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Migraine: acute treatment and prevention

A detailed Australian summary of migraine: acute treatment and prevention, with source-attributed priorities, a practical workflow, safety escalation and state or territory implementation boundaries.

JurisdictionAustralia
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Australia
This is an iatroX educational summary of named Australia sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. Apply current TGA product information, PBS restrictions, state or territory law, local referral criteria, formulary and antimicrobial policy. A national recommendation does not create uniform service access.

Scope

Confirm recurrent migraine by episodic disabling headache with characteristic associated symptoms and screen every new pattern for secondary red flags. Treat early in the attack with an appropriate non-opioid analgesic or triptan plan, adding antiemetic treatment when needed and safe. This summary is limited to the population, decisions and escalation boundaries stated in the named source.
sources for this section:Australian Prescriber migraine

The Bottom Line

  • Confirm recurrent migraine by episodic disabling headache with characteristic associated symptoms and screen every new pattern for secondary red flags.
  • Treat early in the attack with an appropriate non-opioid analgesic or triptan plan, adding antiemetic treatment when needed and safe.
  • Aura developing for the first time on oestrogen-containing contraception requires vascular and contraceptive reassessment.
  • Track monthly migraine and acute-treatment days to identify medication-overuse headache and determine preventive-treatment need.
sources for this section:Australian Prescriber migraine

Practical clinical workflow

1

Topic-specific assessment action

Confirm recurrent migraine by episodic disabling headache with characteristic associated symptoms and screen every new pattern for secondary red flags.
2

Topic-specific diagnostic action

Track monthly migraine and acute-treatment days to identify medication-overuse headache and determine preventive-treatment need.
3

Topic-specific management action

Choose prevention by attack burden, comorbidity, pregnancy potential, adverse effects and preference and review after an adequate therapeutic trial.
4

Topic-specific follow-through

CGRP-targeting preventives and botulinum toxin have specialist and PBS criteria that must be checked live in Australia.
sources for this section:Australian Prescriber migraine

Safety boundaries and escalation

  • Thunderclap onset, focal deficit, fever or meningism, papilloedema, pregnancy hypertension or a major change in pattern requires urgent investigation.
  • Pregnancy planning changes valproate, topiramate, renin鈥揳ngiotensin and CGRP medicine choices and should occur before conception.
sources for this section:Australian Prescriber migraine

Implementation

The named source is national or binational guidance used in Australia, but referral access, public-health directions, formularies and funded services can still differ by state, territory and health service. Check current TGA product information for medicines. Offer culturally safe care and use the NACCHO鈥揜ACGP National Guide where Aboriginal and Torres Strait Islander preventive or chronic-care recommendations differ.
sources for this section:Australian Prescriber migraine

Clinical use boundary

This independently written summary is not an official guideline. Check the linked source version, current TGA-approved product information where medicines are involved, and the applicable state, territory and local pathway at the point of care.

sources for this section:Australian Prescriber migraine

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Australian PrescriberMigraine managementPeer-reviewed Australian clinical review, current article checked 2026-08-20 路 accessed 2026-08-20
    view source
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