Italian guidelines for primary headaches: 2012 revised version

Table 6 Drugs for symptomatic treatment of migraine with a level of recommendation III and IV

Drug	Route of administration	Dosage (mg)	Level of evidence	Scientific strength of evidence	Clinical effectiveness	Adverse events	Level of recommendation
NSAIDs
Indomethacin	os	25–50	C	+	++	Frequent, not severe	III
	Rectal	50–100	C	+	++	Frequent, not severe	III
Nimesulide	os	100	C	+	+	Occasional, not severe	IV
Paracetamol	os	650–1,000	B	+	++	Rare, not severe	III
Piroxicam	Rapid dissolving formulation	40	B	++	+	Frequent, not severe	III
Ergot derivatives
Ergotamine + caffeine	os, rectal	2 + 200	C	+	+	Frequent, not severe	III
Combination analgesics
Butalbital + propyphenazone + caffeine	os	50 + 150 + 125; 175 + 25 + 75	C	0	+	Those of each active substance	IV
Antiemetics
Metoclopramide	os	10	C	0	0/+	Infrequent	IV
Prochlorperazine	Rectal	20	B	++	+	Infrequent	III
Chlorpromazine	i.m.	0.1 /kg to 3 dosages	C	0	+	Occasional	IV
	i.v.	12.5–37.5	B	++	++	Slight to moderate	III
Domperidone	os	10	C	0	+	Rare	IV
Opioid analgesics
Meperidine		50–100	B	++	++	Frequent, not severe	III
Tramadol		100	B	+	+	Occasional, not severe	III
Tramadol + paracetamol		37.5 + 325	B	+	+	Occasional, not severe	III
Other drugs
Lidocaine	Intranasal	0.4 ml 4 % solution	B	++	+	Frequent, potentially severe	III
Prednisone	os	50–100	B	++	+	Frequent, potentially severe	III
Dexamethasone	i.v.	10	B	++	+	Frequent, potentially severe	III
Valproic acid		300–800	B	+	++	Frequent	III

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