Acute medicines

Acute treatment

• Simple painkillers can be bought over the counter from a pharmacy. These include paracetamol (also known as acetaminophen), aspirin, ibuprofen and codeine. Some products contain a combination of painkillers, perhaps even combined with something to stop you being sick (an anti-emetic).
• Overuse of these painkillers can sometimes cause a ‘rebound headache’. This is a headache which is actually caused by the painkiller, which is then relieved by taking more painkillers. You should talk to your doctor if you feel you may be using too many painkillers.
• If your attacks are more severe, you may require a prescription medication from your doctor.

Triptans

The introduction of a group of medicines known as the triptans in recent years has significantly improved the treatment of migraine.

• Triptans are an acute treatment specifically for migraine. Click here to see how triptans work. [Link to triptan MoA animation file.]
• There are a number of different triptans available:

• almotriptan
• eletriptan
• frovatriptan
• naratriptan
• rizatriptan
• sumatriptan
• zolmitriptan

• - These medicines are available in a range of different formulations, such as tablets, oral disintegrating tablets and wafers (both of which dissolve quickly in the mouth), nasal sprays, suppositories, and injections. You may find that one specific formulation will be best for you. Of all the formulations available, nasal sprays and injections provide the most rapid relief.
• Extensive research has shown that triptans are highly effective and well tolerated for the treatment of migraine. There is growing evidence that they are even more effective if you use them early in the migraine attack.

Other prescription products

Ergot alkaloids such as ergotamine and dihydroergotamine used to be commonly used to treat a migraine attack. These medicines act by narrowing (constricting) blood vessels in the brain. Many headache experts believe that ergotamine is less effective and is associated with more side effects than triptans.

If you are sick during a migraine attack, your doctor may prescribe something to stop you feeling sick (an anti-emetic) such as metoclopramide. It is important to realise that any medicine taken by mouth and swallowed may be less effective if you are sick within two hours of taking it. Nasal sprays, injections and tablets that dissolve quickly in the mouth may be of use if you experience sickness during an attack.