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Whether you take preventive medications, rescue medications, or both, it’s important to be aware of any side effects they might cause. Also called adverse reactions, side effects are unwanted or unexpected symptoms or occurrences that happen in response to taking a medication.
Anytime you start a new prescription medication for chronic migraine, ask your doctor about the most common side effects and how you can recognize them. While many side effects are mild and minimally bothersome, some can be dangerous or life-threatening and must be reported right away.
In this article, we’ll give you a quick rundown of some of the most common side effects of migraine medications and what to watch for while taking them.
Medications can have different effects on different people. Just as a medication can be more effective for one person than another, a medication that causes side effects for you may not cause them for everyone else who takes it. Even if a medication has known side effects, that doesn’t mean you’ll experience those side effects while taking it.
Medication side effects occur because the balance of your body’s internal systems, called homeostasis, is thrown off by the medication. In an attempt to correct the imbalance, your body might activate or otherwise alter specific systems like your sympathetic nervous system (fight-or-flight system) or digestion. As a result, you get side effects like dizziness or diarrhea.
Medications commonly taken for migraine are no exception. Side effects of migraine medication vary based on the type of medication you take and can range in severity. If any side effects are intense, long-lasting, or bothersome, your doctor may change the dose or prescribe a different medication.
Some migraine medications are taken on an as-needed basis to reduce symptoms like headache and nausea during an active migraine attack. Others are taken regularly to hopefully prevent migraine attacks or reduce their frequency.
Medications in both categories can cause side effects, though some have a lower risk of causing side effects than others. Here we list some of the most common migraine medications in both categories, along with their most common side effects.
Triptans are widely prescribed to reduce symptoms during migraine attacks by altering pain signals inside the brain. Their only purpose is treating migraine attacks. Today, they’re more commonly used than older migraine rescue medications like ergotamines because they tend to be more effective and have fewer and less severe side effects.
The most common side effects are:
Many people automatically reach for nonsteroidal anti-inflammatory drugs (NSAIDs), which are pain relievers, when they feel a migraine headache starting. These medications are available over the counter (without a prescription) to treat pain and fever.
Serious side effects are less likely when NSAIDs are used only sometimes and at the right dose. But NSAIDs can still cause serious problems for some people, like hypersensitivity, stomach bleeding or ulcers, kidney problems, or heart problems — especially at higher doses or if you take them often.
You may need to take an antiemetic medication if you experience symptoms like nausea and vomiting during your migraine attacks. Antiemetics can also be helpful to take alongside other medications that can cause nausea and vomiting as side effects. Although not all antiemetics cause the same side effects, some may cause:
Gepants, which block the calcitonin gene-related peptide (CGRP) receptor, can treat migraine attacks and also help prevent them. Your doctor might prescribe gepants if you don’t tolerate triptans well or if triptans aren’t safe for you to take.
Side effects of gepants are usually mild and can include nausea, fatigue, and constipation. But researchers are still learning about gepants because they’re relatively new migraine treatments, so some long-term side effects might still be unknown.
Certain migraine prevention medicines are CGRP antibodies. These are shots (or an IV infusion) given on a schedule to help prevent migraine.
Common side effects can include discoloration or pain where the shot goes in and constipation. Rarely, some people may notice higher blood pressure. Tell your doctor if you have ongoing constipation, chest pain, or a big change in blood pressure.
Doctors may prescribe certain anti-seizure medications to reduce the frequency and severity of migraine attacks, but researchers aren’t sure exactly how they work to treat migraine. The side effects of one anti-seizure medication may not be the same as another, but anti-seizure medications taken to prevent migraine attacks may cause:
Your doctor might prescribe beta-blockers to help prevent migraine attacks, though researchers aren’t sure how they work for this purpose. More commonly, beta-blockers are used as medications for high blood pressure. Their most common side effects include fatigue, cold hands and feet, and dizziness.
Certain antidepressants can help prevent migraines when taken daily. Tricyclic antidepressants, some selective norepinephrine reuptake inhibitors (SNRIs), and a selective serotonin reuptake inhibitor (SSRI) may be used for migraine prevention. Some general side effects include:
Serious and life-threatening side effects from migraine medications aren’t very common if you take them according to your doctor’s instructions. In fact, serious side effects from triptans affect less than 1 percent of people who take them. It’s still important to be aware of the possibilities, so you know serious side effects when you see them and can get medical attention right away.
Some migraine medicines aren’t safe for people with certain heart or blood vessel problems, and some can affect the heart. Also, migraine symptoms and medication side effects can sometimes feel scary and may be confused with a stroke. Both are serious and require immediate medical attention.
Call your doctor right away if you experience:
It’s possible to experience an allergic reaction to a medication you take for migraine, even if you were unaware of any medication allergies. A mild medication allergy might cause a rash.
Serious allergic reactions can involve anaphylaxis, a life-threatening reaction that involves face and throat swelling, a weak pulse, and a constricted airway. Get emergency medical help right away if you notice signs of anaphylaxis, even if you used an epinephrine auto-injector.
Medication side effects can happen unexpectedly, but some factors can make side effects more likely to occur. Your doctor can give you more information on when you’re at risk of experiencing side effects from a migraine medication.
Increasing or decreasing your medication dose (how much of the medication you take at a time) can lead to side effects you didn’t experience before the change in dose. Most side effects will improve as your body adjusts to the new dose.
Certain rescue medications for migraine attacks, like NSAIDs and triptans, can cause medication overuse headaches. A medication overuse headache is a type of headache that occurs because you’ve taken too much of the medication or used it too frequently.
Having an underlying medical condition may increase your risk of experiencing side effects or complications from a medication because of changes in the ways your body functions. Your doctor will tell you more about your medical conditions and how they might interact with your migraine medications.
It’s possible to experience medication interactions between the medications you take to manage migraine and other medications or supplements you take. Be sure to tell your doctor about every medication or supplement you use, including those that don’t require a prescription.
Ask your doctor about any side effects that might come from your migraine treatment. If you experience side effects, tell your healthcare provider about them if they’re bothersome, unexpected, or concerning. A healthcare professional may offer tips for reducing side effects, or they may change your medications if your side effects are bothering you.
On MyMigraineTeam, people share their experiences with migraine, get advice, and find support from others who understand.
Which migraine medication side effects have you experienced? Let others know in the comments below.
Are your headaches a symptom of migraine? Get a quick assessment.
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