Drug Safety in Episodic Migraine Management in Adults Part 1: Acute Treatments

Curr Pain Headache Rep. 2022 Jul;26(7):481-492. doi: 10.1007/s11916-022-01057-3. Epub 2022 May 10.

Abstract

Purpose of review: The aim of this review is to aid in choosing safe options when assessing potential risks of acute migraine treatments based on known mechanisms of action and anticipated safety concerns.

Recent findings: Part 1 highlights safety issues associated with commonly used medications to treat acute migraine attacks. Strategies to mitigate cardiovascular and gastrointestinal risks of nonsteroidal anti-inflammatory drugs, evaluation of cardiovascular risks of triptan and ergot alkaloids, and precautions with use of antiemetics and the novel drugs gepants and ditans are discussed to help practitioners in clinical decision-making. When available, we included recommendations from professional societies and data from pharmacovigilance systems. While guidelines on efficacy are available, one must also consider the possible risks and adverse effects of a drug when creating treatment plans.

Keywords: Acute migraine treatment; Ditans; Gepants; Safety.

Publication types

  • Review

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Calcitonin Gene-Related Peptide Receptor Antagonists / therapeutic use
  • Humans
  • Migraine Disorders* / chemically induced
  • Migraine Disorders* / drug therapy
  • Tryptamines / adverse effects

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Calcitonin Gene-Related Peptide Receptor Antagonists
  • Tryptamines