Combination Analgesics Treatment for Migraine Relief in Plano, TX

What are Analgesics?

Simply put, analgesics are medications that are used for pain relief. Unlike the sedative drugs that we use for anesthesia during surgery, analgesic medications do not “turn off” your nerves, change your ability to sense surroundings, or alter your consciousness. More often than not, analgesics are called pain relievers or pain killers. Typically, the term, “analgesic” refers to a drug that is able to provide adequate pain relief without making you lose consciousness or putting you to sleep. Many types of medications have pain relief properties, and people tend to group mediations together that work in a similar way. Two of the most common pain killer groups are opioids (narcotics) and nonsteroidal anti inflammatory drugs (NSAIDs). However, many other types of pain relievers exist. Also, sometimes medical experts will group analgesic properties based on potency, or how strong the medications are. A good example of this is the WHO’s analgesic properties ladder. This “ladder approach” to pain relievers recommends non-opioid analgesics, like NSAIDs for mild to moderate pain; weak opioids, such as codeine or tramadol, for moderate to severe pain, and then, stronger opioids, such as oxycodone and morphine for treatment of pain that is severe.
analgesic treatment PLANO

What are Analgesics Used For?

A person may take an analgesic to relieve pain that comes from a wide variety of conditions.

A few of these conditions can include but certainly aren’t limited to:

  • cancer
  • congenital conditions
  • chronic pain (including chronic nociceptive pain, chronic non cancer pain and cancer pain, chronic low back pain)
  • fibromyalgia
  • gastrointestinal disorders
  • headaches
  • infections
  • menstruation
  • migraines
  • multiple sclerosis
  • musculoskeletal pain
  • nerve damage
  • neuropathic pain disorders (including chronic neuropathic pain)
  • osteoarthritis
  • postoperative pain
  • rheumatoid arthritis
  • sprains or fractures

What are the Differences Between Analgesics?

Analgesics differ in three ways:

  1. the way they work
  2. their potency (how strong they are)
  3. how they’re absorbed, distributed, metabolized, or excreted within a person’s body

Then, within the same class of analgesics, there are also differences in their potential for side effects, potency, and how they should be taken. Some analgesics should be taken by mouth, while some are injected and some are applied topically.

9 Major Classes of Analgesics

There are nine major classes of analgesics. These include:

  1. analgesic combinations
  2. antimigraine agents
  3. CGRP inhibitors
  4. cox-2 inhibitors
  5. misc. analgesics
  6. narcotic analgesics
  7. narcotic analgesic combinations
  8. nonsteroidal anti inflammatory drugs
  9. salicylates

Analgesic Combinations for Migraine Pain Relief

During a migraine, blood vessels swell, pushing on nearby tissues and contributing to head pain. Our Plano migraine doctors may recommend combination analgesics, or painkillers, containing ingredients like aspirin, caffeine and acetaminophen, to treat migraines with moderate pain to severe pain.

While analgesics reduce acute pain by preventing the production of certain pain-inducing materials in the body, analgesics also treat severe pain by sending receptor sites to the brain to halt pain signals. Analgesics treat both strengths of headaches by reducing or eliminating pain.

Producers of the combination analgesics combine multiple ingredients that work in a specific way when mixed and place the mixture in a single tablet.

Our migraine doctors most commonly combine codeine and caffeine to create a combination analgesic to treat migraine pain. Drugs that prevent nausea can also be added to the combination. Migraine sufferers use aspirin as well, a traditionally common analgesic that has some anti-inflammatory abilities and can be used in a combination analgesic. Paracetamol also acts as an analgesic but lacks anti-inflammatory characteristics. Many combination analgesics do not require prescriptions.

For more severe cases, combination analgesics can be more effective than NSAIDs. Visit Dr. Gabriel Rodriguez, an experienced migraine pain relief doctor in the Dallas and Fort Worth area, and the staff at the Migraine Institute who are ready to serve patients suffering from migraines in the Dallas, Plano, Frisco, McKinney, Allen and Carrollton areas.


Which Analgesic is Best for a Migraine: Mild to Moderate Pain?

Nonsteroidal anti-inflammatory drugs, or NSAIDs, are the first line of pain treatment for migraines. This includes Ibuprofen and Naproxen. Those who suffer from migraines can also take Aspirin or Acetaminophen. However, since the mechanism of a migraine involves inflammation, and since Acetaminophen isn’t one of the anti-inflammatory drugs, it will be less effective.

There are certain migraine medicines created specifically for headache or migraine pain that are available over the counter. The best example of this is Excedrin. It combines Acetaminophen, Aspirin, and caffeine. In this case, caffeine is extremely useful for combating persistent pain caused by migraines, as it causes the blood vessels that have been inflamed to constrict.

Which Analgesic is Best for a Migraine: Severe Pain?

If someone has migraine pain that is severe enough to land them in an emergency room or pain management center, it’s safe to say that person is in extreme pain. As a matter of fact, most of the people who visit an emergency room for a migraine have already been experiencing symptoms for over 72 hours.

For this reason, those who visit the ER for chronic pain are typically given what’s called a “migraine cocktail”.

This migraine cocktail may contain a combination of commonly prescribed treatments for pain. These can include:

Triptans are approved by the FDA for an effective first-line treatment of pain, specifically for moderate pain to severe pain.

These prescription medications also have an anti-inflammatory effect. We believe that this helps narrow the blood vessels in the brain, and thus, provides pain treatment for migraines.

The most common types of triptans include: almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, and zolmitriptan.

Studies suggest that triptans are the most effective at relieving pain when they are taken at the onset of a migraine.

Antiemetics are considered dopamine antagonist medications. They are usually given through an injection and can be especially helpful at treating the nausea that comes with a migraine headache. However, antiemetics do have some adverse effects, such as sedation.

Ergot alkaloids are similar to triptans, but nausea is one of the known side effects.

Nonsteroidal anti-inflammatory drugs, or NSAIDs, are the first recommended treatment for acute pain management to moderate pain management associated with migraine headaches.

Certain steroids can relieve pain and also reduce inflammation.

Dehydration is one of the most common triggers for migraines. Unfortunately, some of the symptoms of a migraine include nausea and vomiting. These can both exacerbate the dehydration. So, oftentimes, ER physicians will provide IV fluids for good measure!

Magnesium sulfate is one of the most effective forms of treatment for those who experience severe pain as a symptom of a migraine with aura.

Valproic acid is a seizure medication that is only used in severe cases to treat pain symptoms.

Are Analgesics Safe?

When patients use analgesics for a short period of time and only take the prescribed dose, most analgesics are safe. There are some analgesics, such as acetaminophen and ibuprofen, that are safer than others.

Both narcotic analgesics and narcotic analgesic combinations are associated with health risks, such as respiratory depression and opioid use disorder. Also, anyone who takes higher doses of opioid analgesics or more potent opioids does run the risk of a potentially fatal overdose.

Narcotic analgesics can be addictive and should only be used for specific conditions and under a doctor’s care.

Nonsteroidal anti-inflammatory drugs also have associated side effects. The more adverse effects include the risk of a fatal heart attack or stroke. Some nonsteroidal anti-inflammatory drugs, such as diclofenac and celecoxib, are more likely to cause this.

Side Effects of Analgesics

Every medication on the market has side effects. But, how vulnerable a person is will depend on various factors, such as genetics, age, gender, and kidney function.

Narcotic analgesics have a variety of side effects. However, those taking pain management medication for cancer related pain may become tolerant to many of the side effects.

The most common side effects associated with most narcotic analgesics include drowsiness, dizziness, or sleepiness. Alcohol may exacerbate these side effects.

NSAIDS may also cause side effects when they are used at higher doses than recommended for long periods of time.

The gastrointestinal side effects can include:

  • constipation
  • bloating
  • diarrhea
  • irritation of the stomach lining
  • nausea
  • vomiting

NSAIDs can also affect your kidney function and reduce how quickly blood is able to flow from the kidneys. They may also cause sodium retention and water. This can lead to edema and higher potassium levels.

When Should You See a Doctor for Migraine Pain Management?


Not all severe headaches are a sign of a migraine. In rare but serious cases, a severe headache may be a sign of something more dangerous.

If you experience any of the following symptoms, you need to seek medical treatment immediately:

  • a headache prompted by a head injury or accident
  • confusion
  • double vision
  • fever
  • nausea
  • severe and sudden headache
  • shortness of breath
  • stiff neck
  • the “worst” headache imaginable
  • weakness in the body

Migraine Pain Relief in Plano, Dallas, and Frisco, Texas

Severe pain associated with migraine headaches can cause debilitating symptoms and have a negative impact on your quality of life. But, this doesn’t mean that you don’t have access to treatment, prevention and long term relief from chronic pain.

Contact The Pain Relief Center in Plano, Texas to discuss which treatment options will work best for you. In the meantime, consider keeping a migraine calendar when you start to experience migraine symptoms. This will help you keep track of any triggers.


The most critical step on the path to recovery is finding a pain management doctor who can address your pain management needs successfully. The Pain Relief Center and its five specialized institutes are dedicated to meeting any and all of a patient’s needs. Located in the Dallas-Fort Worth area, Dr. Rodriguez and his friendly staff will help you along the path to recovery.

Our new center in Dallas is part of a nationwide development by Pain Relief Centers, geared to providing individualized and comprehensive healing and pain management services with unprecedented levels of compassion, care, and comfort for each patient.

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