Migraine Prescription Drugs

Many types of medicines can be used to treat or prevent migraine. For example, abortive medicines help stop migraine pain and its associated symptoms during a migraine attack. Preventive medicines reduce the severity or frequency of migraine attacks and may also reduce the need to take abortive treatments.¹

Over-the-counter (OTC) drugs can be purchased without a prescription however many migraine pain medicines require a prescription. Talk to your doctor about the risks and benefits of each medicine. They can help you decide on the best options for you.^1,2

Abortive prescription medicines for migraine

Abortive medicines relieve pain during a migraine attack. They are designed to stop symptoms. They work best when taken as soon as the head pain begins. Some patients also find taking their abortive during the first warning sign of migraine (ie. during the prodrome or aura symptoms). Several types of abortive medicines require a prescription.^1,3

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are used for mild to moderate migraine. They are often effective and have few side effects. with stomach upset being the most common. But they should not be taken long-term. Some NSAIDs are available over the counter. Prescription NSAIDs for migraine include:^1,3

• Naprosyn (naproxen sodium)
• Cambia® (diclofenac potassium)
• Cataflam® (diclofenac potassium)
• Indocin® (indomethacin)
• Elyxyb® (celecoxib)

Triptans

Triptans work by blocking pain pathways in the brain. They can relieve many symptoms of migraine. Prescription triptans include:^1,3-6

• Imitrex® (sumatriptan) tablets or nasal spray
• Maxalt® (rizatriptan) dissolving tablets
• Tosymra® (sumatriptan) nasal spray
• Symbravo® (meloxicam and rizatriptan) tablets

Ergots

Ergots are used for moderate to severe migraine. They work by blocking pain pathways in the brain. Prescription ergots include:^1,3-5

• DHE 45® (dihydroergotamine mesylate) injection
• Ergomar® (ergotamine tartrate) dissolving tablets
• Migranal®, Trudhesa® (dihydroergotamine mesylate) nasal spray

Ditans

Ditans are similar to triptans, but they do not constrict blood vessels. Ditans may be a better option for people with heart or blood vessel conditions. The only ditan approved to treat migraine is:^1,3-5

• Reyvow® (lasmiditan)

Gepants

Gepants are a group of medicines that block the action of calcitonin gene-related peptide (CGRP). CGRP is a protein that has been linked to migraine. When taken at the start of a migraine attack, gepants can reduce symptoms. Prescription gepants used as abortive medicines include:^1,3-5,7

• Nurtec ODT® (rimegepant) tablets
• Ubrelvy® (ubrogepant) tablets
• Zavzpret® (zavegepant) nasal spray

Anti-nausea drugs

Drugs that treat vomiting and nausea, called antiemetics, can help if a migraine causes vomiting or nausea. They are often taken along with pain relievers. Examples of anti-nausea drugs include:^1,3

• Compro® (prochlorperazine)
• Gimoti®, Reglan® (metoclopramide)

Preventive prescription medicines for migraine

Preventive medicines help reduce the frequency and severity of migraine attacks. Your doctor may prescribe this type of drug if you have severe symptoms that do not respond to abortive treatments or your migraine attacks are too frequent to take abortive treatments that often. Several types of preventive medicines require a prescription.¹

Beta-blockers

Beta-blockers are commonly used to treat high blood pressure. They also can be effective migraine preventive medicines. Prescription beta blockers used to prevent migraine include:^1,4,5,8

• Inderal®, InnoPran®, Hemangeol® (propranolol)
• Lopressor® (metoprolol)
• Timoptic® (timolol)

Calcium channel blockers

Calcium channel blockers are also often used to treat high blood pressure and may be used for migraine prevention. Examples used for migraine include:^1,4,8

• Calan®, Verelan® (verapamil)
• Procardia®, Afeditab® (nifedipine)

Antidepressants

Antidepressants are generally used to treat mental health conditions. But they also can be effective migraine prevention drugs. Tricyclic antidepressants (TCA) are the most common type prescribed for migraine. TCAs used to prevent migraine include:^1,4,8

• Amitriptyline
• Pamelor® (nortriptyline)

A type of antidepressant called a serotonin and norepinephrine reuptake inhibitor (SRNI) is also sometimes prescribed to prevent migraine. These include:⁸

• Cymbalta® (duloxetine)
• Effexor® (venlafaxine)

Anti-seizure drugs

Some drugs that treat seizures, called anticonvulsants, can help prevent migraine if you have less frequent symptoms. Examples include:^1,4,8

• Depakote® (valproate)
• Topamax®, Topiragen® (topiramate)

Botox injections

Botox® (onabotulinumtoxin A) injections into various areas of the head and scalp every 3 months may help prevent migraine. Experts do not yet know exactly how Botox works to prevent migraine but think this treatment works by blocking the transmission of pain signals from nerves to the brain.^1,4,8

Gepants

While some gepants act as abortive medicines, certain gepants can help prevent migraine. These include:^1,4-8

• Nurtec ODT® (Rimegepant)
• Qulipta® (atogepant)

CGRP monoclonal antibodies

CGRP monoclonal antibodies are proteins designed to block the activity of CGRP. They are given by injection, often once a month. Examples of CGRP monoclonal antibodies include:^4,5,8

• Aimovig® (erenumab-aooe)
• Ajovy® (fremanezumab-vfrm)
• Emgality® (galcanezumab-gnlm)
• Vyepti® (eptinezumab-jjmr)

Other things to know

All drugs can cause side effects, and side effects can vary depending on the specific drug you are taking. Ask your doctor about the possible side effects of any migraine drug they prescribe.

Some treatments listed here are not approved by the US Food and Drug Administration to treat migraine. They may be approved for other conditions. Doctors may prescribe them “off-label” for migraine because there has been evidence in clinical trials that they prevent or relieve migraine symptoms.¹

The best source of advice about treating your migraine is your doctor or migraine specialist. Before beginning treatment for migraine, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.¹