Medications for Headache

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. Remember that all medications, including over-the-counter, can cause or worsen certain chronic headaches. It is important that you become aware of the alternative treatments, including stress management, which are an important part of treatment. If you have further questions about usage or side effects, contact your doctor.

Medications for Treating Migraines

Prescription Medications to Treat MigrainesTriptans (Serotonin Agonists)Common names include:
  • Sumatriptan
  • Almotriptan
  • Naratriptan
  • Rizatriptan
  • Zolmitriptan
  • Frovatriptan
Triptans are drugs that act similar to the brain chemical serotonin, which constricts blood vessels in the brain. For best results, these drugs should be taken at the first signs of migraine or cluster headache. Some are injectable and others are taken by mouth or by nasal spray. Do not use within 24 hours of taking ergotamine tartrate or similar medications. Do not take with monoamine oxidase (MAO) inhibitors.Triptans should not be used if you have uncontrolled high blood pressure, coronary artery disease, angina, severe liver disease, or neurovascular disease. Possible side effects include:
  • Dry mouth
  • Headache
  • Nausea
  • Tiredness
  • Sensation of burning or tingling
Ergot-based Preparations (Ergotamine Tartrate) Common brand names include:
  • Ergomar
  • Cafergot
  • Migergot
Ergotamine tartrate constricts blood vessels. It helps offset blood vessel widening during a migraine. Do not use within 24 hours of taking triptan drugs or serotonin agonists. Ergot preparations should not be used if you have coronary artery disease, uncontrolled high blood pressure, kidney or liver disease, peripheral artery disease, or severe systemic infections. Possible side effects include:
  • Nausea and vomiting
  • Feelings of coldness in hands and feet
  • Weakness and pain in the leg muscles
DihydroergotamineCommon brand names include:
  • DHE 45
  • Migranal
Dihydroergotamine constricts dilated blood vessels. It is injected to prevent or stop a migraine headache. Do not take this drug long-term. Notify your doctor right away if side effects occur.Possible side effects include:
  • Nausea and vomiting
  • Feelings of coldness in hands and feet
  • Weakness and pain in the leg muscles
  • Chest pain
  • Risk of heart attack and stroke
PhenothiazinesCommon names include:
  • Prochlorperazine
  • Metoclopramide
Certain phenothiazines have been FDA-approved for the treatment of nausea and vomiting associated with migraines.Possible side effects may include:Over-the-Counter Medications to Treat MigrainesNonsteroidal Anti-inflammatory Drugs (NSAIDs)Common names include:
  • Naproxen sodium
  • Ibuprofen
  • Aspirin
These drugs should not be used if you have peptic ulcer disease, recent bleeding from the gastrointestinal tract, kidney disease, or heart disease. These drugs work to control pain and inflammation. Possible side effects include:
  • Rebound headache if pain reliever is taken on a regular basis
  • Gastrointestinal bleeding
  • Stomach upset
Analgesic Combinations
  • Excedrin Migraine—contains aspirin, acetaminophen, and caffeine
  • Advil Migraine—contains ibuprofen
  • Motrin Migraine—contains ibuprofen
These drugs also work to control pain and inflammation. Possible side effects include:
  • Rebound headache if pain reliever is taken on a regular basis
  • Gastrointestinal bleeding
  • Stomach upset
  • Acetaminophen can cause liver problems if taken with alcohol. Do not take more than the recommended dose.

Medications for Preventing Migraines

Beta-BlockersCommon names include:
  • Propranolol
  • Metoprolol
  • Timolol
Beta-blockers are commonly used to treat high blood pressure, but are also used to prevent migraine headaches. Beta-blockers work by affecting the response to some nerve impulses in certain parts of the body. They also decrease the heart's need for blood and oxygen by reducing its workload.Possible side effects include:
  • Lightheadedness
  • Drowsiness
  • Nausea
  • Vomiting
  • Upset stomach
AnticonvulsantsCommon name: Valproic acidValproic acid may be used to prevent migraine headaches. Your doctor will order periodic blood tests to check drug levels and liver function. This drug should not be used if you have severe liver disease. This medication should not be used by women who are pregnant.Possible side effects include:
  • Sedation
  • Nausea and vomiting
  • Liver problems
  • Blood problems
  • Pancreatitis
  • Hyperammonemia
  • Increased risk of suicidal thinking and behavior
Topiramate Common name: TopiramateTopiramate may be used to treat migraine headaches. Do not abruptly discontinue this drug.Possible side effects include:
  • Lightheadedness
  • Problems with coordination and concentration
  • Fatigue
  • Tingling in the fingertips and toes
  • Kidney stones
  • Glaucoma

Other Medications for Treating Migraines

Tricyclic Antidepressants Common names: Amitriptyline, Nortiptyline Antidepressants are given for their pain-relieving abilities. Do not stop taking antidepressants without first checking with your doctor. These drugs should not be used if you have glaucoma, are recovering from a recent heart attack, or have used MAO inhibitors within 2 weeks. Possible side effects include:
  • Blurred vision
  • Dry mouth
  • Lightheadedness when standing up
  • Constipation
  • Weakness
Botulinum Toxin Injections Botulinum toxin is made from a type of bacteria. The toxin blocks the chemical signals from the nerves to muscles. This will decrease the muscle contraction. Botulinum toxin injections can be used to prevent migraines. This treatment may also help to decrease the duration and intensity of migraines if they do occur.

Medications for Treating Cluster Headaches

Many medications may be prescribed to treat cluster headaches. Examples include:
  • Oxygen therapy
  • Sumatriptan or other triptans
  • Octreotide given as an injection

Medications for Preventing Cluster Headache

Other medications may be given to prevent or reduce the frequency of headaches. Examples of these drugs include:
  • Intranasal civamide and capsaicin cream
  • Steroid injections
  • Verapamil
  • Lithium
  • Melatonin
  • Valproate or gabapentin
  • Topiramate
  • Baclofen
  • Prednisone
  • Clonidine

Medications for Treating Sinus Headache

AntibioticsCommon name: AmoxicillinAntibiotics may be ordered to treat a sinus infection caused by bacteria. Take with food to decrease stomach upset. It is important that you finish the complete course of therapy. Do not stop taking the antibiotics even if you feel better.Possible side effects include:
  • Upset stomach
  • Diarrhea
  • Vaginal yeast infections
Decongestants Common names include:
  • Pseudoephedrine hydrochloride
  • Phenylephrine
Decongestants may be given to treat sinusitis. Decongestants open clogged nasal passages, allowing the sinuses to drain. Do not use these drugs longer or more often than directed. Overuse of decongestant nose sprays may increase swelling and make your symptoms worse. Possible side effects include:
  • Increased blood pressure and pulse
  • Anxiety
  • Palpitations

Special Considerations

If your child is taking medication, follow these general guidelines:
  • Give your child the medication as directed. Do not change the amount or schedule.
  • Use the measuring device that came with the medication. If you need to use a spoon, cup, or syringe, make sure it has the units that match your child’s prescription. For example, if the medication is given in milliliters (mL), the device should have mL on it.
  • Ask what side effects could occur. Report them to your child’s doctor.
  • Talk to your child’s doctor before stopping any prescription medication.
  • Plan ahead for refills if your child needs them.
  • Do not share your child’s prescription medication with anyone.

References

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