A migraine cocktail is a combination of medications that people can take to treat severe migraine.
It may contain a combination of anti-inflammatories, drugs that alleviate nausea and vomiting, and medications that specifically target migraine. Doctors administer these medications in hospitals, although over-the-counter (OTC) migraine cocktails are also available.
In this article, we will look at migraine cocktails, their ingredients, potential side effects, OTC and homemade options, and other migraine treatments.
The term “migraine cocktail” is an informal way of describing the combination of medications doctors can administer to people in the hospital when they experience severe migraine.
If a person visits the emergency room (ER) with severe migraine symptoms, including intense pain, doctors will first rule out other conditions, such as a thunderclap headache. Then, they can provide several medications through an intravenous (IV) line.
How long it takes for a migraine cocktail to offer relief can vary from person to person. Doctors may add one medication at a time, but typically, they administer several at once, as research suggests this improves the outcome.
If the migraine cocktail does not appear to be working, doctors may try other medications, such as valproic acid,
Doctors can use a variety of drugs in migraine cocktails. The ones they choose may depend on a person’s symptoms and medical history.
A migraine cocktail from doctors in the ER may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications reduce inflammation, which contributes to pain and throbbing. Several NSAIDs are effective at treating acute migraine, but for a migraine cocktail, doctors may use ketorolac.
- Acetaminophen: This pain medication
can be usefulTrusted Source together with NSAIDs. However, doctors can only use acetaminophen if a person has not already taken some before heading to the ER. - IV fluids: People experiencing severe vomiting as a result of migraine can become dehydrated. Dehydration itself can also be a migraine trigger. In these cases, doctors may recommend IV fluids.
- Antiemetics: These drugs reduce symptoms such as nausea and vomiting. Doctors may also include the antihistamine diphenhydramine (Benadryl) to reduce the risk of side effects.
- Dexamethasone: This type of steroid medication reduces inflammation in the body. Research suggests that dexamethasone may help prevent migraine from coming back after initial treatment.
A 2022 study also suggests that magnesium, both in oral and intravenous (IV) form, may help prevent and treat migraine pain.
In severe cases where first-line treatments do not work, doctors may prescribe opioids.
Typically, people tolerate the medications in migraine cocktails well. However, some individuals may experience side effects.
The side effects of a migraine cocktail depend on the drugs it contains. The most common include:
| Drug type | Side effects |
|---|---|
| ketorolac | • headaches • dizziness • drowsiness • nausea • constipation |
| acetaminophen | • rash • itching • swelling |
| • mild headaches • dizziness • constipation | |
| • high magnesium levels • minor facial flushing and warmth • temporary low blood pressure | |
| dexamethasone | • indigestion • sleep problems |
Frequent or high doses of any of these medications may cause more severe adverse reactions or toxicity. In rare cases, people can also experience allergic reactions.
A person should tell a doctor if a migraine cocktail causes severe or prolonged side effects.
OTC migraine cocktails are also available for the treatment of mild to moderate migraine. These products
Aspirin and acetaminophen reduce pain and inflammation. Caffeine acts as a vasoconstrictor, which narrows the blood vessels to reduce pain.
This combination is highly effective in treating migraine pain. However, it is worth noting that for some people, caffeine can be a migraine trigger. It can also cause anxiety, agitation, and trouble sleeping.
According to the American Migraine Foundation, taking OTC migraine medications too frequently can cause medication overuse headaches and reduce how effective they are.
If a person takes OTC migraine cocktails more than 2–3 times per week, they should speak with a doctor or migraine specialist. People should also check if it is OK to take these products if they are pregnant, breastfeeding, taking other medications, or have any other underlying conditions.
A migraine cocktail can be an effective treatment for occasional migraine. However, other treatment options may be more suitable for people with frequent or severe migraine. These include:
Avoiding triggers
A wide variety of factors can contribute to the development of migraine. Some people find that by identifying and eliminating migraine triggers, they can reduce the number of episodes they have.
Depending on a person’s triggers, this may include:
- getting enough sleep and having a regular sleep-wake schedule
- staying hydrated
- eating regular meals
- avoiding caffeine and alcohol
- avoiding specific trigger foods
- getting enough exercise
- managing stress levels
Keeping a migraine diary can help with identifying migraine triggers over time.
Medications
A person who experiences chronic migraine may benefit from taking more specialized migraine medications,
- triptans, which can stop the progression of individual migraine attacks
- ergotamines, which work in a similar way to triptans
- calcitonin gene-related peptide (CGRP) inhibitors, such as erenumab (Aimovig), which can prevent migraine
- Botox injections
These may be more effective than OTC analgesics, particularly for people with severe or frequent migraine.
Some other common medications that can reduce the frequency of migraine include:
- some antidepressants, such as amitriptyline
- some seizure medications
- some blood pressure medications, including beta-blockers
- hormonal medications, such as estrogen-free hormonal birth control, for those with menstrual migraine
If a person already requires one of these medications, they may also help treat or manage migraines.
Relaxation and biofeedback
Several complementary therapies show promise for reducing migraine frequency. These
Is Motrin good for migraines?
Motrin is a brand name for ibuprofen and is effective for acute migraine treatment. It is one of the most commonly used medications for migraine and is available over the counter and by prescription.
However, a person should not overuse the medication to avoid adverse side effects.
What works better for a migraine Tylenol or Motrin?
Tylenol and Motrin are brand names for painkillers, known as acetaminophen and NSAIDs, both of which
When should a person see a doctor about migraines?
A person should talk with their doctor about their migraines when they are:
- severe or getting worse, or lasting longer than usual
- occurring more than once a week
- difficult to control
- regularly happening before or during a period
A migraine cocktail is a combination of medications that reduce migraine symptoms, such as pain and vomiting. Doctors may administer a migraine cocktail to those who go to the hospital with severe migraine.
OTC versions of migraine cocktails are available. These can effectively treat migraine in people with moderate symptoms. Alternatively, people can take a combination of aspirin, acetaminophen, and caffeine at home.
Individuals who have severe or frequent migraine should contact their doctor about other treatment options available.
