Know Your Options for Acute Migraine Treatments in the ED
April 2026
Updated guidelines aim to take the pain out of choosing injectable meds for acute migraine in the emergency department (ED).
First line. Continue to start with IV prochlorperazine. It has strong evidence...and guidelines consider it a “must offer” med.
Data show lower rates of side effects, less rescue med use, and fewer ED return visits with prochlorperazine compared to some other treatments. Consider adding diphenhydramine to limit extrapyramidal symptoms.
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