best migraine medicines

by Kelsie
(Canada)

I'm taking 25 mg Topamax for migraines and I cannot sleep at night because I’m still experiencing headaches can I take two Tylenol 3s before I go to sleep?

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Dear Kelsie,

I am so sorry to learn about the difficulties you are experiencing with your migraine attack. Straight to your questions. No. Do not take Tylenol 3’s for your migraine.

What you obviously need is a good guide on the best migraine medicines available to treat migraine during an acute attack.

What you can take tonight at this point is plain Tylenol (acetaminophen) 1g start with an anti-sickness medication if available, plus or minus ibuprofen 400 to 600mg. Codeine containing medicines are not good for migraine headaches.


I can see that you are using Topamax for migraine. Topamax does not TREAT migraine. It is only used to PREVENT an attack. Once an attack has started like in your case, this drug is virtually of no effect.

The best approach to migraine treatment during an attack (that is, once the actual headache has started), is to follow the steps below:

1. Take Aspirin, 600mg to 900mg every 6 to 8 hours in 24 hours, if not
   allergic to aspirin or have bleeding disorder or on warfarin or have
   co-existing severe asthma.
   
   An alternative to aspirin is Ibuprofen, 400m to 600mg, again up to 3
   times in 24 hours. Check with your doctor if you are okay to take
   ibuprofen, or if you have used it in the past.
   
   You can take an anti-sickness medication like domperidone 20mg along
   with any of the above, if you also feel sick with your migraine.
   
   
2. If the above does not help with your migraine, you can proceed to
   taking Diclofenac , preferably as a rectal suppository, 100mg into the
   back passage (rectum), or oral tablet, 50mg, again with domperidone, if
   you feel nauseated.
   
   
3. Step 3, where the above fails, proceed to use specific migraine medication, like Sumaptriptan (also called Imigran), 50 to 100mg, or zolmitriptan, 2.5 to 5mg. Both come as rapid dispersal tablets or nasal spray.

Do not be tempted to go straight to using these 3rd stage medications, as they are shown not be be effective if taken soon after the onset of migraine. These should also be taken with an anti-sickness like domperidone or metoclopromide.

Hopefully, symptoms should get better with the above steps. Where the headache continues, the diagnosis may need reviewing.

Please note that it is always important to seek medical advice if you have a sudden onset headache, or even if you are having a "migraine" that seem worse than usual.

Also in the list of best migraine medicines or best migraine medications, if you like, are agents like frovatriptan and naratriptan (less effective, compared to sumatriptan and zolmatriptan or almoptriptan).

Some have used magnesium sulphate, ergotamine, and some antiepileptic medications like Topamax. But as mentioned above, topamax is completely useless, once the headache has started.

Please what ever you do, avoid using medications that contain codeine during an attack of migraine, like Tylenol 3’s (or Tylenol 1, or 2), cocodamol, co-dydramol, or any other combination of acetaminophen (paracetamol)and codeine. Read the label or leaflet to be sure.


I hope this helps you and you are able to find some sleep tonight - if you can get your hands on any of the medications above.

I have put a link below to reputable and genuine online source for these medications. But please verify with your doctor that they are safe for your particular medical history and tolerance.

Links to best migraine medicines

• Sumatriptan 50mg
  
  
• Ibuprofen 600mg
  
  
• Metoclopramide 10mg

Please note that domperidone and metoclopromide are both anti sickness medications, and only use one type. Metoclopromide is not recommended for children under 16 years of age.

I hope this helps.

Please do not hesitate to contact us again, should you have any further concerns.

Dr Edema

Abdopain.com