Moderate Migraine Headaches
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, may provide relief for sufferers of moderate migraine pain. Potential gastrointestinal side effects (i.e., upset stomach) may make use of these medications undesirable.
If NSAIDs are ineffective, triptans or ergotamines (specifically dihydroergotamine) may be recommended.
Triptans tend to be most effective at relieving migraine pain when they're taken at the beginning of an attack, before the pain becomes severe.
It's generally recommended that patients with nausea and vomiting use a nasal or injected form of triptan.
Ergotamines are sometimes used, often in conjunction with a medication that alleviates nausea, to treat moderate migraine pain.
Dihydroergotamine, which may be administered in inhalant, injectable, or intravenous (IV) form, is longer-acting than sumatriptan and is associated with lower rates of headache recurrence.
- Ergotamine overuse is associated with the potential for developing rebound headaches.
- The medication also carries the potential for addiction and, therefore, withdrawal symptoms when discontinued.
- Dihydroergotamine and other ergotamines should not be used on the same day because of the increased potential for side effects.
When initial drug therapy fails or patients have conditions that limit the use of certain medications, combination medications may be used to treat moderate migraine headache pain.
- Some combination preparations include acetaminophen with codeine; aspirin with codeine and caffeine; and aspirin with butalbital and caffeine (with or without codeine).
- Overuse of these combination drugs is discouraged because they are associated with the risk of developing medication-overuse headaches.
