Some Medications Used to Treat Migraines
Type | Examples | Some Side Effects |
|---|---|---|
Prevention | ||
Divalproex Valproate | Hair loss, stomach upset, liver dysfunction, a tendency to bleed, tremors, and weight gain Not used in pregnant women with migraines | |
Topiramate | Weight loss, confusion, and depression | |
Atenolol Metoprolol Nadolol Propranolol Timolol | Spasm of the airways (bronchospasm), an abnormally slow heart rate (bradycardia), fatigue, insomnia, worsening of heart failure, and sexual dysfunction Changes in blood sugar levels (possibly making it difficult for doctors to know when blood sugar levels become too low in people with diabetes) With some beta-blockers, unfavorable effects on lipid (fat) levels | |
A botulinum toxin (used to block nerve activity) | OnabotulinumtoxinA | Neck pain and stiffness Weakness of muscles in the face and sometimes the neck |
Verapamil | Dizziness, low blood pressure, and weakness Constipation | |
Ditans* | Lasmiditan | Dizziness and drowsiness |
Monoclonal antibodies | Erenumab Fremanezumab Galcanezumab | Pain and irritation at the injection site and constipation Very rarely, allergic reactions |
Tricyclic antidepressants | Amitriptyline | Drowsiness, weight gain, increased heart rate, dry mouth, confusion, and constipation |
Treatment of severe migraines | ||
Antiemetic medications (used to relieve nausea) | Metoclopramide Prochlorperazine | Low blood pressure, drowsiness, involuntary movements, and muscle spasms |
Ergot derivatives | Dihydroergotamine | Medication overuse headache (rebound headache) if the medication is taken too frequently Nausea, vomiting, and minor muscle cramping Rarely, chest pain due to an inadequate blood supply to the heart muscle (angina) |
Gepants* | Rimegepant Ubrogepant | Minimal |
Triptans (5-hydroxytryptamine [5-HT], or serotonin, agonists) | Almotriptan Eletriptan Frovatriptan Naratriptan Rizatriptan Sumatriptan Zolmitriptan | Medication overuse headache if the medication is taken too frequently Flushing, tingling, dizziness, drowsiness, nausea, and a sense of pressure or pain in the throat or chest |
Codeine Meperidine Oxycodone | Medication overuse headache if the medication is taken too frequently Slowing of breathing, constipation, retention of urine, drowsiness, and nausea | |
Treatment of mild to moderate migraines | ||
Analgesics | Acetaminophen | Medication overuse headache if the medication is taken too frequently Occasionally rash |
Antiemetic medications | Metoclopramide Prochlorperazine | Low blood pressure, drowsiness, involuntary movements, and muscle spasms |
Nonsteroidal anti-inflammatory drugs (NSAIDs) | Aspirin Ibuprofen Indomethacin Ketorolac Naproxen | Medication overuse headache if the medication is taken too frequently Gastritis (inflammation of the stomach) and peptic ulcers With indomethacin, worsening of depression, seizures, and tremors with decreased mobility and muscle stiffness and, in older people, dizziness and confusion If ketorolac is overused, possibly impaired kidney function |
* Ditans can also be used to treat mild to moderate and severe migraines. | ||
† Opioids should be used as a last resort when migraines cause severe pain and other measures are ineffective. | ||