When managing your triggers is not enough to control your symptoms, you may want to consider a medicine that will “calm down” your nervous system. They are designed to make subtle changes in how the nervous system transfers information and this can reduce the intensity, duration and frequency of pain and other unpleasant symptoms.

These recommendations are based on the strength of clinical trials studies and therefore you must understand that there are other medicines that may work but have not been studied thoroughly enough to be in the top two tiers of these guidelines. 

In other words, these guidelines list those medications that have been best evaluated and showed the greatest promise that they might work.
If you have:

Mild or infrequent symptoms

Start with over-the-counter (non-prescription) pain relievers

  • Acetaminophen (Tylenol and generics)

  • Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil and generics), or naproxen (Aleve and generics)

  • Combination products that contain acetaminophen, aspirin, and caffeine (Excedrin Extra Strength, Excedrin Migraine, and generics)

View the dosage information for mild or infrequent symptoms.

Moderate symptoms

  • Acetaminophen/Aspirin/Caffeine combination

  • Triptan

  • Ergot medicine such as dihydroergotamine (D.H.E. 45, Migranal), ergotamine (Ergomar, Cafergot, Migergot), dihydroergotamine (D.H.E. 45, Migranal), or methylergonovine (Methergine)

  • Acetaminophen/Isometheptene/Dichloralphenazone

View the dosage information for moderate symptoms.

Severe in pain intensity, and/or disrupt your life

  • Triptan, plus pain reliever

  • Triptan, plus anti-nausea medication (if nauseated)

  • Barbiturates

  • Intravenous medicines (available in emergency department or hospital)

View the dosage information for severe symptoms.

Do not use any of these medicines more than 15 days per month for three months. 

Caution: This information is NOT intended to endorse drugs or recommend therapy. Only your doctor can decide which medications are right for you. Never stop, start or change the way you use a prescription medicine without first consulting your doctor. Not all side effects are described. Call your doctor or consult your pharmacist for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.