Am Fam Physician. 2026;113(2):196-198
Author disclosure: No relevant financial relationships.
KEY POINTS FOR PRACTICE
• Abortive medications are most effective when taken early in the headache phase. Most medications, including triptans and NSAIDs, are not effective when taken during migraine aura.
• Triptans are more effective than acetaminophen and NSAIDs, but there is limited additional benefit in increasing triptan dose.
• Although menstrual migraines respond less to medications, triptans (with or without NSAIDs) are effective.
• In children, acetaminophen and ibuprofen are more effective than placebo, whereas triptans are not consistently superior.
From the AFP Editors
Migraine headaches are common throughout the world. The International Headache Society (IHS) published guidelines for acute migraine medical treatment.
MEDICATION TIMING
Abortive medications should be taken early in the headache phase while headache intensity is mild. Most medications, including triptans and nonsteroidal anti-inflammatory drugs (NSAIDs), are not effective in the prodrome or aura phase. However, ubrogepant (Ubrelvy) appears to be effective when taken before the headache phase.
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