by EBSCO Medical Review Board

Here are the basics about each of the medicines below. All medicines can cause or worsen some headaches. Only common problems with them are listed.

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. Do not use them within 24 hours of taking ergotamine tartrate or similar medicine. Do not take with monoamine oxidase (MAO) inhibitors. Triptans should not be used in people who have uncontrolled high blood pressure, coronary artery disease, angina, liver disease, or neurovascular disease.

Problems may be:

  • Dry mouth
  • Headache
  • Nausea
  • Tiredness
  • A feeling of burning or tingling
Ergot-based Preparations (Ergotamine Tartrate)

Common names are:

  • Ergomar
  • Cafergot
  • Migergot

Ergotamine tartrate tightens blood vessels. It helps offset blood vessel widening during a migraine. Do not use within 24 hours of taking triptan drugs or serotonin agonists. Ergot preparations should not be used in people who have coronary artery disease, uncontrolled high blood pressure, kidney or liver disease, peripheral artery disease, or systemic infections.

Problems may be:

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

Common names are:

  • DHE 45
  • Migranal

Dihydroergotamine tightens dilated blood vessels. It is injected to prevent or stop a migraine. It should not be taken long-term.

Problems may be:

  • Nausea and vomiting
  • Feelings of coldness in the 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 are used to treat nausea and vomiting from migraines.

Problems may be:

  • Feeling tired
  • Lightheadedness
  • Dry mouth
  • Constipation
  • Nausea

Common names are:

  • Ubrogepant
  • Rimegapant

CGRP agonists are self-given injections.

Problems may be:

  • Tingling
  • Nausea
  • Headaches
  • Problems seeing
Over the Counter Medicine to Treat Migraines
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Common names are:

  • Naproxen sodium
  • Ibuprofen
  • Aspirin

These drugs should not be used in people with peptic ulcer disease, recent bleeding from the digestive tract, kidney disease, or heart disease. These drugs work to control pain and swelling.

Problems may be:

  • Gastrointestinal bleeding
  • Stomach upset
Analgesic Combinations
  • Excedrin Migraine—aspirin, acetaminophen, and caffeine
  • Advil Migraine—has ibuprofen
  • Motrin Migraine—has ibuprofen

These drugs work to control pain and swelling.

Problems may be:

  • Gastrointestinal bleeding
  • Stomach upset
  • Acetaminophen can cause liver problems if taken with alcohol

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.

Problems may be:

  • Lightheadedness
  • Feeling tired
  • Nausea and vomiting
Anti-Seizure Medicine

Common name: Valproic acid

Valproic acid may be used to prevent migraines. It should not be used by people with liver disease or those who are pregnant. Routine blood tests will be needed.

Problems may be:

  • Feeling tired
  • Nausea and vomiting
  • Liver and pancreas problems
  • Blood problems, such as excess ammonia
  • A risk of suicidal thinking and behavior
Topiramate

Common name: Topiramate

Topiramate may be used to treat migraines. It should not be stopped without talking to one's doctor first.

Problems may be:

  • Lightheadedness
  • Problems with coordination and focus
  • Feeling tired
  • Tingling in the fingertips and toes
  • Kidney stones
  • Glaucoma
Calcitonin Gene-Related Peptide Agonists (CGRP)

Common names are:

  • Erenumab-aooe
  • Freemanezumab
  • Galcanezumab

CGRP agonists are self-given injections.

Problems may be:

  • Tingling
  • Nausea
  • Headaches
  • Problems seeing

Other Medicine to Treat Migraines

Tricyclic Antidepressants

Common names are:

  • Amitriptyline
  • Nortiptyline

Antidepressants are given for their pain-relieving abilities. They should not be stopped without talking to one's doctor first. These drugs should not be used by people with glaucoma, those who are healing from a recent heart attack, or people who have used MAO inhibitors within two weeks.

Problems may be:

  • Blurred eyesight
  • Dry mouth
  • Lightheadedness
  • 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 the 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 that 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 headaches happen. 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.

Problems may be:

  • Upset stomach
  • Diarrhea
  • Vaginal yeast infection
Decongestants

Common names are:

  • Pseudoephedrine hydrochloride
  • Phenylephrine

Decongestants may be given to treat sinusitis. They open clogged nasal passages and let the sinuses drain. They should not be used longer or more often than advised. Overuse of decongestant nose sprays may increase swelling and make symptoms worse.

Problems may be:

  • Higher blood pressure
  • Anxiety
  • Rapid heartbeat

References

Cluster headache. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cluster-headache. Accessed March 9, 2022.

Headache information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Headache-Information-Page. Accessed March 9, 2022.

Migraine in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/migraine-in-adults. Accessed March 9, 2022.

Tension-type headache. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/tension-type-headache. Accessed March 9, 2022.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 11/2021
  • Update Date: 03/09/2022