Table 1.

Common drugs used as abortive treatment in migraine attacks

	Dose	Route of administration	Advantages	Disadvantages
NSAIDs	Higher than usually used for other types of pain • ASA: 1 g • Ibuprofen: 800–1,200 mg • Dexketoprofen: 50 mg • Naproxen 1,000 mg • Ketoprofen 75 mg • Ketorolac oral 20 mg or intramuscular 60 mg • Indomethacin 50 mg	Oral, rectal, intravenous, inhaled	Can be combined with triptans to achieve more efficacy Relief of pain and associated symptoms	Usually not useful for severe attacks
Acetaminophen (paracetamol in Europe)	1 g	Oral, endovenous	Can be combined with antiemetics (as metoclopramide), increasing its efficacy considerably (in some studies similar to sumatriptan)	Generally does not work with moderate–severe attacks
Triptans	Depending on type of triptan and route of administration • Sumatriptan: oral 50–100 mg, inhaled 10–20 mg, rectally 25 mg, transdermal patch 6.5 mg • Almotriptan: oral 12.5 mg • Zolmitriptan: oral and oral dispersible 2.5–5 mg, inhaled 5 mg • Eletriptan: oral 20–80 mg • Naratriptan: oral 2.5 mg • Rizatriptan: oral and oral dispersible 5–10 mg • Frovatriptan oral 2.5 mg	Oral, oral dispersible, subcutaneous, inhaled, rectal	The group with highest efficacy Specific treatment for migraine Able to relieve severe attacks of migraine and its associated symptoms (nausea and vomiting) Can be combined with NSAIDs and simple analgesics Can be administered per different nonoral vials	Expensive Not recommended in patients with elevated cardiovascular risk
Ergots	Dihydroergotamine (DHE): parenteral 0.5–1 mg; intranasal Ergotamine: 1–2 mg in suppositories	Oral, rectal, intravenous, inhaled	Low price Good efficacy Can be combined with antiemetics	Elevated risk of overuse Can increase nausea and vomiting

Abbreviations: ASA, acetylsalicylic acid; NSAIDs, nonsteroidal anti-inflammatory drugs.