| MIGRAINE AND HEADACHE TREATMENTS | |||||
|---|---|---|---|---|---|
| Generic | Strength | Brand | Form | Dose | |
| ANALGESIC + BARBITURATE | |||||
| acetamin– ophen |
325mg | — | Rx | caps, tabs | Adults: 1–2 tabs or caps every 4hrs as needed; max 6/day Children: Not established. |
| butalbital | 50mg | ||||
| caffeine | 40mg | ||||
| acetamin– ophen |
300mg | — | Rx | caps | Adults: 1–2 caps every 4hrs as needed; max 6 caps/day. Children: Not established. |
| butalbital | 50mg | ||||
| caffeine | 40mg | ||||
| acetamin– ophen |
325mg | — | Rx | tabs | Adults: 1–2 tabs every 4hrs; max 6/day. Children: Not recommended. |
| butalbital | 50mg | ||||
| ANALGESIC + BARBITURATE + OPIOID | |||||
| acetamin– ophen |
325mg | Fioricet w. Codeine |
CIII | caps | Adults: 1–2 caps every 4hrs as needed; max 6 caps/day. Children: Not established. |
| butalbital | 50mg | ||||
| caffeine | 40mg | ||||
| codeine phosphate |
30mg | ||||
| ANALGESIC + SALICYLATE | |||||
| acetamin– ophen |
250mg | Bayer Migraine Formula | OTC | caplets | Adults: 2 caplets with a glass of water; max 2 caplets/24hrs. Children: Not recommended. |
| aspirin | 250mg | ||||
| caffeine | 65mg | ||||
| acetamin– ophen |
250mg | Excedrin Migraine | OTC | caplets | Adults: 2 caplets with a glass of water; max 2 caplets/24hrs. Children: Consult physician. |
| aspirin | 250mg | ||||
| caffeine | 65mg | ||||
| BARBITURATE + SALICYLATE | |||||
| aspirin | 325mg | Fiorinal | CIII | caps | Adults: 1–2 caps every 4hrs as needed; max 6 caps/day. Children: Not established. |
| butalbital | 50mg | ||||
| caffeine | 40mg | ||||
| BARBITURATE + SALICYLATE + OPIOID | |||||
| aspirin | 325mg | Fiorinal w. Codeine |
CIII | caps | Adults: 1–2 caps every 4hrs as needed; max 6 caps/day. Children: Not established. |
| butalbital | 50mg | ||||
| caffeine | 40mg | ||||
| codeine phosphate |
30mg | ||||
| ERGOT ALKALOID | |||||
| dihydro– ergotamine mesylate |
1mg/mL | D.H.E. 45 | Rx | IM, IV, or SC inj | Adults: 1mL IV at 1hr intervals; max 2 doses/day. Or, 1mL IM or SC at 1hr intervals; max 3 doses/day. For all: max 6 doses/wk. Not for chronic use. Children: Not recommended. |
| 4mg/mL | Migranal | Rx | nasal spray† | Adults: 1 spray in each nostril, repeat 15mins later; max 6 sprays/24hrs and 8 sprays/wk. Children: Not recommended. |
|
| ergotamine tartrate |
1mg | — | Rx | tabs | Adults: 2 tabs at onset of attack, then 1 tab every ½hr if needed; max 6 tabs/attack, 10 tabs/wk. Children: Not recommended. |
| caffeine | 100mg | ||||
| ergotamine tartrate |
2mg | — | Rx | rectal supp | Adults: 1 supp rectally at onset of attack, then 1 supp after 1hr if needed; max 2 supps/attack, 5 supps/wk. Children: Not recommended. |
| caffeine | 100mg | ||||
| NON-STEROIDAL ANTI‑INFLAMMATORY (NSAID) | |||||
| diclofenac potassium |
50mg | Cambia | Rx | buffered pwd for oral soln* | Adults: Mix 1 packet (50mg) with 30–60mL of water only and drink immediately. Not interchangeable with other forms of diclofenac. Children: <18yrs: not recommended. |
| ibuprofen | 200mg | Advil Migraine | OTC | liq-filled caps | Adults: Usually 400mg once daily. Children: Not recommended. |
| 200mg | Motrin Migraine Pain | OTC | caplets | Adults: Usually 200–400mg once daily. Children: Not recommended. |
|
| SELECTIVE 5-HT1B/1D RECEPTOR AGONIST | |||||
| almotriptan (malate) |
6.25mg, 12.5mg | Axert | Rx | tabs | Adults: 6.25–12.5mg single dose; may repeat once after 2hrs; max 25mg/24hrs. Hepatic impairment, CrCl 10–30mL/min, or concomitant potent CYP3A4 inhibitors: initially 6.25mg once; max 12.5mg/24hrs. The safety of treating an average of more than 4 migraines over 30 days is not established. Children: Not established. |
| eletriptan HBr | 20mg, 40mg | Relpax | Rx | tabs | Adults: 20mg or 40mg once. May repeat once after 2hrs; max 80mg/day. The safety of treating an average of more than 3 headaches in a 30-day period has not been established. Children: Not established. |
| frovatriptan (as succinate) |
2.5mg | Frova | Rx | tabs | Adults: 2.5mg with fluids; may repeat once after 2hrs; max 7.5mg/24hrs. The safety of treating an average of more than 4 headaches in a 30-day period has not been established. Children: Not recommended. |
| naratriptan HCl | 1mg, 2.5mg | Amerge | Rx | tabs | Adults: 1mg or 2.5mg with fluids; may repeat once after 4hrs; max 5mg/24hrs. The safety of treating, on average, more than 4 headaches in a 30-day period has not been established. Mild-to-moderate renal/hepatic impairment: initially 1mg; max 2.5mg/24hrs. Children: Not recommended. |
| rizatriptan (as benzoate) |
5mg, 10mg | Maxalt | Rx | tabs | Adults: Initially 5 or 10mg; may repeat after 2hrs; max 30mg/day. Concomitant propranolol: 5mg; max 3 doses/day. The safety of treating, on average, more than 4 headaches in a 30-day period has not been established. Children: Not recommended. |
| 5mg, 10mg | Maxalt-MLT | Rx | ODT* | ||
| sumatriptan (as succinate) |
6mg/ 0.5mL |
Alsuma | Rx | soln for SC inj | Adults: One (6mg) dose SC to the lateral thigh or upper arm only. May repeat after 1hr; max two (6mg) doses in 24hrs. Children: Not recommended. |
| 4mg/ 0.5mL, 6mg/ 0.5mL |
Imitrex Injection | Rx | SC inj | Adults: 6mg SC (may start at lower dose if 6mg not tolerated). May repeat after 1hr; max two 6mg doses in 24hrs. Children: Not recommended. |
|
| 5mg/ spray, 20mg/ spray |
Imitrex Nasal Spray | Rx | nasal spray | Adults: 5mg, 10mg, or 20mg once. May repeat once after 2hrs; max 40mg/day. The safety of treating an average of more than 4 headaches in a 30-day period has not been established. Children: Not recommended. |
|
| 25mg, 50mg, 100mg | Imitrex Tablets | Rx | tabs | Adults: 25–100mg once, swallow whole with fluids as soon as possible after migraine onset; may repeat dose at intervals of at least 2hrs, max 200mg/day; or single-dose tablets up to 100mg/day if injection has been used. The safety of treating an average of more than 4 headaches in a 30-day period has not been established. Children: Not recommended. |
|
| 11mg | Onzetra Xsail | Rx | caps for nasal inh | Adults: 1 nosepiece (11mg) in each nostril (22mg total), using Xsail delivery device. May repeat once after ≥2hrs; max 44mg (4 nosepieces)/day or one dose of Onzetra Xsail and one dose of another sumatriptan product separated by ≥2hrs. The safety of treating an average of more than 4 headaches in a 30-day period has not been established. Children: Not established. |
|
| 3mg/0.5mL | Zembrace Symtouch | Rx | soln for SC inj | Adults: 3mg SC. May repeat after ≥1hr; max 12mg in 24hrs. May also be given ≥1hr after another sumatriptan product. Children: <18yrs: not recommended. |
|
| zolmitriptan | 2.5mg+, 5mg | Zomig | Rx | tabs | Adults: Initially 1.25–2.5mg; max recommended single dose: 5mg. If headache returns, may repeat after 2hrs; max 10mg/day. The safety of treating an average of more than 3 headaches in a 30-day period has not been established. Concomitant cimetidine: max single dose: 2.5mg, not to exceed 5mg in 24-hr period. Children: Not recommended. |
| 5mg/ spray |
Zomig Nasal Spray | Rx | nasal spray | Adults: 5mg once. If headache returns, may repeat once after 2hrs; max 10mg/day. The safety of treating an average of more than 4 headaches in a 30-day period has not been established. Children: Not recommended. |
|
| 2.5mg, 5mg | Zomig-ZMT | Rx | ODT* | Adults: Initially 1.25–2.5mg; max recommended single dose: 5mg. If headache returns, may repeat after 2hrs; max 10mg/day. The safety of treating an average of more than 3 headaches in a 30-day period has not been established. Concomitant cimetidine: max single dose: 2.5mg, not to exceed 5mg in 24-hr period. Children: Not recommended. |
|
| SELECTIVE 5-HT1B/1D RECEPTOR AGONIST + NON‑STEROIDAL ANTI‑INFLAMMATORY (NSAID) | |||||
| sumatriptan succinate/ naproxen sodium |
10/ 60mg, 85/ 500mg |
Treximet | Rx | tabs | Adults: 1 tab (85/500mg) once; may repeat once after 2hrs; max 2 tabs/day. Mild-to-moderate hepatic impairment: 1 tab (10/60mg)/day. The safety of treating an average of more than 5 migraines in a 30-day period has not been established. Children: <12yrs: Not established. 12–17yrs: 1 tab (10/60mg) once; max 1 tab (85/500mg)/day. The safety of treating an average of more than 2 migraines in a 30-day period has not been established. |
| NOTES | |||||
|
Key: ODT = orally disintegrating tablets; soln = solution; supp = suppositories; + = scored tablets *contains phenylalanine; †contains caffeine Not an inclusive list of medications, official indications and/or dosages. Please see drug monograph at www.eMPR.com, contact company for full drug labeling and/or consult your healthcare provider. (Rev. 4/2018) |
|||||
This article originally appeared on MPR
