Migraine affects approximately 12% of adults worldwide — around three-quarters of sufferers are women, and peak prevalence is in the 25-55 age range. Unlike tension headache, migraine is a distinct neurological disorder driven by trigeminal nerve activation, calcitonin gene-related peptide (CGRP) release, and cortical spreading depression. A typical attack lasts 4-72 hours with moderate-to-severe throbbing pain, often one-sided, with nausea, photophobia, and phonophobia; around 30% of sufferers experience preceding visual, sensory, or motor aura.
Migraine management on MedsBase follows the two-track approach endorsed by the American Headache Society, NICE, and the European Headache Federation: acute (abortive) treatment taken at the first sign of an attack, plus preventive treatment taken daily when attacks happen more than 4 times per month or are disabling.
Acute (abortive) treatments stocked at MedsBase: Rizatriptan (Maxtan, Rizatop, Rizact) — the fastest-onset oral triptan with the highest 2-hour pain-freedom rate. Sumatriptan (Sumitop, Leemigran) — the original triptan and the most evidence-rich option. Zolmitriptan (Zolitas ODS — oro-dispersible, and Zolmist Neusspray — fastest 10-15 min onset). Sumatriptan + Naproxen fixed-dose combination (Headset — Treximet generic, superior to either component alone). For mild-to-moderate attacks, Naprosyn (naproxen) is the NSAID of choice.
Preventive treatments stocked at MedsBase: Propranolol (Inderal IR and Inderal LA) — the classic first-line preventive; safe in pregnancy; 80-160 mg/day. Topiramate (Topicon) — FDA-approved migraine preventive; target 100 mg/day; causes weight loss; contraindicated in pregnancy. Flunarizine (Sibelium) — European first-line calcium-channel blocker; 10 mg nightly; particularly effective for paediatric and vestibular migraine; 6-month course limit. Sodium Valproate (Encorate IR and Encorate Chrono ER) — reserved for patients where first-line preventives have failed; highly teratogenic so not used in women of childbearing potential without formal pregnancy prevention.
Critical safety message — medication-overuse headache. Using triptans, ergots, or combination analgesics more than 10 days per month, or simple NSAIDs / paracetamol more than 15 days per month, causes a paradoxical rebound headache called medication-overuse headache (MOH). If you need acute treatment more than these limits, you need to add a preventive drug, not more acute medication. Keep a migraine diary tracking monthly acute-medication days — if crossing the threshold, start a preventive.
Migraine is a chronic condition — the aim of treatment is functional reduction of frequency and severity, not cure. Use under medical guidance where needed. If your headaches are new, severely different from usual, accompanied by fever, neurological deficits, neck stiffness, or come with a “thunderclap” onset, seek emergency medical care — these are not migraine.