What to do if Nausea & Vomiting Occurs in Migraine?

The commonly used medications in management/treatment of migraine headache are generally given by oral route. If early nausea or vomiting occurs while treating the patient with migraine, it may cause some technical difficulty in managing the patients with migraine headache.

The early nausea or early vomiting may be due to the drugs used (as many orally used drugs can cause nausea and/or vomiting as their side effects) for management of migraine. The early nausea and vomiting may not be related to the drugs administered for management of migraine. Nausea and vomiting are also common symptoms of migraine headache. Nausea is a very common side effect of migraine and it occurs in approximately 87% of the patients with migraine. Vomiting is also a common symptom of migraine (vomiting occurs in approximately 56% of patients with migraine), although it is not as common as that of nausea.

Whatever may be the cause of nausea and vomiting, it is always a problem to manage a patient with these symptoms. The drug of choice and the route of administration of drugs are changed if there is nausea or vomiting. Generally as a rule oral drugs can not be given and other routes of drug administration have to be chosen.

In case of nausea:

If migraine patient is suffering from early nausea or difficulty in taking oral tablets the treatment/management of migraine has to be modified. The drugs which are commonly used in nausea and difficulty in taking oral tablets are zolmitriptan 5 mg nasal spray, sumatriptan 20 mg nasal spray and rizatriptan 10 mg MLT wafer. Any of these drugs can be used and the efficacy is approximately same for all of these drugs.

In case of vomiting:

If there is vomiting in migraine patient (due to any cause) zolmitriptan 5 mg nasal spray, sumatriptan 25 mg per rectally, sumatriptan 6 mg subcutaneously can be given to avoid vomiting. The drugs should be used as per the convenience of the patient and the response of the drug.