Migraines are severe headaches that are associated with symptoms like nausea, light sensitivity, and numbness. For some a migraine lasts a few hours but for others it may last several days if left untreated. Migraine headaches can occur with or without what is called an “aura.” An aura includes visual disturbances like flashes of light, blind spots, or wavy vision and occurs about a half hour before the onset of the headache.  The combined symptoms of these headaches can be incapacitating and make it difficult to go about regular activities. Acute treatment at the onset of a migraine can greatly improve symptoms and reduce the severity of the headache.

Migraine Causes and Triggers

The exact reason why an individual is susceptible to migraines is not completely known, although it does tend to be hereditary. About 1 out of 8 Americans get migraine headaches and a majority of them are women. Triggers for migraine headaches can include environmental factors like light and noise, the use of certain medications, stress and anxiety, and other factors. Trying to prevent migraines by being aware of triggers is important, but most migraine sufferers will not be able to completely avoid an attack all the time. It can be a great benefit to have a medication available that can quickly treat a migraine as soon as it starts.

Compounded Capsules for Acute Migraine Treatment

A combination of ingredients can be made into a single capsule for acute treatment of migraines. These capsules can be taken at the onset of a migraine to quickly bring the attack under control. Two examples of capsules we compound at our pharmacy for migraines include:

Migraine Capsule 1 (Difmetre Alternate): Contains indomethacin, caffeine, and prochlorperazine. This is the same combination of ingredients found in a brand-name product sold in Italy called Difmetre. We offer multiple strength versions of this compound, including with 2mg, 4mg, or 8mg prochlorperazine.

Migraine Capsule 2 (Keto/Ribo/Caff): Contains ketoprofin, riboflavin, and caffeine.  We most commonly include ketoprofen 12.5mg, riboflavin 100mg, and caffeine 65mg in this effective headache treatment.

Two effective ingredients we include in many migraine formulations are indomethacin and caffeine. Indomethacin is an NSAID that provides relief for many types of headaches. Certain headache types like hemacrania continua only respond to treatment with indomethacin, as it acts somewhat differently than other NSAIDs. Caffeine is frequently found in headache medicines for its vasoconstrictive properties. Headaches tend to cause blood vessels to enlarge. Caffeine constricts the blood vessels, which reduces pain.

Other ingredients that may be included in migraine capsules include riboflavin (Vitamin B2) and prochlorperazine. Vitamin B2 deficiency may be associated with susceptibility to migraines and has been shown to reduce the frequency of headaches when supplements are taken regularly. Prochlorperazine is a powerful medication that is effective at treating severe migraine attacks. For any ingredient included in our migraine capsules, multiple strengths are available to meet the needs of individual patients.

Compounded Topical Treatments for Migraines

One benefit of a topical medication is that it greatly reduces the risk of systemic effects. Migraine medications applied transdermally or intranasally have a much lower absorption rate into the blood stream than those taken orally. Using a topical cream or gel for migraines with an NSAID like ketoprofen can prevent negative effects on the gastrointestinal system and other complications.

One popular topical medication we make for migraines is lidocaine nasal spray. When applied to the nasal passage during a migraine attack this medication can provide fast pain relief – usually within a few minutes. A nerve bundle called the sphenopalatine ganglion (SPG), which is located behind the nose, is associated with migraines and lidocaine nasal spray numbs this area. Many patients find this provides instant relief that lasts about one hour.

Customized Migraine Treatment

At Park Compounding Pharmacy, making custom medications that are not commercially available is our specialty. There are many combinations of migraine medication ingredients that are possible in different dosages. We frequently work with doctors who are looking for a specific migraine treatment that will be most effective for their patients. Having a powerful acute migraine treatment available can greatly improve a patient’s quality of life.