Acute or Abortive Medications for Migraines
- Take ASAP for max efficacy.
- Avoid using > 2 x / wk as can lead to overuse HA.
- Will develop “toolbox” of different medications for different presentations (mild/early vs. severe vs. refractory) with patient.
Over the counter
- NSAIDS: 1st line for mild to moderate headache. OTC medications: Ibuprofen (Motrin), Naproxen (Aleve).
- Combination treatment: Acetaminophen/ Aspirin/Caffeine (Excedrin Migraine) – 1st line for mild to moderate headache. OTC.
Prescription medications
- Acetaminophen 250 mg/aspirin 250 mg/caffeine 65 mg (Excedrin Migraine). Take 2 tablets PO x 1. (Maximum: 2 tablets per 24 hours) i.e. Excedrin Migraine two tablets daily.
- Triptans: Sumatriptan (Imitrex) 50-100 mg PO at first onset of headache; may repeat x 1 after 2 hr. Max 200 mg / 24 hr. OR
- Zolmitriptan 2.5 mg tablet, repeated in 2 hr if no relief; max dose 10 mg/24hr.