Migraine Cocktail: What It Is, Ingredients, And More - Healthline

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HealthlineSubscribeBalancing Life with Acute MigraineWhat to Know About a Migraine Cocktail

Medically reviewed by Alisha D. Sellers, BS Pharmacy, PharmD — Written by Jill Seladi-Schulman, Ph.D. — Updated on March 19, 2025

Ingredients
Administration
Side effects
OTC options
OTC safety
Other medications
Natural remedies
FAQ
Bottom line

Key Takeaways

A migraine cocktail is a combination of drugs given to relieve severe migraine symptoms, often including anti-inflammatories, anti-nausea medication, and triptans.
An over-the-counter migraine cocktail typically contains a combination of acetaminophen, aspirin, and caffeine, but should not be taken more than 10 days a month to avoid medication overuse headaches.
Besides migraine cocktails, other treatments and prevention methods include prescription medications, supplements, relaxation techniques, and alternative therapies. Speaking with a doctor is important to find the best approach for you.

It’s estimated that 1 in 7 adults in the United States experience migraine. While there’s no cure, migraine is often treated with medications that ease symptoms or help prevent migraine attacks from happening in the first place.

Sometimes, in medical settings, migraine symptoms may be treated with a “migraine cocktail.” This isn’t a drink, but rather a combination of specific medications to help relieve migraine symptoms.

Keep reading to learn more about what’s in a migraine cocktail, the possible side effects, and other migraine treatment options.

What is a migraine cocktail?

The exact medications in a migraine cocktail could vary depending on other medical conditions you may have and your previous response to migraine rescue treatments.

Some of the medications that may be included in a migraine cocktail include:

Triptans: These medications have anti-inflammatory effects and may narrow the blood vessels in your brain, helping to ease pain. An example of a triptan in a migraine cocktail is sumatriptan (Imitrex).
Antiemetics: These medications can help relieve nausea and vomiting. Examples that could be used in a migraine cocktail include prochlorperazine (Compazine) and metoclopramide (Reglan).
Ergot alkaloids: Ergot alkaloids work similarly to triptans. Dihydroergotamine is an example of an ergot alkaloid used in a migraine cocktail.
Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs are a type of pain-relieving medication. One type of NSAID that may be present in a migraine cocktail is ketorolac (Toradol).
Injectable steroids: These medications help ease pain and inflammation. They may be given to help prevent your migraine from coming back in the next few days.
Intravenous (IV) fluids: IV fluids help replace any fluids you may have lost and prevent possible side effects from the medications in a migraine cocktail.
IV magnesium: Magnesium is a natural element that’s often used to prevent migraine attacks.
IV valproic acid (Depakote): This is a seizure medication that can be used to treat a severe migraine attack.

Who administers a migraine cocktail?

A migraine cocktail is typically administered in an emergency room or urgent care facility by a nurse or general practitioner, according to the American Migraine Foundation.

A migraine cocktail may be administered:

if your usual at-home treatment plan isn’t working
to treat a migraine attack that lasts 3 or more days

The medications in a migraine cocktail are usually given intravenously (via IV). It may take up to 2 hours for the effects of this treatment to start working and to feel symptom relief.

Are there side effects?

The possible side effects of a migraine cocktail will depend on the specific type of medication you take. Some of the more common side effects include:

Triptans: fatigue, aches and pains, and tightness in areas like the chest, neck, and jaw
Neuroleptics and antiemetics: muscle tics, muscle tremors, and restlessness
Ergot alkaloids: sleepiness, stomach upset, nausea, and vomiting
NSAIDs: stomach upset, diarrhea, and abdominal pain
Steroids: nausea, dizziness, and trouble sleeping

What about an OTC migraine cocktail?

An over-the-counter (OTC) migraine cocktail is a combination of three medications:

Aspirin, 250 milligrams (mg): This medication is used to reduce pain and inflammation.
Acetaminophen, 250 mg: This pain reliever works by reducing the number of prostaglandins your body produces.
Caffeine, 65 mg: This causes vasoconstriction (narrowing of blood vessels).

OTC medications that contain all three ingredients, such as Excedrin Migraine and Excedrin Extra Strength, are known as combination medications. When taken together, each ingredient is more effective at relieving migraine than the individual ingredient alone.

However, it’s important not to take combination medications more than 10 days per month to help treat migraine, as this may lead to medication overuse headaches.

Instead, consider taking simple analgesics like ibuprofen (Advil, Motrin), naproxen (Aleve), or acetaminophen (Tylenol) alone to treat migraine.

That said, it’s also important not to take simple analgesics for 15 days or more during the month, as this may lead to medication overuse headaches, too.

Generic brands may also have the same combination of ingredients, so be sure to check the product packaging to confirm the active ingredients.

How safe is an OTC migraine cocktail?

OTC migraine medications that contain aspirin, acetaminophen, and caffeine may not be safe for everyone. This is especially the case for:

people who’ve had a prior allergic reaction to any of the three components
anyone taking other medications that contain acetaminophen
children under age 12 years, due to the risk of Reye’s syndrome

Some potential side effects of this type of medication include:

abdominal pain
nausea
vomiting
diarrhea
dizziness
trouble sleeping
medication overuse headache

Before taking any OTC migraine medications, speak with a doctor if you:

have a very severe migraine attack or head pain that’s different from your typical episode
are pregnant, breastfeeding, or chestfeeding
have liver disease, heart disease, or kidney disease
have a history of conditions like heartburn or ulcers
have asthma
are taking any other medications, specifically diuretics, blood-thinning drugs, steroids, or other NSAIDs

What other types of medication may help?

Medications for acute migraine aim to help relieve migraine symptoms. These are typically taken as soon as you feel the onset of symptoms. Options include:

OTC medications, such as acetaminophen (Tylenol), NSAIDs like ibuprofen (Advil, Motrin), and aspirin (Bayer)
triptans, such as sumatriptan (Imitrex), rizatriptan (Maxalt), and almotriptan (Axert)
Ergot alkaloids, such as dihydroergotamine (Migranal) and ergotamine tartrate (Ergomar)
gepants, such as ubrogepant (Ubrelvy) and rimegepant (Nurtec ODT)
ditans, such as lasmiditan (Reyvow)

Medications to help prevent a migraine attack from occurring may include:

blood pressure medications, such as beta-blockers and calcium channel blockers
tricyclic antidepressants, such as amitriptyline and venlafaxine
antiseizure medications, such as valproate and topiramate (Topamax)
calcitonin gene-related peptide (CGRP) inhibitors, such as erenumab (Aimovig) and fremanezumab (Ajovy)
botox injections

What about vitamins, supplements, and other remedies?

Some nonpharmaceutical treatments may also help relieve symptoms or prevent migraine onset. Some options may include:

biofeedback
breathing exercises
meditation
regular exercise
acupuncture
yoga
cognitive behavioral training (CBT)
taking supplements, such as vitamin B2, coenzyme Q10, and magnesium

It’s important to note that some herbs, vitamins, and mineral supplements may not be safe for everyone. Be sure to talk with a doctor before trying these remedies.

Frequently asked questions

What are the three ingredients in a migraine cocktail?

OTC migraine cocktail

What is in a migraine cocktail at urgent care?

may include

What is the migraine cocktail with Benadryl?

sometimes used

include

The bottom line

A migraine cocktail is a combination of medications given in a medical setting to treat severe migraine symptoms. The exact medications used in a migraine cocktail can vary, but typically include triptans, NSAIDs, and antiemetics.

A migraine cocktail is also available in OTC medication. OTC products usually contain aspirin, acetaminophen, and caffeine. These components are more effective when they’re used together than when they’re taken alone.

Many different types of medications are routinely used to treat or prevent migraine symptoms. Additionally, some herbs, supplements, and relaxation techniques may help.

It’s important to talk with a doctor about the type of treatment that may work best for you.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Aleksenko D, et al. (2025). Medication overuse headache.https://www.ncbi.nlm.nih.gov/books/NBK470171/
Altabakhi IW, et al. (2023). Acetaminophen/Aspirin/Caffeine.https://www.ncbi.nlm.nih.gov/books/NBK513274/
Cortel-LeBlanc MA, et al. (2023). Managing and preventing migraine in the emergency department: A review.https://www.annemergmed.com/article/S0196-0644(23)00420-1/fulltext
D’Souza RS, et al. (2025). Extrapyramidal side effects.https://www.ncbi.nlm.nih.gov/books/NBK534115/
Lew C, et al. (2023). Migraine medications.https://www.ncbi.nlm.nih.gov/books/NBK553159/
Migraine cocktails: What they are and why they are misunderstood. (2022).https://americanmigrainefoundation.org/resource-library/migraine-cocktail/
Pescador Ruschel MA, et al. (2024). Migraine headache.https://www.ncbi.nlm.nih.gov/books/NBK560787/

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Medically reviewed by Alisha D. Sellers, BS Pharmacy, PharmD — Written by Jill Seladi-Schulman, Ph.D. — Updated on March 19, 2025

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