Migraine Medication Comparison: What Works Best?

If you suffer from migraines, you’ve probably tried a few pills that promised relief. Not all meds act the same, and picking the right one can feel like guessing. This guide breaks down the most common migraine drugs, shows where they shine, and tells you what to watch out for. By the end, you’ll have a clear picture of which options fit your headaches, budget, and health.

Top Prescription Options

Prescription meds dominate migraine treatment because they target the root cause of the pain. Triptans—like sumatriptan, rizatriptan, and zolmitriptan—are the first line for moderate to severe attacks. They work within an hour, relieve pain, and usually wear off after a few hours. The downside? Some people feel tingling, tightness in the chest, or nausea. If you have heart disease, triptans aren’t a good fit.

CGRP inhibitors are newer and pricey, but they’re great for folks with frequent attacks. Drugs such as erenumab (Aimovig) and fremanezumab (Ajovy) are injected once a month or quarterly. They don’t treat an ongoing attack; instead, they lower the number of attacks you get. Side effects are mild—often just a sore arm or constipation.

For those who can’t take triptans or need a backup, gepants like ubrogepant and rimegepant are an oral alternative. They block the same pain pathway without the vascular risks of triptans. Onset is a bit slower, about 30‑60 minutes, but they’re safe for most heart patients. The main downside is cost, especially without insurance.

If you have a migraine with aura or need a non‑serotonin route, ditans such as lasmiditan are an option. They avoid blood vessel effects but can cause drowsiness, so you shouldn’t drive after taking them.

Over‑the‑Counter Choices

Not everyone wants a prescription, and many can get relief from OTC meds. NSAIDs—ibuprofen (Advil) and naproxen (Aleve)—reduce inflammation and work best when taken early. They’re cheap, but you need to watch for stomach upset and kidney issues if you use them often.

Acetaminophen (Tylenol) is gentler on the stomach but less effective on its own for migraine pain. When combined with an NSAID, it can boost relief without adding extra side effects.

Some people find success with caffeine‑containing combos like Excedrin Migraine (acetaminophen, aspirin, caffeine). Caffeine narrows blood vessels, which can stop a migraine in its tracks, but too much caffeine can trigger rebound headaches.

Finally, magnesium and riboflavin (vitamin B2) supplements don’t stop an attack fast, but daily use can reduce the frequency of migraines for many. They’re cheap and have few side effects, making them a safe preventive addition.

When you compare meds, think about three things: how fast they work, how long they last, and how they fit your health profile. If you need a quick fix for occasional attacks, a triptan or an NSAID combo works well. If you battle attacks several times a week, talk to your doctor about a CGRP inhibitor or daily supplements.

Remember, the best migraine medication is the one that eases your pain without causing new problems. Talk to a health professional, note how each medication affects you, and adjust as needed. With the right info, you can stop guessing and start feeling better.