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This sample plan shows how you can “step up” your treatment of a migraine attack if one particular combination of treatments fails. Use the combination that works best for you; different migraine attacks may need different combinations of medications. If you are not headache-free 4 hours after your migraine attack started, contact your doctor.
  1. Step 1: onset of migraine

    Immediately at onset of migraine attack:

    • Drink 8 fluid ounces of water

    • Stop what you are doing and find somewhere quiet, dark, and free of excess stimulation to rest until you are headache-free.

    • Eat one serving each of carbohydrate and protein

    • Take abortive medication: NSAID (N) and/or triptan (T), or NSAID with metoclopramide

    If you are not headache-free 2 hours after commencing Step 1, you may need to “step up” treatment of your migraine attack. Move on to Step 2 of this migraine treatment plan.

  2. Step 2: if migraine persists

    • Drink 8 fluid ounces of water

    • Eat one serving each of carbohydrate and protein

    • Take abortive medication: same NSAID (N) and same triptan (T) plus adjunctive antiemetic (A)

    • Sleep
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