What are Medications That Make Migraine Worse? 2023
Migraine is a genetic, familial related neurological problem involving the thalamus, the cerebral arteries, and the trigeminal nerve. In the migraine process the inflammatory neurochemicals CGRP, Neurokinan A, and Substance P are released and inflame brain structures.
Migraine has many triggers and certain medications can act as a migraine trigger and make it worse. Doctors need to educate and patients need to learn the medicines that can make their headaches worse.
What are the medications that make Migraine worse?
Read my Mini Book on Migraine Here.
This is an article by Britt Talley Daniel MD, member of the American Academy of Neurology, the American Headache Society, migraine textbook author, and blogger.
As a general rule the main medications that aggravate Migraine are:
SSRIs, antihypertensive drugs, vasodilators, birth control pills, bronchodilators, opioid narcotics, caffeine, PPIs, and estrogens.
Certain chemicals in these drugs cause the release of inflammatory neurochemicals and the start of the migraine process. This is Medication Induced Migraine. Other drugs listed cause medication overuse headache from overtreatment.
The drugs listed here cause a migraine headache to occur soon after taking a single dose of the drug; acting in this regard like a “trigger.”
Many are aware that environmental triggers like stress and insomnia often aggravate migraine, but few know that medications for unrelated and relatively benign conditions can also set off migraine attacks.
List of drugs that worsen Migraine.
Antihypertensive drugs:
Reserpine (Ser-ap-Es, Hydropres)
Hydralazine (Apresoline)
Nifedipine (Caalan).
Birth control pills:
Oral birth control pills: norethindrone/ethinyol estradiol (Orthonovum)
Levonorgestrel/ethinyl estradiol (Alesse)
Estrogen patches, and intramuscular injection (Estrace, Estradiol).
Coronary vasodilators:
for angina--Nitroglycerin, Nitrates.
Histamine receptor antagonists:
Cimetidine (Tagamet)
Decongestants:
pseudoephedrine Advil sinus, Dristan.
Nasal Steroids
Budesonide (Rhinocort, Rhinocort Aqua)
Triamcinolone (Nasacort, Nasacort AQ)
Ciclesonide (Zetonna, Omnaris)
Flunisolide (Nasarel, Aerospan)
Fluticasone (Flonase, Veramyst, Xhance)
Beclomethasone (QNASL, Beconase QA)
SSRIS-Selective Serotonin Receptor Inhibitors-for treatment of Depression, Anxiety and Panic Disorder:
Fluoxetine (Prozac)
Paroxetine (Paxil)
Sertraline (Zoloft(
Citalopram (Celexa)
Escitalopram (Lexapro)
Bronchodilators:
Theophylline
Aminophyline
Proton Pump Inhibitors (PPIs):
omeprazole (Prilosec, Prilosec OTC, Zegerid)
lansoprazole (Prevacid)
pantoprazole (Protonix)
rabeprazole (Aciphex)
esomeprazole (Nexium)
Nasal Steroids and Decongestants
dexlansoprazole (Dexilant)
Opioids Narcotics:
Vicodin
Hydrocodone
Tramadol
Tracking medication usage.
Watch out for caffeine as coffee, tea, chocolate, Excedrin, BC Powder. In the US caffeine is the number one drug causing medication overuse headache.
Medication tip
Unfortunately, the most common of all medical side effects that any medication, drug, or supplement may cause is HEADACHE.
Sometimes, just tracking all of your medication usage and step wise eliminating one drug at a time will reveal the one that makes your headaches worse.
Check out my Big Book on Migraine Here.
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All the best.
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Britt Talley Daniel MD
