Migraine and Headache Treatments

MIGRAINE AND HEADACHE TREATMENTS
Generic Strength Brand Form Adult Dose
ANALGESIC + BARBITURATE
acetamin-
ophen
325mg Esgic Rx caps, tabs 1−2 tabs or caps every 4hrs as needed; max 6/day
butalbital 50mg
caffeine 40mg
acetamin-
ophen
300mg Fioricet Rx caps 1−2 caps every 4hrs as needed; max 6/day
butalbital 50mg
caffeine 40mg
acetamin-
ophen
325mg Phrenilin Rx tabs 1−2 tabs every 4hrs; max 6 tabs daily
butalbital 50mg
ANALGESIC + BARBITURATE + OPIOID
acetamin-
ophen
300mg Fioricet
w. 
Codeine
CIII caps 1−2 caps every 4hrs as needed; max 6/day
butalbital 50mg
caffeine 40mg
codeine
phosphate
30mg
ANALGESIC + SALICYLATE
acetamin-
ophen
250mg Bayer Migraine Formula OTC caplets ≥18yrs: 2 caplets with a glass of water; max 2 caplets/24hrs
aspirin 250mg
caffeine 65mg
acetamin-
ophen
250mg Excedrin Migraine OTC caplets ≥18yrs: 2 caplets with a glass of water; max 2 caplets/day
aspirin 250mg
caffeine 65mg
BARBITURATE + SALICYLATE
aspirin 325mg Fiorinal CIII tabs, caps 1−2 tabs or caps every 4hrs as needed; max 6/day
butalbital 50mg
caffeine 40mg
BARBITURATE + SALICYLATE + OPIOID
aspirin 325mg Fiorinal
w. 
Codeine
CIII caps 1−2 tabs or caps every 4hrs as needed; max 6/day
butalbital 50mg
caffeine 40mg
codeine
phosphate
30mg
ERGOT ALKALOID
dihydro-
ergotamine
mesylate
1mg/mL D.H.E. 45 Rx IM, IV, or SC inj 1mL IV at 1‑hr intervals; max 2 doses/day. Or, 1mL IM or SC at 1‑hr intervals; max 3 doses/day. For all: max 6 doses/wk. Do not use chronically.
4mg/mL Migranal Rx nasal spray 1 spray in each nostril, repeat 15min later; max 6 sprays/24hrs and 8 sprays/wk
ergotamine 
tartrate
1mg Rx tabs 2 tabs at onset of attack, then 1 tab every ½hr if needed; max 6 tabs/attack, 10 tabs/wk
caffeine 100mg
ergotamine 
tartrate
2mg Rx rectal supp 1 supp rectally at onset of attack, then 1 supp after 1hr if needed; max 2 supp/attack, 5 supp/wk
caffeine 100mg
NON-STEROIDAL ANTI‑INFLAMMATORY (NSAID)
diclofenac
potassium
50mg Cambia Rx buffered pwd for oral soln* ≥18yrs: Mix 1 packet (50mg) with 30−60mL of water only and drink immediately
ibuprofen 200mg Advil Migraine OTC liq-filled caps ≥18yrs: Usually 400mg once daily
200mg Motrin Migraine Pain OTC caplets ≥18yrs: Usually 200−400mg once daily
 
Generic Strength Brand Form Adult Dose
SELECTIVE 5-HT1B/1D RECEPTOR AGONIST
almotriptan
(malate)
6.25mg, 12.5mg Axert Rx tabs Children: Not established.
Adults: 6.25−12.5mg single dose; may repeat once after 2hrs; max 25mg/24hrs. The safety of treating an average of more than 4 migraines over 30 days is not established.
eletriptan HBr 20mg, 40mg Relpax Rx tabs ≥18yrs: 20mg or 40mg once. Reevaluate if no response. 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.
frovatriptan
(as succinate)
2.5mg Frova Rx tabs ≥18yrs: 2.5mg with fluids; may repeat once after 2hrs; max 7.5mg/24hrs. Reevaluate if no response after 1st dose. The safety of treating an average of more than 4 headaches in a 30‑day period has not been established.
naratriptan HCl 1mg, 2.5mg Amerge Rx tabs ≥18yrs: 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.
rizatriptan
(as benzoate)
5mg, 10mg Maxalt Rx tabs ≥18yrs: 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.
5mg, 10mg Maxalt-MLT Rx ODT*
sumatriptan
(as succinate)
6mg/
 
0.5mL
Alsuma Rx soln for SC inj ≥18yrs: One (6mg) dose SC to the lateral thigh or upper arm only. Reevaluate if no response. May repeat after 1hr; max two (6mg) doses in 24hrs.
4mg/
 
0.5mL, 6mg/
 
0.5mL
Imitrex Injection Rx SC inj ≥18yrs: 6mg SC (may start at lower dose if 6mg not tolerated). Reevaluate if no response. May repeat after 1hr; max two 6mg doses in 24hrs.
5mg/
 
spray, 20mg/
 
spray
Imitrex Nasal Spray Rx nasal spray ≥18yrs: 5mg, 10mg, or 20mg once. Reevaluate if no response. 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.
25mg, 50mg, 100mg Imitrex Tablets Rx tabs ≥18yrs: 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.
6mg/
 
0.5mL
Sumavel Dosepro Rx soln for SC inj ≥18yrs: One DosePro (6mg) SC to the abdomen or thigh only. Reevaluate if no response. May repeat after 1hr; max two DosePro (6mg) doses in 24hrs.
zolmitriptan 2.5mg+, 5mg Zomig Rx tabs ≥18yrs: Initially 1.25−2.5mg; max recommended single dose: 5mg. If headache returns, may repeat after 2hrs; max 10mg/day. Reevaluate if no response after 1st dose. 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.
5mg/
 
spray
Zomig Nasal Spray Rx nasal spray ≥18yrs: 5mg once. If headache returns, may repeat once after 2hrs; max 10mg/day. Reevaluate if no response after 1st dose. The safety of treating an average of more than 4 headaches in a 30‑day period has not been established.
2.5mg, 5mg Zomig-ZMT Rx ODT* ≥18yrs: Initially 1.25−2.5mg; max recommended single dose: 5mg. If headache returns, may repeat after 2 hrs; max 10mg/day. Reevaluate if no response after 1st dose. 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.
SELECTIVE 5-HT1B/1D RECEPTOR AGONIST + NON‑STEROIDAL ANTI‑INFLAMMATORY (NSAID)
sumatriptan
(as succinate)
85mg Treximet Rx tabs 1 tab once; may repeat once after 2hrs; max 2 tabs/day. The safety of treating an average of more than 5 migraines in a 30‑day period has not been established.
naproxen
sodium
500mg
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. These medications are not recommended for use in children. Please see drug monograph at www.eMPR.com, contact company for full drug labeling and/or consult your healthcare provider.

(Rev. 4/2015)

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