MSD Manual

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Some Drugs Used to Treat Migraines

Some Drugs 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

Gepants

Rimegepant

Ubrogepant

Minimal

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 drugs (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 drug is taken too frequently

Nausea, vomiting, and minor muscle cramping

Rarely, chest pain due to an inadequate blood supply to the heart muscle (angina)

Triptans (5-hydroxytryptamine [5-HT], or serotonin, agonists)

Almotriptan

Eletriptan

Frovatriptan

Naratriptan

Rizatriptan

Sumatriptan

Zolmitriptan

Medication overuse headache if the drug 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 drug 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 drug is taken too frequently

Occasionally rash

Antiemetic drugs

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 drug 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

* Opioids should be used as a last resort when migraines cause severe pain and other measures are ineffective.