Migraine attacks can last for hours—or even days. They can cause intense pain, nausea and vomiting. They can make you sensitive to light or noise and they can affect your life and work.

To treat migraines, you may be given a prescription for an opioid (narcotic) or a barbiturate (sedative) called butalbital. These are pain medicines. But you should think twice about using these drugs for migraine. Here’s why:

These drugs can make headaches worse.

Using too much pain medicine can lead to a condition called medication overuse headache (MOH). Two kinds of pain medicine are more likely to cause MOH:

• Drugs containing opioids—such as codeine (Tylenol-3 and generics), morphine (Statex and generics), Hycodan (5 mg) or oxycodone (Percocet and generics).
• Drugs containing butalbital (Fiorinal, Pronal, Trianal and generics).

Which drugs are good for migraines?

If you have migraine attacks, try one of the drugs listed below. They all work best if you use them when the migraine is just beginning.

1. Start with a non-prescription pain drug like acetylsalicylic acid (ASA), ibuprofen or acetaminophen. If these are not helpful, you can try other non-steroidal anti-inflammatory drugs (NSAIDs), some of which need a prescription, like diclofenac potassium and naproxen sodium.
2. If these drugs do not help, or your headaches are more severe, try one of the prescription migraine drugs called triptans, such as sumatriptan (Imitrex and generic).
3. If a triptan is helpful but not as effective as you would like, you may combine a triptan with an NSAID (take them simultaneously).
4. If the above options are not helpful, you can try dihydroergotamine nasal spray (Migranal). This drug works even better as an injection (Dihydroergotamine AMP and generic). You can do the injections yourself once you are trained.
5. If you have a lot of nausea with your attacks, all of the above medications can be combined with an anti-nausea medication, like metoclopramide.

For more information, visit www.migrainecanada.org.

Conditions: migraine attacks, headaches

Treatments: paikillers, analgesics, butalbital (Fiorinal, Pronal, Trinal, and generics), opioid painkillers, Codeine (Tylenol 3 and other brands and generics), Hycodon, Oxycodone (OxyContin, Percocet and others), Morphine, triptans, ASA, ibuprofen, acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), diclofenac , naproxen. sumatriptan, Imitrex, dihydroergotamine, Migranal, Dihydroergotamine AMP, metoclopramide