MTW NHS Trust West Kent CCG

Drug Status Key

  • Preferred
  • Second Line
  • Third Line
  • Specialist Initiation
  • Hospital Only
  • Not Approved for Formulary

Migraine

Drug Safety Update

June 2023: Non-steroidal anti-inflammatory drugs (NSAIDs): potential risks following prolonged use after 20 weeks of pregnancy

 January 2017: Intravenous N-acetylcysteine (NAC) for paracetamol overdose: reminder of authorised dose regimen; possible need for continued treatment with NAC. 

 December 2014: Treating paracetamol overdose with intravenous acetylcysteine: new guidance

NICE Guidance (see also drug specific links below)

 CG150 Headaches in over 12s: diagnosis and management, updated November 2015

 TA260 Botulinium toxin type A for the prevention of headaches in adults with chronic migraine, June 2012

Treatment of a migraine attack should be guided by response to previous treatment and the severity of the attacks. A simple analgesic such as aspirin, paracetamol (preferably in a soluble or dispersible form) or ibuprofen is often effective; concomitant antiemetic treatment may be required. If treatment with an analgesic is inadequate, an attack may be treated with a specific antimigraine compound such as a 5HT1-receptor agonist (‘triptan’).

Other drugs used in the treatment of migraine particularly prophylaxis against an attack include propranolol, topiramate, gabapentin and botulinum toxin.

See here for K&M CCG Management of Adults with Headaches and Migraines in Primary Care

Pack Price
100 tablet £3.09
100 tablet (10 x 10 tablets) £2.08
1000 tablet £34.76
16 tablet (2 x 8 tablets) £0.50
30 tablet (3 x 10 tablets) £0.80
32 tablet £0.67
Pack Price
100 capsule (10 x 10 capsules) £3.09
16 capsule £0.60
32 capsule £0.99
Pack Price
100 tablet (10 x 10 tablets) £25.52
24 tablet (4 x 6 tablets) £10.64
60 tablet
Pack Price
100 ml £6.28
500 ml
Pack Price
100 ml £2.71
1000 ml
200 ml £6.02
Pack Price
100 ml £7.04
500 ml £34.87
Pack Price
100 ml £3.30
1000 ml £47.30
200 ml £13.20
500 ml £18.70
Pack Price
10 suppository £11.95
Pack Price
10 suppository £23.01
Pack Price
10 suppository £62.31
Pack Price
10 suppository £41.27
Pack Price
10 vial
Pack Price
32 tablet (4 x 8 tablets) £0.93
100 tablet
Pack Price
10 suppository
Pack Price
10 suppository
Pack Price
24 tablet £0.66
48 tablet (4 x 12 tablets) £2.72
84 tablet £2.35
Pack Price
24 tablet £2.57
48 tablet (4 x 12 tablets) £1.46
84 tablet (7 x 12 tablets) £2.59
Pack Price
100 ml £1.52
150 ml £4.18
500 ml £17.16
Pack Price
42 tablet (3 x 14 tablets)
Pack Price
12 tablet £3.46
6 tablet £1.46
Pack Price
3 tablet
6 tablet £28.26
Pack Price
12 tablet
2 tablet
3 tablet £9.65
6 tablet
Pack Price
12 tablet
2 tablet
4 tablet
6 tablet £0.88
Pack Price
12 tablet
2 tablet
4 tablet
6 tablet £1.17
Pack Price
2 unit dose £14.16
Pack Price
2 pre-filled disposable injection £50.96
Pack Price
12 tablet (2 x 6 tablets) £34.52
6 tablet £24.00
Pack Price
6 tablet £71.17
Pack Price
6 tablet £10.53
Pack Price
6 tablet £14.13
Pack Price
6 unit dose £36.50
Pack Price
1 pre-filled disposable injection £386.50
Pack Price
28 tablet (4 x 7 tablets) £182.16

Reduce dose to 10 mg once daily with concurrent use of potent CYP3A4 inhibitors, OATP inhibitors, or telmisartan.

Pack Price
28 tablet (4 x 7 tablets) £182.16

In accordance with NICE TA919

See here for K&M Rimegepant Prescribing Guideline for Primary Care

Pack Price
2 tablet £25.80
8 tablet £103.20

In accordance with NICE TA906

Pack Price
2 tablet £25.80
8 tablet £103.20