Migraine prophylaxis: General prescribing (Formulary: CNS)

TAM (Treatments and Medicines) NHS Highland
NHS Highland

Guidelines

General prescribing: May be prescribed in Primary or Secondary care. 

PROPRANOLOL - (First line)

Therapy notes

FIRST LINE: unless contra-indicated by asthma, COPD, peripheral vascular disease, heart failure or depression.

Formulation and dosage details

Formulation:

  • Propranolol tablets 10mg, 40mg

Formulation and dosage details

Formulation:

  • Propranolol modified release capsules 80mg, 160mg

AMITRIPTYLINE

Therapy notes

ALTERNATIVE FIRST LINE: when migraine co-exists with troublesome tension-type headache, another chronic pain condition, disturbed sleep or depression.

Formulation and dosage details

Formulation:

  • Amitriptyline tablets 10mg, 25mg, 50mg

CANDESARTAN

Formulation and dosage details

Formulation:

  • Candesartan tablets 2mg, 4mg, 8mg, 16mg, 32mg

NORTRIPTYLINE

Therapy notes

LESS COST-EFFECTIVE ALTERNATIVE: if amitriptyline is poorly tolerated.

Formulation and dosage details

Formulation:

  • Nortriptyline tablets 10mg, 25mg

Indication: 

  • Migraine prophylaxis off-label: initially 10mg at night, increased if necessary to maintenance of 50 to 75mg at night.

Editorial Information

Document Id: F069