Table 4 Clinical stratification of acute specific migraine treatments

Clinical situation

Treatment options

Failed analgesics/NSAIDs

First tier

* Sumatriptan 50 mg or 100 mg p.o.

* Rizatriptan 10 mg p.o.

* Almotriptan 12.5 mg

* Zolmitriptan 2.5mg p.o.

Early nausea or difficulties taking tablets

Headache recurrence

Tolerating acute treatments poorly

Early vomiting

Menstrually related headache

Slower effect/better tolerability

* Naratriptan 2.5 mg

* Frovatriptan 2.5 mg

Infrequent headache

* Dihydroergotamine nasal spray 2 mg

Sumatriptan 20 mg nasal spray Zolmitriptan 5 mg nasal spray Rizatriptan 10 mg MLT wafer Zolmitriptan 2.5 mg dispersible

Ergotamine 2 mg (perhaps most effective p.r./usually with caffeine) Naratriptan 2.5 mg p.o. Eletriptan 80 mg

Naratriptan 2.5 mg Frovatriptan 2.5 mg

Sumatriptan 25 mg p,r. Sumatriptan 6 mg s.c.


* Ergotamine p.o. nocte

* Estrogen patches


* Triptans

* Dihydroergotamine nasal spray

Very rapidly developing symptoms

Sumatriptan 6 mg s.c. Dihydroergotamine 1 mg i.m.

Stop Headache Drug Free

Stop Headache Drug Free

If you are suffering from headaches, you can make the pain stop just by following some basic but little known principles. Take 15 minutes browsing through this guide and you'll find dozens of tips to gain control in the battle against headache pain.

Get My Free Audio Book

Post a comment