The best thing to take for a migraine depends on how severe it is and how often you get them. For mild to moderate attacks, over-the-counter pain relievers like ibuprofen, naproxen, or aspirin work well when taken early. For moderate to severe migraines, prescription medications called triptans are the most widely used option, and newer drug classes now offer alternatives for people who can’t tolerate triptans. If you’re getting four or more migraine days per month, preventive treatments can reduce how often attacks happen in the first place.
Over-the-Counter Options for Mild Attacks
For migraines that are mild or just starting, standard pain relievers are often enough. Ibuprofen (400 mg), naproxen sodium (500 mg), and aspirin (900 to 1000 mg) all have solid evidence behind them. Taking them at the first sign of a migraine, before the pain escalates, makes a significant difference in how well they work. Waiting until the pain is fully established reduces their effectiveness considerably.
Acetaminophen can also help, though it tends to be less effective than anti-inflammatory options for most people. Combination products that pair a pain reliever with caffeine (like Excedrin Migraine, which contains aspirin, acetaminophen, and caffeine) can boost relief because caffeine enhances absorption and has mild pain-relieving properties on its own.
One critical limit to keep in mind: using any acute pain medication more than 10 to 15 days per month can cause medication overuse headache, where your headaches actually become more frequent. The threshold is roughly 15 days per month for simple pain relievers and 10 days per month for combination medications and triptans. If you’re approaching those numbers, it’s a sign you need a preventive strategy rather than more acute treatment.
Triptans for Moderate to Severe Migraines
Triptans are the standard prescription treatment for migraines that don’t respond to over-the-counter options. Seven triptans are available, and while they all work through the same basic mechanism (targeting serotonin receptors to constrict blood vessels and reduce inflammation in pain pathways), they differ in speed, duration, and how you take them.
Rizatriptan has the fastest onset of action, typically working within 30 minutes, with about 71% of patients reporting relief at two hours. Sumatriptan is the most versatile, available as a pill, nasal spray, and injection. The injectable form works fastest of all for people with severe nausea or rapidly escalating pain. Naratriptan has a slower onset but lasts up to 24 hours, making it a good choice for long migraines or menstrual migraines that tend to recur. Frovatriptan also has a longer duration and is sometimes used for predictable migraines, like those tied to your menstrual cycle.
A combination tablet pairing sumatriptan (85 mg) with naproxen sodium (500 mg) is also available, which attacks the migraine through two different pathways at once.
Triptans are not safe for everyone. They are contraindicated if you have a history of coronary artery disease, heart attack, stroke, or transient ischemic attack. A large study published in JAMA Neurology confirmed that triptans should not be prescribed to patients with these cardiovascular conditions. If you have significant heart disease risk factors, your doctor will need to evaluate whether triptans are appropriate for you.
Newer Prescription Alternatives
Two newer drug classes offer options for people who either can’t take triptans or don’t get adequate relief from them.
Gepants block a protein called CGRP that plays a central role in migraine pain. Ubrogepant (50 mg) and rimegepant (75 mg) are taken as pills during an attack. They don’t constrict blood vessels the way triptans do, which makes them safe for people with cardiovascular concerns. Rimegepant is particularly effective at providing sustained pain freedom from 2 to 24 hours after taking it, and it has a unique dual role: it can also be used on a regular schedule for migraine prevention.
Lasmiditan targets a more specific serotonin receptor than triptans and works on the neuronal side of migraine without affecting blood vessels. It appears to be the most effective of the newer acute medications in terms of headache freedom and relief from associated symptoms at two hours. The trade-off is more side effects, particularly dizziness and sedation. You shouldn’t drive for at least eight hours after taking it.
Supplements That Reduce Migraine Frequency
Three supplements have enough clinical evidence to be recommended by the American Headache Society for migraine prevention. They won’t stop a migraine in progress, but taken daily, they can reduce how many you get.
- Magnesium oxide: 400 to 500 mg per day. Magnesium plays a role in nerve signaling, and people with migraines tend to have lower levels. It’s one of the most well-supported supplements and is generally well tolerated, though higher doses can cause loose stools.
- Riboflavin (vitamin B2): 400 mg per day. This is far higher than the amount in a standard multivitamin. It supports energy production in brain cells, and trials have shown it reduces migraine frequency over two to three months of consistent use.
- CoQ10: 300 mg per day. Research has found this dose reduces migraine frequency in adults. Like riboflavin, it takes consistent daily use over several weeks to see results.
These supplements are generally safe and inexpensive. They work best as part of a broader prevention plan and can be combined with each other or with prescription preventives.
Prescription Preventive Medications
If you have four or more migraine days per month, or if your attacks are severe enough to significantly disrupt your life, preventive medication can cut migraine frequency by half or more. The American Headache Society considers CGRP-targeting therapies a first-line option for migraine prevention.
Four injectable CGRP-blocking medications are currently available. Erenumab (140 mg) and galcanezumab (120 mg after an initial loading dose) are self-injected once a month. Fremanezumab offers flexibility: you can choose a monthly injection (225 mg) or a quarterly injection (675 mg every three months). Eptinezumab is given as an IV infusion every three months at a clinic, which suits people who prefer not to manage injections at home.
These medications were designed specifically for migraine, unlike older preventives (certain blood pressure medications, antidepressants, and anti-seizure drugs) that were borrowed from other conditions. CGRP-targeting treatments tend to have fewer side effects, with the most common being injection site reactions. Many people notice improvement within the first month.
Devices That Treat Migraine Without Drugs
Four neuromodulation devices are currently available for migraine, and they all work by stimulating nerves to disrupt pain signals. They can be used alongside medications or as standalone options for people who want to minimize drug use.
Cefaly is an external nerve stimulator worn on the forehead that targets the trigeminal nerve. It’s the only one available without a prescription, sold directly through the manufacturer’s website. It can be used both during an attack and daily for prevention. Nerivio is a remote electrical stimulator worn on the upper arm during a migraine. GammaCore stimulates the vagus nerve on the side of the neck. The sTMS mini delivers a single magnetic pulse to the back of the head.
These devices are not appropriate for everyone. Anyone with a cardiac pacemaker or certain other implants should not use them, and some people experience skin irritation at the application site. But for many people, they offer a useful way to reduce how much medication they need, especially when used in a prevention role alongside other treatments.
Choosing the Right Approach
The most effective migraine treatment plan usually combines acute and preventive strategies. For occasional migraines (fewer than four per month), having a reliable acute medication and taking it early is often enough. Over-the-counter options are a reasonable first step, and if they’re not cutting it, triptans or the newer gepants are the next move.
Once you’re treating migraines more than two days a week, the priority shifts to prevention. That might start with daily supplements, move to a CGRP-blocking injection, or include a neuromodulation device. The goal is to reduce the number of attacks so you need acute medication less often, keeping you well below the overuse threshold that can make the whole problem worse.