastrointestinal tract, rising the speed at which meals within the abdomen strikes into the small gut. In distinction, chlorpromazine, droperidol, and prochlorperazine scale back nausea by blocking chemical substances within the mind related to vomiting.
antihypertensive medication
Folks usually use beta-blockers to handle hypertension and coronary artery illness, nevertheless it’s additionally frequent for medical doctors to prescribe beta-blockers to forestall migraine assaults. These beta blockers could also be useful in treating migraines.
- Propranolol (Inderal LA or Innoplan XL)
- Metoprolol tartrate (Lopressor)
- Timolol (vetimol)
Extra analysis is required to know how beta blockers work in individuals with migraine.
Potential unwanted side effects embrace despair, insomnia, nausea, and excessive fatigue.
Calcium channel blockers are one other blood stress remedy that will assist stop migraine assaults. One frequent instance is verapamil (Calan, Verelan).
antidepressants
Tricyclic antidepressants work by altering the degrees of serotonin and different chemical substances within the mind. So far, amitriptyline (Elavil) is the one tricyclic antidepressant confirmed to forestall migraine assaults. Nortriptyline (Aventil, Pamelol) can be efficient for some individuals. Negative effects embrace dry mouth, constipation, weight achieve, and sexual dysfunction.
antiepileptic drug
Sure anti-seizure or antiepileptic medication, similar to divalproex sodium (Depakote) and topiramate (Topamax), have been proven to cut back the frequency of migraine assaults. These can be found as tablets, capsules, and sprinkle capsules (capsules stuffed with small drug beads designed to be sprinkled on tender meals).
The precise mechanism by which these medication stop migraine assaults is unknown. Take them a couple of times a day.
Antiepileptic medication have severe unwanted side effects, together with nausea, fatigue, surprising weight adjustments, hair loss, dizziness, diarrhea, and problem concentrating. Medical doctors suggest not utilizing it in case you are pregnant or planning to turn into pregnant.
botox
The FDA has accepted onabotulinumtoxinA (Botox) for the remedy of power migraine in adults. Medical doctors inject the drug in about 31 locations on the brow and neck to cut back muscle contractions and block nerve ache indicators for about 12 weeks.
Botox injections can scale back the variety of migraine assaults by about half. It often causes neck ache as a short lived aspect impact, which can be relieved by making use of an ice pack.
Injections are given roughly each three months, and the results are solely felt after the second or third injection. Within the meantime, you possibly can take different migraine medicines with out the danger of dangerous interactions.
CGRP monoclonal antibody
CGRP monoclonal antibodies are laboratory-made proteins that particularly goal CGRP within the physique and scale back its results on ache and irritation.
CGRP antibody medication embrace the next:
- Eptinezumab (Viputi)
- Erenumab (Aimovig)
- Fremanezumab (Ajovy)
- Galcanezumab (Emgality)
CGRP monoclonal antibodies are a preventive remedy for migraine. A assessment of information revealed in 2023 concluded that it diminished the variety of migraine days in comparison with placebo in each episodic and power migraine. CGRP antibodies are administered both as an intravenous (IV) infusion as soon as each three months or as a month-to-month injection.
In August 2025, fremanezumab grew to become the primary FDA-approved drug in its class for kids ages 6 to 17 years.
Every monoclonal antibody carries a distinct danger of unwanted side effects. For instance, erenumab may cause constipation, ulcers, hypertension, and hair loss. Eptinezumab may cause an itchy throat and nasal congestion.
corticosteroids (steroids)
Medical doctors might prescribe steroid medication, similar to methylprednisolone or dexamethasone, to deal with migraines that haven’t responded to different remedies or that last more than 72 hours, a situation often called migraine standing epilepticus. Most research on steroids for migraine reduction present that these medication are most helpful for migraine prevention and relieve migraine assaults.
Medical doctors prescribe steroids, particularly dexamethasone, along with different sorts of migraine medicines, similar to triptans, to enhance ache reduction. Steroids could also be administered intravenously at a hospital or clinic. Steroids are solely appropriate for short-term use due to the danger of unwanted side effects similar to insomnia and excessive blood sugar.
Nerve blocks to cut back acute migraine ache
A nerve block entails injecting a small quantity of a numbing drug, similar to lidocaine or bupivacaine, into the bottom of the cranium, above the eyes, or on the temples to dam ache indicators from the nerves. Nerve blocks can present ache reduction inside minutes, and the results can final for days, weeks, and even months.
Your physician may also inject nerve blocks into set off factors in your fascia, which can scale back ache in these delicate areas. Myofascial set off factors are nodules in skeletal muscle groups which might be painful when stress is utilized and might trigger ache in different elements of the physique. In some individuals with migraines, urgent set off factors within the fascia can set off a migraine assault.
Emergency remedy for intractable migraine
Medical doctors often confer with extreme migraine assaults that final greater than 72 hours and don’t reply to common acute remedies as refractory migraine, or standing migraine. In these instances, further remedy within the emergency division is commonly needed. There, many medicines may be given intravenously to interrupt the headache cycle.
These medication might embrace the next sorts:
- antiepileptic drug
- triptan preparations
- NSAID
- steroid
- muscle relaxant
- antipsychotic medication
Intractable migraines may cause weak spot and anxiousness, and you could not be capable of assume clearly once you arrive on the ER. Think about asking your physician to put in writing and signal an emergency migraine remedy plan that you may take to the hospital or pressing care heart. This may enable you to entry the medicines which might be simplest for you.
Ideally, an emergency migraine remedy plan ought to embrace the next components:
- your prognosis
- Related info relating to medical historical past
- Physician’s suggestions for the most secure and simplest medicines for you
- Doctor signature and get in touch with info
