Migraine drugs are designed to work either as abortives or as migraine prevention for those who have chronic migraine or another headache disorder.
Abortive migraine medications are intended to alleviate a migraine or cluster headache after it comes on.
Preventive medications (and tools like migraine glasses) are designed to help prevent further attacks, reducing their frequency.
This article will focus on abortive migraine medications. We’ll talk about your options, how abortive migraine drugs work, and the potential side effects. Being familiar with these abortive treatments can help you be prepared when a migraine attack hits.
What are Abortive Migraine Medications?
Abortive migraine medications are sometimes called “acute” rather than abortive, but it means the same thing. Whatever you call them, they’re taken during an active migraine headache.
As an acute migraine treatment, migraine abortives are targeted at relieving your migraine symptoms. They are designed to work during the attack. The sooner after onset you can take them, the more effective they’ll be.
A doctor may give a patient a specific type of abortive medication, depending on their symptoms and severity. Abortive migraine medications may alleviate your pain, nausea, dizziness or other symptoms of migraine or vestibular migraine. But as an abortive treatment, they aren’t designed for migraine prevention.
Abortive Migraine Medications and Potential Side Effects
Abortive migraine drugs are available either over-the-counter or by prescription. Let’s look at the different abortive treatment options and the side effects you could experience.
Over-the-counter abortive medicines for migraine include several names you already know:
- Ibuprofen (Motrin or Advil)
- Naproxen (Aleve)
- Acetaminophen (Tylenol)
- Combination of acetaminophen, aspirin, and caffeine (Excedrin Migraine)
With the exception of caffeine, the drugs above are all commonly called NSAIDs, or non-steroidal anti-inflammatory medicines. They fight pain by targeting inflammation. When a migraine comes on, a lot of migraineurs will take these as their first-line of migraine treatment. They’re inexpensive and easy to find.
But just because they’re convenient doesn’t mean they don’t have side effects. Be careful to follow the directions and stick with the amount recommended on the label. But even then, there could be some consequences.
These may cause nausea or sour stomach, and diarrhea – probably last on your list of preferred ‘extras’ during a migraine headache.
Some may experience an allergic reaction. Liver damage is a rare side effect, but becomes more of a risk if you take too much.
Caffeine may produce nausea, nervousness, dizziness, and irregular heartbeat, particularly in the higher doses you could get from pills or energy drinks.
These drugs may help with mild or even moderate migraine pain. However, they usually aren’t as effective as abortive migraine medications prescribed by a doctor. So let’s talk about those next.
While we’re talking about NSAIDs, we’ll mention a few which are available as prescribed abortive migraine medications. These include:
- Diclofenac (i.e. Voltaren)
- Ketorolac (i.e. Toradol)
- Piroxicam (i.e. Feldene)
While these drugs are stronger than your typical OTC NSAID medications, they work in a similar way, by targeting inflammation to alleviate pain.
Prescription NSAIDs have similar side effects to OTC NSAIDs. But there are potentially a handful of extra side effects, including:
- Abdominal pain
- Bleeding gums
- Bloody stools
Other Prescription Abortive Medications
There are a number of non-NSAID abortive medications for migraine available by prescription. These drugs may not be an appropriate migraine treatment if you have certain health conditions like high blood pressure, kidney disease, and more. Talk to a doctor familiar with your health history about these and other abortive treatment options.
Prescription abortive migraine medications are available in a few different classes; we’ll tackle one class at a time.
Triptans work by increasing serotonin in the brain, constricting blood vessels, and countering inflammation. Depending on the drug, they may be taken in pill form, nasal spray, or injection. FDA approved triptans for migraine include:
- Sumatriptan (Imitrex)
- Naratriptan (Amerge)
- Almotriptan (Axert)
- Rizatriptan (Maxalt)
- Eletriptan (Relpax)
- Zolmitriptan (Zomig)
- Frovatriptan (Frova)
Taking triptans could cause some of the following common side effects:
- Muscle aches and pains
- Heavy feeling in the limbs
- Tightness or pressure in the throat, jaw, or chest
Ergotamines (also called ergot derivatives) are classified as abortive migraine medications, but aren’t typically used as a first-line treatment. They are not for daily use, but could be prescribed if the triptans or OTC drugs you’ve taken haven’t been effective. Like triptans, they may come in pills, injections, or nasal sprays. Ergotamines include:
- Dihydroergotamine (Migranal)
- Ergotamine tartrate
Some potential side effects of ergotamines are:
- Abdominal and leg cramps
- Chest pain
- Tingling or numbness in hands or feet
Also known as Reyvow, lasmiditan is an abortive migraine medication the FDA approved in late 2019 . Since it’s relatively new, some may not be familiar with it. It comes in pills or capsules.
Lasmiditan could bring on a few side effects, including:
- “Pins and needles” feeling in the body (paresthesia)
- Tiredness or fatigue
- Muscle weakness
Also FDA-approved in late 2019, ubrogepant pills or capsules is another abortive migraine medication some haven’t heard of yet.
The most common side effects of ubrogepant include:
- Dry mouth
Another prescribed abortive migraine drug is an isometheptene compound often called by the brand name Midrin . It’s a combination of acetaminophen, isometheptene, and dichloralphenazone. It’s used for both migraine and tension headaches.
The most common side effect of this medication is drowsiness. Less common side effects could include:
- Rapid or irregular heartbeat
- Tarry stools
- Blood in urine or stools
- Skin rash
- Hives or itching
- Sore throat
- Unusual bruising or bleeding
- Yellowing of skin or eyes
These side effects are in addition to the potential side effects of acetaminophen.
Antiemetics are often simply called anti-nausea medications. Since migraines frequently bring nausea with them as a second uninvited guest, antiemetics are often used as an abortive migraine medication to alleviate that symptom.
Antiemetics could be used in conjunction with an OTC or prescription abortive. Examples include:
- Chlorpromazine (Thorazine)
- Metoclopramide (Reglan)
- Prochlorperazine (Compazine)
Taking these anti-nausea medications has the potential to bring on certain side effects, such as:
In rare cases, a patient taking antiemetics could experience tremors or involuntary muscle movements or contractions.
Alternatives to Abortive Migraine Medications
Medications definitely have their place during a migraine. If you’re like most migraineurs, you’ll probably do just about anything to be more comfortable during a migraine attack. But you might also not be comfortable relying 100% on pharmaceuticals. Fortunately, there are some other things that can help during migraine attacks.
- Migraine glasses – Most migraneuers are light sensitive. Wearing Axon Optics migraine glasses could help you be more comfortable without sitting in a dark room or wearing sunglasses, which could dark-adapt your eyes and make your sensitivity worse. They can also help with migraine prevention.
- Cool packs – Putting an ice pack or cool compress on your head or neck could help numb the pain and make you more comfortable.
- Green light therapy – Green light is known for its soothing properties. In fact, migraine glasses don’t filter it out because it could actually help you feel better.
Read this article on our blog for more information about migraine relief products that could help you during an attack. With a variety of tools at your disposal, you may be able to reduce your dependence on abortive migraine medications.