This is a case where “an ounce of prevention is worth a pound of cure”. Migraines are often caused by hormone imbalance or triggered by foods or additives such as MSG (monosodium glutamate, commonly found in flavor sauces and soy products) or artificial sweeteners such as aspartame. It can help to keep a food diary and try an elimination diet if you see a pattern of migraine occurrence after eating certain foods.
When migraines do occur, the most appropriate drug for you depends on the unique characteristics of your migraine attack, as well as your preference for dosage form, etc. The optimal medication produces a rapid, sustained pain-free response with minimal adverse effects. Suspensions or suppositories can be used to treat migraines when an oral tablet or nasal spray is not suitable for a particular patient. When commercially available preparations do not provide adequate symptom relief or cause intolerable side effects, we can work together with patient and physician to individualize therapy.
A combination of isometheptene mucate, dichloralphenazone, and acetaminophen (most commonly known as Midrin®) has been used for decades to treat migraine. The isometheptene mucate helps reverse vasodilation that may occur during a migraine, dichloralphenazone is a sedative (so cautions apply), and acetaminophen is an analgesic. A multicenter, double-blind, randomized, parallel-group study concluded that this combination may have a slight advantage compared with sumatriptan succinate in the early treatment of mild-to-moderate migraine.
Recently, Midrin® and other commercial preparations containing the same active ingredients have been discontinued due to manufacturing problems. OUR PHARMACY CAN HELP by compounding a preparation containing isometheptene, acetaminophen, and chloral hydrate (in place of dichloralphenazone).
Ask us for more information about therapies for migraine, and also how we can help if you need a medication that is no longer commercially available.