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Migraine tablets are specifically used to combat migraine attacks that go far beyond normal tension headaches. Depending on the severity and type of headache, different tablets with different active ingredients are used. They are suitable for both children and adults. However, the advice of a doctor should always be sought before taking them, in order to avoid avoidable side effects or excessive dosages.

With our big migraine tablet test 2021 we want to help you find the right tablets for you. For this purpose, we have looked at different migraine tablets and have highlighted the most important facts for you. We also show you which criteria are important when choosing migraine tablets and list the advantages and disadvantages of the different types.




The most important

  • Migraine tablets are specifically used to combat migraine attacks that go far beyond normal headaches. Depending on the severity and type of headache, different tablets with different active ingredients are used.
  • Basically, a distinction is made between painkillers and triptans, where the dosage is adjusted depending on the severity of the migraine. Both forms of migraine tablets are available as film-coated tablets, effervescent tablets, melting tablets and capsules.
  • Painkillers are more suitable for mild to moderate migraine attacks. If these no longer help, triptans made specifically for migraine are used. Medical advice should always be sought regarding the appropriate dose and active ingredient.

The Best Migraine Tablets: Our Picks

Buying and evaluation criteria for migraine tablets

The range of migraine tablets on the market is very large and varied. In the following, we would like to show you which criteria you can use to decide between these many and thus find the right migraine tablets for you.

The criteria that make it easier to compare migraine tablets with each other are:

In the following paragraphs, we will go into more detail about each criterion and explain what you should look for when choosing.

Type of migraine

When determining a migraine, there is no one migraine. The duration and severity of the symptoms can vary greatly. In addition, some people experience only mild nausea and sensitivity to light in addition to the headache, while others vomit repeatedly or can only endure the migraine attack in dark rooms.

Migraines are as individual as the person who suffers from them.

Depending on the type, other medications can be helpful. A basic distinction is made between two types:

  • Migraine without aura: A migraine attack without aura is also called a classic migraine attack. It is difficult to distinguish from a normal headache. It usually starts with a throbbing, severe pain on one side and is typically accompanied by at least one symptom, such as nausea or sensitivity to light.
  • Migraine with aura: If the migraine is preceded by neurological symptoms, such as impaired vision, speech or sensory disturbances, it is called a migraine with aura. As soon as the headache starts, these symptoms usually disappear.

The causes of migraine attacks can be very different. Stress, lack of sleep, hormonal fluctuations, climatic influences, alcohol or the use of certain medications are among the most common triggers for migraines.

When choosing migraine tablets, it is therefore important to consider whether the migraine is with or without aura.

Active ingredient

The active ingredients used to treat migraines are often substances that are also used for ordinary headaches - painkillers. These are usually recommended for mild to moderate migraine attacks. The German Migraine and Headache Society (Deutsche Migräne- und Kopfschmerzgesellschaft e.V.). (DMKG) advises the following painkillers and dosages:

  • Acetylsalicylic acid, dose: 1000 mg
  • Paracetamol, dose: 1000 mg
  • Ibuprofen, dose: 400-600 mg
  • Naproxen, dose: 500-1000 mg
  • Diclofenac, dose: 50-100 mg
  • Metamizole, dose: 1000 mg

If these migraine tablets are no longer sufficient against the migraine attacks that occur, or if you suffer from side effects of these painkillers, you should turn to triptans. They were developed specifically for migraines and therefore only work for migraines and no other types of headaches. These types of migraine tablets also combat symptoms such as nausea and vomiting. The DMKG recommendations are as follows:

  • Sumatriptan, dose: 50-100 mg
  • Zolmitriptan, dose: 2.5-5 mg
  • Rizatriptan, dose: 10 mg
  • Naratriptan, dose: 2.5 mg
  • Almotriptan, dose: 12.5 mg
  • Eletriptan, dose: 20-80 mg
  • Frovatriptan, dose: 2.5 mg

Depending on the severity of the migraine attacks, a distinction should therefore be made between the migraine tablet categories painkillers and triptans. In addition, migraine patients should always seek advice from a doctor regarding the appropriate active ingredient and dose.

Prescription / without prescription

Low-dose migraine tablets can usually be bought without a prescription from a doctor on the internet or in pharmacies. However, these are usually only suitable for a mild to moderate form of headache.

If these types of migraine tablets no longer help, you have to switch to stronger doses or triptans.

In most cases, these are prescription medicines. They require a prescription from a doctor because of the increased safety requirements.

Regardless of the strength of the migraine tablets, sufferers should always seek support in choosing the medication.

Advice can be given by a doctor, but also by pharmacy staff. Strong painkillers and especially triptans should not be taken arbitrarily or even combined.

Tolerance

The tolerability of migraine tablets is also an important selection criterion, but it is difficult to assess in advance. How sufferers react to a certain medication, or which side effects are triggered in them, can usually only be said after taking it.

Since painkillers are usually only taken for a short time to treat a migraine attack, side effects are rare. However, side effects such as stomach pain, diarrhoea, nausea or allergic reactions can never be completely ruled out.

It is therefore important to take certain pre-existing conditions into account when choosing migraine tablets and to observe any side effects that occur while taking them and to switch to a different medication in an emergency.

However, certain migraine tablets can already be ruled out in the case of certain pre-existing conditions, as they could otherwise lead to serious consequences.

For example, medicines such as acetylsalicylic acid or ibuprofen can affect the stomach lining and are therefore not suitable for people with stomach ulcers. Paracetamol, on the other hand, is not recommended for people with impaired liver function because it is broken down by the liver.

Tablet type

Migraine tablets come in many different forms. Basically, we can distinguish between the following types of tablets:

  • Film-coated tablet
  • Effervescent tablet
  • Melting tablets
  • Capsules

The most common form of migraine tablets are film-coated tablets. They are taken in one piece with plenty of liquid. Effervescent tablets, on the other hand, are dissolved in water and are therefore suitable for older people or people who have difficulty swallowing.

Melting tablets are absorbed through the mucous membranes of the mouth by letting them melt on the tongue. Capsules must also be taken with plenty of liquid. In contrast to film-coated tablets, however, they are usually somewhat softer.

Guide: Questions you should ask yourself before buying migraine tablets

Before you buy migraine tablets, there are some factors you should consider. In the following sections, we have summarised some of these factors and answered the most frequently asked questions about migraine tablets.

What is special about migraine tablets?

Migraine tablets are specifically designed to combat migraine attacks that go far beyond normal headaches. Depending on the severity and type of headache, different tablets with different active ingredients are used.

Migräne Tabletten-1

(Migraine tablets are used to quickly combat migraine attacks. The most common form of tablet is the film-coated tablet.
(Image source: James Yarema / unsplash)

While painkillers such as ibuprofen are usually enough for mild migraine attacks, only triptans are usually helpful for severe attacks. Migraine tablets, in the right dose and type, are suitable for children and teenagers as well as adults.

What types of migraine tablets are there?

In the following, we will introduce you to the different types of migraine tablets. There are four different types, all of which have different advantages and disadvantages.

Migraine tablets in film form

Migraine tablets in the film-coated form are solid, single-dose medicines that are meant to be taken unchewed with plenty of liquid. They consist of one or more active ingredients surrounded by a film coating. This film coating consists of very thin pharmaceutical plastic.

This coating has many advantages because on the one hand it weakens the unpleasant taste of the active ingredients and on the other hand it can determine the place and time of the release of the active ingredient. This is possible because the release of the active ingredient is regulated by the pH value. Thus, the film coating only dissolves when the correct pH value is present.

Advantages
  • Pleasant taste
  • Easy to swallow
  • Long shelf life
  • Control of the effect
Disadvantages
  • Swallowing tablets can be problematic for children or elderly people
  • Dosage can only be adjusted to a limited extent
  • Oral intake can delay effect

Effervescent migraine tablets

Effervescent migraine tablets are non-coated tablets that are dissolved in water before administration. The resulting solution is then drunk. The effervescence of the effervescent tablet has the effect of accelerating the dissolution process and eliminating the need for stirring.

Effervescent tablets are taken with sufficient cold tap water. Effervescent tablets are particularly suitable for children. Many medicines in the form of effervescent tablets are available over the counter and do not require a prescription from a doctor. This is also the case with effervescent tablets for mild migraines.

Advantages
  • Rapid effect due to already dissolved active ingredient
  • Suitable for patients with swallowing difficulties or for children
  • Easy on the stomach due to plenty of water intake
Disadvantages
  • Inconvenient to take
  • Must be stored away from moisture

Migraine tablets as melting tablets

Migraine tablets as melting tablets are also non-coated tablets. They are kept in the mouth and dissolve quickly there.

This can be especially beneficial if accompanying symptoms of migraine like nausea and vomiting make it difficult to take a conventional film-coated tablet. It is important that melting tablets are not pushed out of the blister-like ordinary tablets, otherwise, they can be damaged. The protective foil should be pulled off and the tablet carefully removed.

Advantages
  • Can be taken without water
  • Suitable for people with swallowing difficulties
  • Faster effect due to active ingredients already dissolved
Disadvantages
  • Slightly more expensive
  • Not as stable as conventional tablets

Migraine tablets as capsules

Migraine tablets in capsule form are solid, single-dose medicines designed to be taken with plenty of liquid. Capsules consist of a capsule shell and a filling. The shell is usually made of gelatine, occasionally also of cellulose.

A distinction can be made between hard and soft capsules. While hard capsules are preferably filled with solid substances such as powders or granules, soft capsules are usually filled with liquid or paste-like contents. For migraine, they are available both as hard and soft capsules.

Advantages
  • Can be taken quickly
  • Long shelf life
  • No unpleasant taste due to the shell
Disadvantages
  • Swallowing tablets can be problematic for children or older people
  • Dosage can only be adjusted to a limited extent
  • Oral intake can delay effect

For whom are migraine tablets suitable?

In principle, migraine tablets are suitable for everyone who suffers from migraine with or without aura. They help relieve sufferers with severe, often pulsating headaches, as well as symptoms such as nausea. Approximately 8 - 12 million people in Germany suffer from migraine, and 10 percent have migraine with aura.

Migräne Tabletten-2

People with migraine attacks often feel paralysed and not as powerful. To avoid a migraine attack, the most effective way is to take migraine tablets at the first sign of an attack.
(Image source: Andrea Piacquadio / Pexels)

Whether for children or adults - migraine tablets are available in many different types and dosages so that basically everyone can make use of them.

The only important thing to remember is that you should always consult a doctor before taking them, to avoid avoidable side effects or too high a dosage.

How do the migraine tablets triptans work and what should be considered when taking them?

Triptans are vasoconstrictive, anti-inflammatory and pain-relieving drugs that are used for the acute treatment of migraine attacks with or without aura. They are used when the migraine attacks are moderate or severe, attacks last a long time and are accompanied by severe nausea, or the previous medication with painkillers has led to severe side effects.

Before taking the medication for the first time, it should be clarified whether the patient really suffers from migraines.

Triptans block the release of nerve messengers (neuropeptides and neurotransmitters) that can trigger local neurogenic inflammation in the blood vessels of the brain.

On the other hand, dilated blood vessels constrict again, resulting in a normalisation of the oxygen supply to the brain. This is possible because triptans do not act everywhere in the body like painkillers, but bind specifically to the sites in the brain where the disease processes take place.

Since some triptans are also available over-the-counter, there are a few things to keep in mind when taking these migraine tablets. Firstly, it is important to know that triptans only work for migraine and cluster headaches - not for other types of headaches.

They are not suitable for migraine prophylaxis and are only used for acute therapy. In addition, the active ingredient is now available as a tablet, pre-filled syringe, suppository or nasal spray.
The latter is particularly suitable for children.

Triptans differ in terms of efficacy, effectiveness, onset and duration of action and can be divided into three groups:

  • Group 1: fast and strong effect, short duration of action, high likelihood of side effects (sumatriptan)
  • Group 2: balanced effect and side-effect profile (almotriptan, eletriptan, rizatriptan, zolmitriptan)
  • Group 3: long duration of action, slow onset of action (frovatriptan, naratriptan)

Triptans can be taken for migraine with or without aura. It is important that they are not taken until after the aura phase in migraine with aura, otherwise the symptoms will worsen. However, it is best to take them within the first hour after the onset of the migraine attack.

As with painkillers, the 10-20 rule also applies to triptans, which means that migraine patients should not take the medication more than ten days a month.

This means that 20 days out of 30 should be kept free from taking the medication in order to prevent a continuous headache provoked by medication overuse.

Typical side effects of triptans are a general feeling of weakness and dizziness, as well as light-headedness, sensory disturbances, tingling, a feeling of warmth or heat and mild nausea.

Which migraine tablets help with severe migraine nausea?

Not all migraine sufferers experience nausea or vomiting. However, they are one of the most common accompanying symptoms. Timely treatment is also very important here, because after vomiting, oral medications are very difficult to absorb. Many migraine tablets, especially the triptans, often already successfully combat accompanying symptoms, such as nausea.

However, if this does not help, special anti-nausea and anti-vomiting medicines can be taken to help. Taking so-called antiemetics not only combats the nausea and vomiting, but also increases the absorption capacity of the stomach.

Anti-nausea and anti-vomiting medications help to better absorb painkillers, as the stomach can often be paralysed by a migraine attack.

Suitable antiemetics are, for example:

  • Metoclopramide (e.g. Paspertin®)
  • Domperidone (e.g. Motilium®)
  • Dimentydrinate (e.g. Vomex A®)

In some cases, medications such as Vomex can ward off even mild migraine attacks because they relax and make you tired.

Can I still drive after taking migraine tablets?

According to the German Road Traffic Act, driving a car after taking painkillers is generally prohibited (§ 24 Abs. 2 StVG). The exception to this is if the medication is necessary for the treatment of an illness and has been prescribed by a doctor.

Both migraines and the use of triptans can lead to drowsiness, which restricts attention and thus the ability to perform complex tasks.

Driving is a complex activity that requires full alertness and attention.

Whether a person can drive during a migraine attack or afterwards should therefore be carefully considered.

Is it possible to take migraine tablets during pregnancy?

Basically, it is advisable to completely avoid taking painkillers and therefore also migraine tablets during the entire pregnancy and especially during the first trimester. Studies on the use of paracetamol in pregnant women showed, for example, that there was an increased risk of ADHD, asthma and respiratory diseases in the children.

Especially during pregnancy, it is important to make sure which medicines are suitable for migraine.

Even triptans should only be considered after a detailed discussion with the gynaecologist or neurologist in charge because of inconclusive data. Pregnant women should also inform themselves about the possibilities of pain treatment without migraine tablets.

For example, there is the possibility of taking high doses of magnesium, as this relaxes the muscles and can have an anti-inflammatory effect. Preventing migraine attacks is especially important during pregnancy.

This includes, for example, targeted relaxation training, breathing meditation or yoga. These methods can reduce stress hormones and regenerate the body's own pain defence systems.

What are the alternatives to migraine tablets?

Not everyone wants to resort to treatment with migraine tablets. In addition to the classic drug treatment, there are many alternatives that are supposed to help against migraine attacks without medication. However, these are preventive measures. In the following table, we show you a short overview of the different alternatives.

Type of treatment Description
Targeted relaxation training Targeted relaxation training, such as Jacobsen's progressive muscle relaxation or breathing meditations, can relax the muscles, reduce stress hormones and thus regenerate the pain defence systems.
Acupuncture Many migraine patients swear by acupuncture to prevent migraine attacks. In the first step, the therapist checks which of the patient's energy pathways are blocked and places the needles at different points accordingly. It is important that the needles should not disturb during the application so that the patient can relax.
Biofeedback therapy In biofeedback therapy, electrodes are attached at pain-free intervals during migraine. Depending on what is to be measured, they are attached to the head, the neck or the corresponding muscle. The electrodes are used to measure body functions such as head muscle activity or pulse rate. The measurement results then show how relaxed the muscles are or how calm the pulse is, so that the therapist can show the patient in a second step how to consciously influence and relax these body functions.

In addition to these alternative methods, factors such as regular exercise, drinking plenty of fluids, getting plenty of sleep or massages also help to prevent migraines, without having to take migraine tablets.

Image source: Kurhan/ 123rf.com

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