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Migraine Medication and Dosage Table - Adult

Migraine Medication and Dosage Table - Adult - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Clinical Practice Guidelines, Neurology, Related


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Appendix D. Migraine Medication and Dosage Table
Product How supplied Dosage Ranges Generic
Available?
Abortive or Rescue Therapy
Triptans
Almotriptan 6.25, 12.5mg tab 6.25-12.5mg once, may repeat after 2 hours;
Max 25mg/24hr
Yes
Eletriptan 20, 40mg tab 20-40mg once,
may repeat after 2 hours;
Max 80mg/24hr
No
Frovatriptan 2.5mg tab 2.5mg once,
may repeat after 2 hours;
Max 7.5mg/24hr
No
Naratriptan 1, 2.5mg tab 1-2.5mg once,
may repeat after 4 hours;
Max 5mg/24hr
Yes
Rizatriptan 5, 10mg tab
5, 10mg ODT
5-10mg once,
may repeat after 2 hours;
Max 30 mg/24hr
Yes
Sumatriptan 25, 50, 100mg tablet
5, 20mg nasal spray
6mg/0.5mL, 4mg/0.5mL,
3mg/0.5mL subcutaneous
injection
6.5mg/4 hr transdermal
patch
Tab: 25-100mg once, may repeat after 2 hours;
Max 200mg/24hr
Nasal: 5-20mg once, may repeat after 2 hours;
Max 40mg/24hr
SubQ: 1-6mg once, may repeat after 1 hr;
Max 12mg/24hr
TransD: 1 patch once,
may apply second patch at least 2 hours after
activation of first;
Max 2 patches/24hr
Tab: Yes
Nasal: Yes
SubQ: Yes but not
3mg/0.5mL pen
TransD: No
Zolmitriptan 2.5, 5mg tab
2.5, 5mg ODT
2.5, 5mg nasal spray
Tab: 1.25-2.5mg once,
may repeat after 2 hours;
Max 10 mg/24hr
Nasal: 2.5 mg once, may repeat after 2 hours;
Max 10 mg/24hr
Tab: Yes
Nasal: No
Ergot Derivatives
Dihydroergotamine (DHE) 4mg/mL nasal spray
1mg/mL injection solution
IM/SQ/IV: 1mg once, may repeat at 1 hour
intervals;
Max 3mg (2mg IV) per 24hr
Nasal: 1 spray (0.5mg) in each nare, may repeat in
15 minutes;
Max 4 spray (2mg)/24hr
Yes
NSAIDs
Naproxen sodium 220mg (OTC), 275mg,
550mg tab
Tab: 220 to 440mg once Yes
Ketorolac 15, 30mg/mL injection
solution
IM: 30-60mg once
IV: 15-30mg once
Yes
Anti-epileptics
Valproate sodium 100mg/mL injection solution
(must be diluted)
400-1000mg IV once Yes
Other*
Magnesium sulfate 500mg/mL injection solution
(must be diluted)
1-2 grams IV once Yes
*Butorphanol is FDA approved for migraine, however, it is NOT recommended due to high abuse potential and
association with chronification of migraine.
Copyright © 201� University of Wisconsin Hospital s and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 05/2016CCKM@uwhealth.org
Migraine - Adult - Ambulatory/Emergency
Department Clinical Practice Guideline

22
Product How supplied Dosage Ranges Generic
Available?
Supportive Therapy
Antiemetics
Chlorpromazine 25mg/mL injection solution INJ: 12.5mg IV once Yes
Diphenhydramine 50mg/mL injection solution INJ: 25-50mg IV once
Metoclopramide 5, 10mg tab
5mg/mL injection solution
TAB & INJ: 5-10mg q6h PRN Yes
Ondansetron 4, 8mg tab
4, 8mg ODT
4mg/5mL oral solution
2mg/mL injection solution
PO: 4-8mg q12h PRN
INJ: 4mg IV/IM ONCE
Yes
Prochlorperazine 5, 10mg tab
5mg/mL injection solution
25mg rectal suppository
PO: 5-10mg q6h PRN
INJ: 10mg IV/IM ONCE
SUPP: 25mg q6h PRN
Yes
Promethazine 12.5, 25, 50mg tab
6.25mg/5mL oral syrup
12.5, 25mg rectal
suppository
PO: 25-50mg q6h PRN
SUPP: 25-50mg q6h PRN
Yes
Lorazepam 2mg/1mL, 4mg/1 mL
injection solution
IV: 0.5mg ONCE Yes
Haloperidol 5mg/1mL injection solution IV: 0.5mg ONCE Yes
Preventative Therapy
Beta-blockers
Propranolol 10, 20, 40, 60, 80mg tab
60, 80, 120, 160mg ER cap
20mg/5mL, 40mg/5mL oral
solution
IR tab & solution: 40-240mg 2-3 times per day in
divided doses
ER tab: 80-240mg once daily
Yes
Metoprolol 25, 37.5, 50, 75, 100mg tab IR tab: 25-100mg twice daily Yes
Timolol 5, 10, 20mg tab 10 -15mg twice daily Yes
Atenolol 25, 50, 100mg tab 50-100mg once daily Yes
Tricyclic Antidepressants
Amtriptyline 10, 25, 50, 75, 100, 150mg
tab
25-150mg HS
Start low and titrate dose upward
Yes
SNRIs
Venlafaxine 25, 37.5, 50, 75, 100mg tab
37.5, 75mg, 150mg ER cap
37.5, 75, 150, 225mg ER
tab
IR tab: 75-150mg divided 2-3 times per day
ER tab & cap: 37.5-150mg daily
Yes
Anti-epileptics
Divalproex 125, 250, 500mg DR tab
250, 500mg ER tab
DR tab: 250-500mg twice daily
ER tab: 500-1000mg once daily
Yes
Topiramate 25, 50, 100, 200mg tab 25mg once daily. Titrate by 25mg weekly up to
50mg twice daily
Yes
OTC/Supplements
Magnesium Various OTC preparations 250-500mg twice daily Yes
Riboflavin Various OTC preparations 400mg once daily Yes
Copyright © 201� University of Wisconsin Hospital s and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 05/2016CCKM@uwhealth.org