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Only the basic side effects are listed for each of the medicines below. Ask your doctor if you need to take any special steps. Use each of these medicines as advised by your doctor, or based on the instructions you were given. All medicines can cause or worsen some headaches. If you have questions about usage or side effects, call your doctor.

  Medicines to Treat Migraines

Prescription Medicine to Treat Migraines

Triptans (Serotonin Agonists)

Common names are:

  • Sumatriptan
  • Almotriptan
  • Naratriptan
  • Rizatriptan
  • Zolmitriptan
  • Frovatriptan

Triptans are drugs that act like a chemical in the brain called serotonin. It tightens blood vessels in the brain. These drugs should be taken at the first signs of migraine or cluster headache. Some are injectable and others are taken by mouth or by nose spray. Don't use them within 24 hours of taking ergotamine tartrate or similar medicine. Do not take with monoamine oxidase (MAO) inhibitors. Triptans shouldn't be used if you have uncontrolled high blood pressure, coronary artery disease, angina, liver disease, or neurovascular disease.

Some side effects are:

  • Dry mouth
  • Headache
  • Nausea
  • Tiredness
  • A feeling of burning or tingling

  Ergot-based Preparations (Ergotamine Tartrate)

Common brand names are:

  • Ergomar
  • Cafergot
  • Migergot

Ergotamine tartrate tightens blood vessels. It helps offset blood vessel widening during a migraine. Don't use within 24 hours of taking triptan drugs or serotonin agonists. Ergot preparations shouldn't be used if you have coronary artery disease, uncontrolled high blood pressure, kidney or liver disease, peripheral artery disease, or systemic infections.

Some side effects are:

  • Nausea and vomiting
  • Feelings of coldness in hands and feet
  • Weakness and pain in the leg muscles

Dihydroergotamine

Common brand names are:

  • DHE 45
  • Migranal

Dihydroergotamine tightens dilated blood vessels. It is injected to prevent or stop a migraine. Don't take this drug long-term. Tell your doctor right away if you have side effects.

Some side effects are:

  • Nausea and vomiting
  • Feelings of coldness in hands and feet
  • Weakness and pain in the leg muscles
  • Chest pain
  • Risk of heart attack and stroke

Phenothiazines

Common names are:

  • Prochlorperazine
  • Metoclopramide

Certain phenothiazines have been FDA-approved to treat nausea and vomiting from migraines.

Some side effects are:

Over the Counter Medicine to Treat Migraines

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Common names are:

  • Naproxen sodium
  • Ibuprofen
  • Aspirin

These drugs shouldn't be used if you have peptic ulcer disease, recent bleeding from the digestive tract, kidney disease, or heart disease. These drugs work to control pain and swelling. Some side effects are:

  • Rebound headache if the pain reliever is taken on a routine basis
  • Gastrointestinal bleeding
  • Stomach upset

Analgesic Combinations

  • Excedrin Migraine—aspirin, acetaminophen, and caffeine
  • Advil Migraine—has ibuprofen
  • Motrin Migraine—has ibuprofen

These drugs also work to control pain and swelling. Some side effects are:

  • Rebound headache if the pain reliever is taken on a routine basis
  • Gastrointestinal bleeding
  • Stomach upset
  • Acetaminophen can cause liver problems if taken with alcohol. Don't take more than the advised dose.

  Medicine to Prevent Migraines

Beta-Blockers

Common names are:

  • Propranolol
  • Metoprolol
  • Timolol

Beta-blockers are used to treat high blood pressure, but are also used to prevent migraines. They work by swaying the response to some nerves in parts of the body. They also lower the heart's need for blood and oxygen by reducing its workload.

Some side effects are:

  • Lightheadedness
  • Drowsiness
  • Nausea
  • Vomiting
  • Upset stomach

Anti-Seizure Medicine

Common name: Valproic acid

Valproic acid may be used to prevent migraines. Your doctor will order periodic blood tests to check drug levels and liver function. This drug shouldn't be used if you have liver disease. It shouldn't be used by women who are pregnant.

Some side effects are:

  • Sleepiness
  • Nausea and vomiting
  • Liver problems
  • Blood problems
  • Pancreatitis
  • Hyperammonemia
  • A risk of suicidal thinking and behavior

  Topiramate

Common name: Topiramate

Topiramate may be used to treat migraines. Don't stop taking this drug without talking to your doctor first.

Some side effects are:

  • Lightheadedness
  • Problems with coordination and focus
  • Tiredness
  • Tingling in the fingertips and toes
  • Kidney stones
  • Glaucoma

  Calcitonin Gene-Related Peptide Agonists (CGRP)

Common names: Erenumab-aooe, Freemanezumab

CGRP agonists are once monthly self-given injections.

Some side effects are:

  • Tingling
  • Nausea
  • Headaches
  • Problems seeing

  Other Medicine to Treat Migraines

  Tricyclic Antidepressants

Common names: Amitriptyline, Nortiptyline

Antidepressants are given for their pain-relieving abilities. Don't stop taking antidepressants without first checking with your doctor. These drugs shouldn't be used if you have glaucoma, are healing from a recent heart attack, or have used MAO inhibitors within 2 weeks.

Some side effects are:

  • Blurred eyesight
  • Dry mouth
  • Lightheadedness when standing up
  • Constipation
  • Lack of strength

Botulinum Toxin Injections

Botulinum toxin is made from a type of bacteria. It blocks the chemical signals from the nerves to muscles. This will lower the muscle contraction. Botulinum toxin injections can be used to prevent migraines. This may also help to lessen the length and strength of migraines if they do happen.

  Medicine to Treat Cluster Headaches

Many medicines may be given to treat cluster headaches. Examples are:

  • Oxygen therapy
  • Sumatriptan or other triptans
  • Octreotide given as an injection

  Medicine to Prevent Cluster Headache

Other medicines may be given to prevent or lower how often you have headaches. Examples are:

  • Intranasal civamide and capsaicin cream
  • Steroid injections
  • Verapamil
  • Lithium
  • Melatonin
  • Valproate or gabapentin
  • Topiramate
  • Baclofen
  • Prednisone
  • Clonidine

  Medicine to Treat Sinus Headache

Antibiotics

Common name: Amoxicillin

Antibiotics may be needed to treat a sinus infection caused by bacteria. Take with food to decrease stomach upset. Take all pills as advised. Do not stop taking the antibiotics even if you feel better.

Some side effects are:

  • Upset stomach
  • Diarrhea
  • Vaginal yeast infections

  Decongestants

Common names are:

  • Pseudoephedrine hydrochloride
  • Phenylephrine

Decongestants may be given to treat sinusitis. They open clogged nasal passages, letting the sinuses drain. Don't use these drugs longer or more often than advised. Overuse of decongestant nose sprays may increase swelling and make your symptoms worse.

Some side effects are:

  • Higher blood pressure and pulse
  • Anxiety
  • Rapid heartbeat

Special Considerations

If you are taking medicine:

  • Take your medicine as advised. Don't change the amount or schedule.
  • Ask what side effects could happen. Tell your doctor if you have any.
  • Talk to your doctor before you stop taking any prescription medicine.
  • Do not share your prescription medicine.
  • Medicine can be harmful when mixed. Talk to your doctor or pharmacist if you are taking more than one, including over the counter products and supplements.
  • Plan for refills.
REFERENCES:

Cluster headache. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116292/Cluster-headache. Updated February 16, 2016. Accessed January 9, 2019.

Dihydroergotamine. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T233099/Dihydroergotamine. Accessed January 9, 2019.

Headaches, migraine. EBSCO Nursing Reference Center website. Available at:https://www.ebscohost.com/nursing/products/nursing-reference-center. Updated December 14, 2018. Accessed January 9, 2019.

Migraine in adults. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114718/Migraine-in-adults. Updated November 8, 2018. Accessed January 9, 2019.

NINDS headache information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Headache-Information-Page. Updated July 13, 2018. Accessed January 9, 2019.

Sumatriptan. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T233503/Sumatriptan. Updated November 6, 2018. Accessed January 9, 2019.

Tension-type headache. EBSCO DynaMed website. Available at:http://www.dynamed.com/topics/dmp~AN~T114522/Tension-type-headache. Updated February 8, 2017. Accessed January 9, 2019.

Vikelis M, Spigos KC, et al. A new era in headache treatment. Neurol Sci. 2018;39(Suppl 1):47-58

4/23/2007 EBSCO DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114718/Migraine-in-adults: Brandes UK, Kurdrow D, Stark SR, et al. Sumatriptan-naproxen for acute treatment of migraine: a randomized trial. JAMA. 2007;297(13):1443-1454.

7/5/2007 EBSCO DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114718/Migraine-in-adults: Mannix LK, Loder E, Nett R, et al. Rizatriptan for the acute treatment of ICHD-II proposed menstrual migraine: two prospective, randomized, placebo-controlled, double-blind studies. Cephalalgia. 2007;27(5):414-421.

10/25/2010 EBSCO DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T116292/Cluster-headache: Francis GJ, Becker WJ, Pringsheim TM. Acute and preventive pharmacologic treatment of cluster headache. Neurology. 2010;75(5):463-473.

2/18/2011 EBSCO DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114773/Headache: Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.

3/3/2011 EBSCO DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114718/Migraine-in-adults: Chankrachang S, Arayawichanont A, Poungvarin N, et al. Prophylactic botulinum type A toxin complex (Dysport) for migraine without aura. Headache. 2011;51(1):52-63.

5/13/2013 EBSCO DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114718/Migraine-in-adults: US Food and Drug Administration. Valproate anti-seizure products contraindicated for migraine prevention in pregnant women due to decreased IQ scores in exposed children. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/ucm350684.htm. Updated May 13, 2013. Accessed November 18, 2013.

Last reviewed December 2018 by EBSCO Medical Review Board Rimas Lukas, MD  Last Updated: 1/7/2019