What Is A Migraine Cocktail? Ingredients, Side Effects, And More

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What is a migraine cocktail?

Medically reviewed by Susan W. Lee, DO — Written by Jayne Leonard — Updated on August 20, 2025

About
Ingredients
Side effects
Over the counter
Other treatments
FAQ
Summary

Key takeaways

Migraine cocktails are medication combinations used to treat severe migraine symptoms, often administered in hospitals via IV, and can include anti-inflammatories, antiemetics, and migraine-specific drugs.
OTC migraine cocktails typically contain acetaminophen, aspirin, and caffeine to reduce pain and inflammation, though overuse can lead to medication overuse headaches.
Beyond migraine cocktails, managing migraines involves avoiding triggers, using specialized medications like triptans or CGRP inhibitors, and exploring relaxation and biofeedback techniques.

It may contain a combination of anti-inflammatories, drugs that alleviate nausea and vomiting, and medications that specifically target migraine. Doctors administer these medications in hospitals, although over-the-counter (OTC) migraine cocktails are also available.

In this article, we will look at migraine cocktails, their ingredients, potential side effects, OTC and homemade options, and other migraine treatments.

What is a migraine cocktail?

The term “migraine cocktail” is an informal way of describing the combination of medications doctors can administer to people in the hospital when they experience severe migraine.

If a person visits the emergency room (ER) with severe migraine symptoms, including intense pain, doctors will first rule out other conditions, such as a thunderclap headache. Then, they can provide several medications through an intravenous (IV) line.

How long it takes for a migraine cocktail to offer relief can vary from person to person. Doctors may add one medication at a time, but typically, they administer several at once, as research suggests this improves the outcome.

If the migraine cocktail does not appear to be working, doctors may try other medications, such as valproic acid, steroids, magnesium, and triptans.

What do migraine cocktails contain?

Doctors can use a variety of drugs in migraine cocktails. The ones they choose may depend on a person’s symptoms and medical history.

A migraine cocktail from doctors in the ER may include:

Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications reduce inflammation, which contributes to pain and throbbing. Several NSAIDs are effective at treating acute migraine, but for a migraine cocktail, doctors may use ketorolac.
Acetaminophen: This pain medication can be useful together with NSAIDs. However, doctors can only use acetaminophen if a person has not already taken some before heading to the ER.
IV fluids: People experiencing severe vomiting as a result of migraine can become dehydrated. Dehydration itself can also be a migraine trigger. In these cases, doctors may recommend IV fluids.
Antiemetics: These drugs reduce symptoms such as nausea and vomiting. Doctors may also include the antihistamine diphenhydramine (Benadryl) to reduce the risk of side effects.
Dexamethasone: This type of steroid medication reduces inflammation in the body. Research suggests that dexamethasone may help prevent migraine from coming back after initial treatment.

A 2022 study also suggests that magnesium, both in oral and intravenous (IV) form, may help prevent and treat migraine pain.

In severe cases where first-line treatments do not work, doctors may prescribe opioids.

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Side effects

Typically, people tolerate the medications in migraine cocktails well. However, some individuals may experience side effects.

The side effects of a migraine cocktail depend on the drugs it contains. The most common include:

Drug type	Side effects
ketorolac	• headaches• dizziness• drowsiness• nausea• constipation
acetaminophen	• rash• itching• swelling
antiemetics	• mild headaches• dizziness• constipation
magnesium sulfate	• high magnesium levels• minor facial flushing and warmth • temporary low blood pressure
dexamethasone	• indigestion• sleep problems

Frequent or high doses of any of these medications may cause more severe adverse reactions or toxicity. In rare cases, people can also experience allergic reactions.

A person should tell a doctor if a migraine cocktail causes severe or prolonged side effects.

OTC migraine cocktails

OTC migraine cocktails are also available for the treatment of mild to moderate migraine. These products typically contain three active ingredients:

acetaminophen, 250 milligrams (mg)
aspirin, 250 mg
caffeine, 65 mg

Aspirin and acetaminophen reduce pain and inflammation. Caffeine acts as a vasoconstrictor, which narrows the blood vessels to reduce pain.

This combination is highly effective in treating migraine pain. However, it is worth noting that for some people, caffeine can be a migraine trigger. It can also cause anxiety, agitation, and trouble sleeping.

According to the American Migraine Foundation, taking OTC migraine medications too frequently can cause medication overuse headaches and reduce how effective they are.

If a person takes OTC migraine cocktails more than 2–3 times per week, they should speak with a doctor or migraine specialist. People should also check if it is OK to take these products if they are pregnant, breastfeeding, taking other medications, or have any other underlying conditions.

Other treatments

A migraine cocktail can be an effective treatment for occasional migraine. However, other treatment options may be more suitable for people with frequent or severe migraine. These include:

Avoiding triggers

A wide variety of factors can contribute to the development of migraine. Some people find that by identifying and eliminating migraine triggers, they can reduce the number of episodes they have.

Depending on a person’s triggers, this may include:

getting enough sleep and having a regular sleep-wake schedule
staying hydrated
eating regular meals
avoiding caffeine and alcohol
avoiding specific trigger foods
getting enough exercise
managing stress levels

Keeping a migraine diary can help with identifying migraine triggers over time.

Medications

A person who experiences chronic migraine may benefit from taking more specialized migraine medications, such as:

triptans, which can stop the progression of individual migraine attacks
ergotamines, which work in a similar way to triptans
calcitonin gene-related peptide (CGRP) inhibitors, such as erenumab (Aimovig), which can prevent migraine
Botox injections

These may be more effective than OTC analgesics, particularly for people with severe or frequent migraine.

Some other common medications that can reduce the frequency of migraine include:

some antidepressants, such as amitriptyline
some seizure medications
some blood pressure medications, including beta-blockers
hormonal medications, such as estrogen-free hormonal birth control, for those with menstrual migraine

If a person already requires one of these medications, they may also help treat or manage migraines.

Relaxation and biofeedback

Several complementary therapies show promise for reducing migraine frequency. These include relaxation training and biofeedback, a technique that teaches people to become aware of bodily processes so they can control them.

Frequently asked questions

Is Motrin good for migraines?

Motrin is a brand name for ibuprofen and is effective for acute migraine treatment. It is one of the most commonly used medications for migraine and is available over the counter and by prescription.

However, a person should not overuse the medication to avoid adverse side effects.

What works better for a migraine Tylenol or Motrin?

Tylenol and Motrin are brand names for painkillers, known as acetaminophen and NSAIDs, both of which can be effective in treating migraines.

When should a person see a doctor about migraines?

A person should talk with their doctor about their migraines when they are:

severe or getting worse, or lasting longer than usual
occurring more than once a week
difficult to control
regularly happening before or during a period

Summary

A migraine cocktail is a combination of medications that reduce migraine symptoms, such as pain and vomiting. Doctors may administer a migraine cocktail to those who go to the hospital with severe migraine.

OTC versions of migraine cocktails are available. These can effectively treat migraine in people with moderate symptoms. Alternatively, people can take a combination of aspirin, acetaminophen, and caffeine at home.

Individuals who have severe or frequent migraine should contact their doctor about other treatment options available.

Headache / Migraine
Neurology / Neuroscience
Pharmacy / Pharmacist

How we reviewed this article:

SourcesMedical News Today 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.

Altabakhi IW, et al. (2023). Acetaminophen/aspirin/caffeine.https://www.ncbi.nlm.nih.gov/books/NBK513274/
Acetaminophen. (2023).https://medlineplus.gov/druginfo/meds/a681004.html
Beverages, coffee, instant, regular, powder. (2019).https://fdc.nal.usda.gov/food-details/171893/nutrients
Diener HC, et al. (2021). Aspirin, paracetamol (acetaminophen) and caffeine for the treatment of acute migraine attacks: A systemic review and meta-analysis of randomized placebo-controlled trials.https://onlinelibrary.wiley.com/doi/10.1111/ene.15103
Domitrz I, et al. (2022). Magnesium as an important factor in the pathogenesis and treatment of migraine—From theory to practice.https://pmc.ncbi.nlm.nih.gov/articles/PMC8912646/
Friedman BW, et al. (2023). Randomized trial comparing low- vs high-dose IV dexamethasone for patients with moderate to severe migraine.https://pmc.ncbi.nlm.nih.gov/articles/PMC10573135/
Hauser JM, et al. (2022). Antiemetic medications.https://www.ncbi.nlm.nih.gov/books/NBK532303/
Hicks MA, et al. (2023). Magnesium sulfate.https://www.ncbi.nlm.nih.gov/books/NBK554553/
Ketorolac injection. (2021).https://medlineplus.gov/druginfo/meds/a614011.html
Migraine. (2024).https://www.ninds.nih.gov/health-information/disorders/migraine
Migraine. (2022).https://www.nhs.uk/conditions/migraine/
Migraine cocktails: What they are and why they are misunderstood. (2022).https://americanmigrainefoundation.org/resource-library/migraine-cocktail/
Non-steroidal anti-inflammatory drugs (NSAIDs) for acute migraine treatment. (2021).https://americanmigrainefoundation.org/resource-library/nsaids-migraine/
Production of excedrin migraine discontinued until further notice (updated). (2020).https://americanmigrainefoundation.org/resource-library/excedrin-migraine-discontinued/
Puledda F, et al. (2024). International headache society global practice recommendations for the acute pharmacological treatment of migraine.https://journals.sagepub.com/doi/full/10.1177/03331024241252666
Rosenthal S, et al. (2023). Efficacy of IV valproic acid and oral valproic acid tapers for the treatment of pediatric headaches in the emergency department.https://www.neurology.org/doi/10.1212/CPJ.0000000000200170
Robblee J, et al. (2020). Emergency deartment and inpatient management of headache in adults.https://pubmed.ncbi.nlm.nih.gov/32189074/
Side effects of dexamethasone tablets and liquid. (2023).https://www.nhs.uk/medicines/dexamethasone-tablets-and-liquid/side-effects-of-dexamethasone-tablets-and-liquid/

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Medically reviewed by Susan W. Lee, DO — Written by Jayne Leonard — Updated on August 20, 2025

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Key takeaways

What is a migraine cocktail?

What do migraine cocktails contain?

Side effects

OTC migraine cocktails

Other treatments

Avoiding triggers

Medications

Relaxation and biofeedback

Frequently asked questions

Is Motrin good for migraines?

What works better for a migraine Tylenol or Motrin?

When should a person see a doctor about migraines?

Summary

How we reviewed this article:

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