So, you’re here for the migraine cocktails? Hate to break it to you, but there’s no alternate reality in which pretty sips with cutellas will soothe your pain.
Intrigued? Let’s dive into the ingredients and side effects and then consider other methods of migraine relief.
Migraine cocktail: The ingredients
Doctors customize migraine cocktails according to your health conditions and which meds have helped soothe your migraine attacks in the past.
These are the most frequently included classes of drugs:
- IV steroids. Buh-bye, painful inflammation!
- IV fluids. Hydration dials down the other ingredients’ side effects.
- IV magnesium. Research suggests that magnesium could reduce migraine pain and kaleidoscope vision.
- IV valproic acid. Technically a seizure med, valproic acid sometimes works against severe migraine attacks.
- Triptans. Triptan meds like sumatriptan (Imitrex) can squash pain by narrowing your blood vessels.
- Ergot alkaloids. Kinda like triptans, e. alkaloids like dihydroergotamine can provide pain relief.
- Antiemetics. Hellooooo, prochlorperazine and metoclopramide… goodbye, pain and nausea (for some folks, at least!).
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Some docs mix supercharged NSAIDs like ketorolac (Toradol) into migraine cocktails.
Hardly a piña colada, but hopefully a pain-a reducer.
If your throbbing head, distorted vision, and nausea land you in the ER, you might receive a migraine cocktail. It’s a common treatment option offered for acute, unrelenting, I’ll-do-anything-to-get-out-of-this migraine attacks.
Often administered intravenously (IV), these “cocktails” are crafted with a specific blend of meds to soothe your most severe symptoms. The emergency team might pump steroids, NSAIDs, and other prescription-infused fluids into your arm until you start to feel sweet, sweet relief.
For instance, you could receive an IV combo of:
- steroids to reduce inflammation
- metoclopramide (Reglan) to soothe nausea
- diphenhydramine (Benadryl) in case your migraine has links to histamines or allergies
PSA: Research on Benadryl’s effect on migraine is pretty inconclusive. It’s a common “cocktail” ingredient, but there’s little significant proof that it matters.
Other key info:
- Migraine cocktails offer relief, not a cure, for the approximately 1 in 7 U.S. adults who deal with these debilitating, painful episodes.
- A doctor should mix this cocktail — docs are pros for a reason.
- The medication effects can take about an hour to kick in.
Are they safe for kids?
And guess what? The same meds used in a grown-up migraine cocktail can help relieve kids’ migraine attacks. Yay! Fun for the whole family!
Just make sure you tell the ER doc about your child’s health history and underlying conditions before suggesting a migraine cocktail. And of course, rely on the doctor’s judgment for the best treatment(s) and dose to help your little one find relief.
When we talk about migraine cocktails, we’re usually referring to the IV infusion you get in the ER for a severe migraine attack.
Still, an over-the-counter (OTC) trio of meds is available to help combat killer headaches:
- Aspirin: 250 milligrams
- Acetaminophen (aka Tylenol): 250 milligrams
- Caffeine: 65 milligrams
The research might be older (Smash Mouth were still cutting-edge back then), but the pills’ effects on your body remain the same (hey, now — it’s still an all-star).
Basically, the aspirin soothes inflammation while the acetaminophen reduces pain and the caffeine narrows your blood vessels, which helps chill out your throbbin’ noggin.
Some OTC pills like Excedrin Migraine and Excedrin Extra Strength *already* contain a blend of these three ingredients. But that doesn’t make them an automatic #win.
Some docs recommend avoiding Excedrin because it’s strong enough to trigger a medication overuse headache — aka a rebound headache. And treating a headache with a headache doesn’t make a whole lot of sense.
Pill popping is nothing to be casual about. It’s always best to consult your doc before combining medications or dosing on OTC caffeine. You might end up with a mess of unwanted side effects.
In general, check the med’s label to figure out which ingredients are active (aim for the three above) and run the combo past your doctor before trying it.
Like any other medication, most ingredients in a migraine cocktail can cause adverse effects. Here are the possible side effects based on what the doctor orders.
Side effects, known as “triptan sensations,” include:
- tingling in your hands and feet
- aches and pains
- tightness in your chest and neck
- skin flushing
Antiemetics and neuroleptics
These can have unintended side effects, including:
- low blood pressure on standing up
- dystonia (involuntary muscle movements)
Possible side effects include:
NSAIDs can mess with your gastric lining and cause:
If you’re an older adult or have underlying kidney issues, it’s best to skip NSAIDs — they could cause you some serious problems.
Depending on the steroid, a high dose might cause:
OTC “migraine cocktails”
Based on the ingredients (acetaminophen, NSAIDs, and caffeine), an OTC migraine cocktail might lead to:
This is definitely something you should ask your doctor or healthcare team. They’ll use your health history and current health status to figure out which med mix is safest (and most effective!) for you.
Oh, and those OTC migraine cocktails? They’re *not* safe for everyone. Avoid OTC blends of aspirin, acetaminophen, and caffeine if any of these apply to you:
- You know you’re allergic to any or all of the medications’ ingredients.
- You’re already taking a med that contains acetaminophen.
- You’re under age 12.
- You know you’re at risk for medication overuse headaches.
🚨Talk with a doc before using a cocktail if…🚨
- Your head pain feels different from your usual migraine attacks.
- You’re pregnant or breastfeeding.
- You have a diagnosis of kidney, heart, or liver disease.
- You have asthma.
- You’re dealing with heartburn or stomach ulcers.
- You’re already taking meds — NSAIDs, steroids, blood thinners, or diuretics, specifically.
Good news! Migraine cocktails are *not* the only way to hand an eviction notice to your pain.
If your headache is just revving up, you might be able to stomp it out with mild OTC meds like acetaminophen (Tylenol) or NSAIDs (ibuprofen or aspirin).
Straight up: Solo drugs that may help
Any single ingredient used in a migraine cocktail might be enough to soothe your pain on its own. A few solo meds that might help:
- triptans (like sumatriptan, rizatriptan, and almotriptan)
- ergot alkaloids (like dihydroergotamine and ergotamine tartrate)
- gepants (to kick your acute migraine gepain in the gepants — types include ubrogepant and rimegepant)
- ditans (like lasmiditan)
You can also take preventive measures against chronic migraine:
- Botox. Yep, these wrinkle-freezing facial injections might also help prevent some folks’ migraine attacks.
- Blood pressure meds. Beta-blockers and calcium channel antagonists might help prevent migraine attacks.
- Antidepressants. *Some* antidepressants (the tricyclic kind — ask your doc for details) can help prevent migraine attacks.
- Antiseizure meds. Options include valproate and topiramate (Topamax).
- CGRP inhibitors. These are injections that help some people avoid future migraine attacks.
Other ways to find relief
Natural remedies probably won’t fix a migraine attack that’s been waging war on you for days, but they may nip one in the bud early on.
Some of these tricks soothe pain, while others may help prevent it from starting in the first place. Either way, it’s best to try to address a migraine attack before you end up in the ER receiving cocktails of drugs:
- Relax. Yep, stress = a pretty common migraine trigger. So dive into some meditation and breathing exercises if you feel the pain coming. (Or even if you don’t — why would anyone *want* to be stressed all the time?)
- Go with the flow. The yoga flow, that is, which has been shown to help with migraine.
- Acupressure or acupuncture. Whether you go for deep, firm pressure or thin, precise needles, pressure point release helps some folks prevent migraine pain.
- Take your vitamins and supplements. Vitamin B2, vitamin D, and the hormone melatonin have all been linked to reduced duration and frequency of migraine attacks.
- Boost your magnesium. Low levels of this essential mineral could trigger migraine attacks. Add more magnesium to your diet through supplements or magnesium-rich foods like nuts, seeds, and greens.
Talk with your doctor before adding new supplements to your routine, since they could interfere with your prescription meds or underlying health conditions. #BetterSafeThanSorry
A migraine cocktail is not a drink. It’s a medley of medications used to treat severe migraine symptoms.
You generally get a migraine cocktail via IV at the ER. But it *is* possible to combine three OTC products — aspirin, acetaminophen, and caffeine — for a milder treatment. Like any other medications, these may have side effects.
Some lifestyle changes and natural remedies might also help relieve migraine pain.
If you live with severe or chronic migraine, talk with your doctor. Only a medical professional can determine the best cocktail of treatments and medications that will work for you.