What Is the Treatment for Paroxysmal Hemicrania Exacerbations and Prevention?
Managing paroxysmal hemicrania requires an agent that addresses both acute exacerbations and longer-term prevention. Agent selection in this condition is evidence-driven, with meaningful differences in pain-free outcomes between available options.
Treatment approach
The protocol centres on an oral anti-inflammatory agent — Piroxicam — identified as the most effective option after indomethacin for exacerbation management and prevention. The complete regimen, including dosing, sequencing, and safety monitoring, is set out in the full protocol.
References
DOI: 10.1186/s10194-017-0777-3
- Piroxicam emerges as the best treatment besides indomethacin for exacerbations management, according to the higher odds of pain-free patients than oxygen and sumatriptan.
- Piroxicam seems to be the most effective treatment other than indomethacin, even if the possibility of having GI AEs remains and, like indomethacin, its use should be avoided for long periods of time.