Triptans

Most triptans work as well as each other, so choice is usually based on personal preference. 

• Tablets: If you prefer taking tablets, then sumatriptan or rizatriptan tablets may be useful. Rizatriptan tablets dissolve when placed on your tongue. They may be useful if you find drinking water during a migraine attack difficult or if you can't swallow tablets. They're not useful if you're vomiting (being sick).
• Injection: An injection may be better if you're vomiting, or if you develop a sudden migraine attack.

If one type of triptan doesn't relieve your migraine symptoms after 2 or 3 trials, you can try a different one. If you don't respond to triptan tablets, you can try the injection.

If you answer 'yes' to any of the following questions, it’s important that you tell your healthcare provider before starting on a triptan.

• Do you have problems with your liver or kidneys?
• Do you have problems with high blood pressure (hypertension)?
• Have you had a heart attack or do you get angina (chest pain)?
• Have you had a stroke or do you get transient ischemia attacks?
• Are you pregnant?
• Are you breastfeeding?
• Are you taking medication for depression?

Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care. For example, triptans aren't recommended for the treatment of hemiplegic migraine.

Repeat doses

Don't take another dose of a triptan if the first dose hasn't provided pain relief. If there was initial relief from the attack but symptoms have reoccurred the dose can be repeated after 2 to 4 hours. Be careful not to exceed the maximum daily dose. The following is a guide to repeated doses:

• Sumatriptan tablet:
  • dose may be repeated after 2 hours if migraine attack recurs
  • maximum 300 mg in 24 hours.
• Sumatriptan injection:
  • dose may be repeated once after one hour if migraine attack recurs
  • maximum 12 mg in 24 hours.
• Rizatriptan tablet: 
  • dose may be repeated after 2 hours if migraine attack recurs
  • maximum 30 mg in 24 hours
  • Propranolol: If you're taking propranolol to prevent migraines and you're also taking rizatriptan you need to talk to your doctor about adjusting the dose of these medicines as they interact with each other. 

Don't use triptans for more than 9 days per month

Medication-overuse headache (also known as medication adaptation headache or rebound headache) can occur if you use pain relief medicines or triptans to treat headaches and migraine attacks over a long time (regularly for 3 months or more).

If you're taking these medicines and you're having headaches more than 15 days per month then you may be experiencing medication-overuse headache.

Headaches often improve within 7 to 10 days after the triptan has been stopped. Symptoms may become worse before an improvement is seen.

To avoid this, do not use triptans for more than 9 days per month. 

Other medicines

Triptans can interact with some medicines, herbal supplements and rongoā Māori, so check with your doctor or pharmacist before starting triptans and before starting any new products.

Like all medicines, triptans can cause side effects, but not everyone gets them. Often side effects improve as your body gets used to the medicine. Common side effects of triptans include:

• feeling sick (nausea), being sick (vomiting) and dizziness
• strange sensations such as tingling, flushing, or feeling of tightness or pressure in areas such as your face, limbs, and sometimes chest
• soreness and tingling at the injection site, with use of the sumatriptan injection.

Read more about medicines and side effects(external link) and reporting a reaction that you think might be a side effect(external link).