Prescriptions Medications for Migraine Headaches

November 1, 2020

Migraine attacks can be debilitating and can last for days in a row. Signs and symptoms include

  • Severe headache, usually on one side of the forehead, often described as pounding or pulsating (but this can vary from person to person)
  • Nausea and vomiting
  • Impressions of light flashes
  • Sensitivity to light and sound

Lifestyle Prevention

Prevention of migraine attacks consists of avoiding triggers. Triggers may differ widely, but there are certain foods that are known to be common triggers:

  • Aged cheese
  • Avocados
  • Freshly baked bread
  • Raspberries
  • Champagne
  • Dark chocolate
  • MSG

Patients with allergies can get migraine attacks when exposed to the same allergens that cause their allergic reactions. Patients should watch for triggers when they get migraine attacks as triggers may be unique to individuals. A helpful tool would be keeping a food diary to figure out patterns.

Migraine Medications

Triptans relieve pain by blocking certain nerves. They work fast and well when taken as soon as migraine symptoms begin:

Imitrex, Tosymra (sumatriptan) is available in tablet, nasal spray, or injectable form. It is one of the most common migraine medications prescribed.

  • Tablets may be taken singly in doses of 25, 50, or 100 mg. The dose may be repeated after 2 hours, but not more than 200 mg in 24 hours.
  • Imitrex can be injected at a dose of 3 mg subcutaneously (just under the skin) and repeated 1 hour apart for a maximum of 4 injections per day.
  • Nasal imitrex may be sprayed once into each nostril or twice into one nostril, and repeated after 2 hours, not to exceed 8 sprays in 24 hours.

Maxalt (rizatriptan) is taken by mouth in a dose of 5 mg, which can be repeated in 2 hours, not to exceed 6 doses in 24 hours.

Calcitonin peptide gene receptor (cpgr) antagonists work by blocking a protein found in migraine patients. They should be taken as soon as migraine attacks start, for immediate relief:

  • Ubrelvy (ubrogepant) is taken as a 50 or 100 mg tablet, which may be repeated 2 hours after the first dose, not to exceed 200mg in 24 hours.
  • Nurtec ODT (rimegepant) is taken orally in tablet form. The 75 mg tablet dissolves on the tongue without added water. One tablet is all that is necessary in 24 hours. The safety of taking more than 15 tablets in 30 days has not been established.

Ditan is a new class of drugs with only one drug approved for use so far. It works by blocking a cranial nerve known as the trigeminal nerve, which send pain messages from the face to the brain.

  • Reyvow (lasmiditan) is taken orally at a dose of 50, 100, or 200 mg, after which patients should not drive or operate machinery for 8 hours. It is extremely costly as of yet. 


Preventive Migraine Medications

  • Topamax (topiramate) is believed to suppress multiple areas in the brain involved with migraine attacks. It is taken orally in a dose of 25 to 100 mg per day.
  • Aimovig (erenumab-aooe) is a cpgr antagonist given as an injection under the skin once a month.

Did you know? QuickMD can prescribe migraine medications online or refill your migraine prescription. No need to leave the house—especially while suffering from a migraine headache.

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